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91_HB0553eng HB0553 Engrossed LRB9100682ACcd 1 AN ACT concerning nursing. 2 Be it enacted by the People of the State of Illinois, 3 represented in the General Assembly: 4 Section 5. The Ambulatory Surgical Treatment Center Act 5 is amended by changing Section 6.5 as follows: 6 (210 ILCS 5/6.5) 7 Sec. 6.5. Clinical privileges; advanced practice nurses. 8 All ambulatory surgical treatment centers (ASTC) licensed 9 under this Act shall comply with the following requirements: 10 (1) No ASTC policy, rule, regulation, or practiceof an11ambulatory surgical treatment center licensed under this Act12 shall be inconsistent with the provision of adequate 13 collaboration, including medical direction of licensed 14 advanced practice nurses, in accordance with Section 54.5 of 15 the Medical Practice Act of 1987. 16 (2) Operative surgical procedures shall be performed 17 only by a physician licensed to practice medicine in all its 18 branches under the Medical Practice Act of 1987, a dentist 19 licensed under the Illinois Dental Practice Act, or a 20 podiatrist licensed under the Podiatric Medical Practice Act 21 of 1987, with medical staff membership and surgical clinical 22 privileges granted by the consulting committee of the ASTC. A 23 licensed physician, dentist, or podiatrist may be assisted by 24 a physician licensed to practice medicine in all its 25 branches, dentist, dental assistant, podiatrist, licensed 26 advanced practice nurse, licensed physician assistant, 27 licensed registered nurse, licensed practical nurse, surgical 28 assistant, surgical technician, or other individuals granted 29 clinical privileges to assist in surgery by the consulting 30 committee of the ASTC. 31 (3) The anesthesia service shall be under the direction HB0553 Engrossed -2- LRB9100682ACcd 1 of a physician licensed to practice medicine in all its 2 branches who has had specialized preparation or experience in 3 the area or who has completed a residency in anesthesiology. 4 An anesthesiologist, Board certified or Board eligible, is 5 recommended. Anesthesia services may only be administered 6 pursuant to the order of a physician licensed to practice 7 medicine in all its branches, licensed dentist, or licensed 8 podiatrist. 9 (A) The individuals who, with clinical privileges 10 granted by the medical staff and ASTC, may administer 11 anesthesia services are limited to the following: 12 (i) an anesthesiologist; or 13 (ii) a physician licensed to practice medicine 14 in all its branches; or 15 (iii) a dentist with authority to administer 16 anesthesia under Section 8.1 of the Illinois Dental 17 Practice Act; or 18 (iv) a licensed certified registered nurse 19 anesthetist. 20 (B) For anesthesia services, an anesthesiologist 21 shall participate through discussion of and agreement 22 with the anesthesia plan and shall remain physically 23 present and be available on the premises during the 24 delivery of anesthesia services for diagnosis, 25 consultation, and treatment of emergency medical 26 conditions. In the absence of 24-hour availability of 27 anesthesiologists with clinical privileges, an alternate 28 policy (requiring participation, presence, and 29 availability of a physician licensed to practice medicine 30 in all its branches) shall be developed by the medical 31 staff consulting committee in consultation with the 32 anesthesia service and included in the medical staff 33 consulting committee policies. 34 (C) A certified registered nurse anesthetist is not HB0553 Engrossed -3- LRB9100682ACcd 1 required to possess prescriptive authority or a written 2 collaborative agreement meeting the requirements of 3 Section 15-15 of the Nursing and Advanced Practice 4 Nursing Act to provide anesthesia services ordered by a 5 licensed physician, dentist, or podiatrist. Licensed 6 certified registered nurse anesthetists are authorized to 7 select, order, and administer drugs and apply the 8 appropriate medical devices in the provision of 9 anesthesia services under the anesthesia plan agreed with 10 by the anesthesiologist or, in the absence of an 11 available anesthesiologist with clinical privileges, 12 agreed with by the operating physician, operating 13 dentist, or operating podiatrist in accordance with the 14 medical staff consulting committee policies of a licensed 15 ambulatory surgical treatment center. 16 (Source: P.A. 90-742, eff. 8-13-98.) 17 Section 10. The Hospital Licensing Act is amended by 18 changing Section 10.7 as follows: 19 (210 ILCS 85/10.7) 20 Sec. 10.7. Clinical privileges; advanced practice 21registerednurses. All hospitals licensed under this Act 22 shall comply with the following requirements: 23 (1) No hospital policy, rule, regulation, or practiceof24a hospital licensed under this Actshall be inconsistent with 25 the provision of adequate collaboration, including medical 26 direction of licensed advanced practice nurses, in accordance 27 with Section 54.5 of the Medical Practice Act of 1987. 28 (2) Operative surgical procedures shall be performed 29 only by a physician licensed to practice medicine in all its 30 branches under the Medical Practice Act of 1987, a dentist 31 licensed under the Illinois Dental Practice Act, or a 32 podiatrist licensed under the Podiatric Medical Practice Act HB0553 Engrossed -4- LRB9100682ACcd 1 of 1987, with medical staff membership and surgical clinical 2 privileges granted at the hospital. A licensed physician, 3 dentist, or podiatrist may be assisted by a physician 4 licensed to practice medicine in all its branches, dentist, 5 dental assistant, podiatrist, licensed advanced practice 6 nurse, licensed physician assistant, licensed registered 7 nurse, licensed practical nurse, surgical assistant, surgical 8 technician, or other individuals granted clinical privileges 9 to assist in surgery at the hospital. 10 (3) The anesthesia service shall be under the direction 11 of a physician licensed to practice medicine in all its 12 branches who has had specialized preparation or experience in 13 the area or who has completed a residency in anesthesiology. 14 An anesthesiologist, Board certified or Board eligible, is 15 recommended. Anesthesia services may only be administered 16 pursuant to the order of a physician licensed to practice 17 medicine in all its branches, licensed dentist, or licensed 18 podiatrist. 19 (A) The individuals who, with clinical privileges 20 granted at the hospital, may administer anesthesia 21 services are limited to the following: 22 (i) an anesthesiologist; or 23 (ii) a physician licensed to practice medicine 24 in all its branches; or 25 (iii) a dentist with authority to administer 26 anesthesia under Section 8.1 of the Illinois Dental 27 Practice Act; or 28 (iv) a licensed certified registered nurse 29 anesthetist. 30 (B) For anesthesia services, an anesthesiologist 31 shall participate through discussion of and agreement 32 with the anesthesia plan and shall remain physically 33 present and be available on the premises during the 34 delivery of anesthesia services for diagnosis, HB0553 Engrossed -5- LRB9100682ACcd 1 consultation, and treatment of emergency medical 2 conditions. In the absence of 24-hour availability of 3 anesthesiologists with medical staff privileges, an 4 alternate policy (requiring participation, presence, and 5 availability of a physician licensed to practice medicine 6 in all its branches) shall be developed by the medical 7 staff and licensed hospital in consultation with the 8 anesthesia service. 9 (C) A certified registered nurse anesthetist is not 10 required to possess prescriptive authority or a written 11 collaborative agreement meeting the requirements of 12 Section 15-15 of the Nursing and Advanced Practice 13 Nursing Act to provide anesthesia services ordered by a 14 licensed physician, dentist, or podiatrist. Licensed 15 certified registered nurse anesthetists are authorized to 16 select, order, and administer drugs and apply the 17 appropriate medical devices in the provision of 18 anesthesia services under the anesthesia plan agreed with 19 by the anesthesiologist or, in the absence of an 20 available anesthesiologist with clinical privileges, 21 agreed with by the operating physician, operating 22 dentist, or operating podiatrist in accordance with the 23 hospital's alternative policy. 24 (Source: P.A. 90-742, eff. 8-13-98.) 25 Section 15. The Medical Practice Act of 1987 is amended 26 by changing Section 54.5 as follows: 27 (225 ILCS 60/54.5) 28 Sec. 54.5. Physician delegation of authority. 29 (a) Physicians licensed to practice medicine in all its 30 branches may delegate care and treatment responsibilities to 31 a physician assistant under guidelines in accordance with the 32 requirements of the Physician Assistant Practice Act of HB0553 Engrossed -6- LRB9100682ACcd 1 1987. A physician licensed to practice medicine in all its 2 branches may enter into supervising physician agreements with 3 no more than 2 physician assistants. 4 (b) A physician licensed to practice medicine in all its 5 branches in active clinical practice may collaborate with an 6 advanced practice nurse in accordance with the requirements 7 of Title 15 of the Nursing and Advanced Practice Nursing Act. 8 Collaboration is for the purpose of providing medical 9 direction, and no employment relationship is required. A 10 written collaborative agreement shall conform to the 11 requirements of Sections 15-15 and 15-20 of the Nursing and 12 Advanced Practice Nursing Act. The written collaborative 13 agreement shall be for services the collaborating physician 14 generally provides to his or her patients in the normal 15 course of clinical medical practice. Physician medical 16 direction shall be adequate with respect to collaboration 17 with certified nurse practitioners, certified nurse midwives, 18 and clinical nurse specialists if a collaborating physician: 19 (1) participates in the joint formulation and joint 20 approval of orders or guidelines with the advanced 21 practice nurse and periodically reviews such orders and 22 the services provided patients under such orders in 23 accordance with accepted standards of medical practice 24 and advanced practice nursing practice; 25 (2) is on site at least once a month to provide 26 medical direction and consultation; and 27 (3) is available through telecommunications for 28 consultation on medical problems, complications, or 29 emergencies or patient referral. 30 (b-5) An anesthesiologist or physician licensed to 31 practice medicine in all its branches may collaborate with a 32 certified registered nurse anesthetist in accordance with 33 Section 15-25 of the Nursing and Advanced Practice Nursing 34 Act. Medical direction for a certified registered nurse HB0553 Engrossed -7- LRB9100682ACcd 1 anesthetist shall be adequate if: 2 (1) an anesthesiologist or a physician participates 3 in the joint formulation and joint approval of orders or 4 guidelines and periodically reviews such orders and the 5 services provided patients under such orders; and 6 (2) for anesthesia services, the anesthesiologist 7 or physician participates through discussion of and 8 agreement with the anesthesia plan and is physically 9 present and available on the premises during the delivery 10 of anesthesia services for diagnosis, consultation, and 11 treatment of emergency medical conditions. Anesthesia 12 services in a hospital shall be conducted in accordance 13 with Section 10.7 of the Hospital Licensing Act and in an 14 ambulatory surgical treatment center in accordance with 15 Section 6.5 of the Ambulatory Surgical Treatment Center 16 Act. 17 (b-10) The anesthesiologist or operating physician must 18 agree with the anesthesia plan prior to the delivery of 19 services. 20 (c) The supervising physician shall have access to the 21 medical records of all patients attended by a physician 22 assistant. The collaborating physician shall have access to 23 the medical records of all patients attended to by an 24 advanced practice nurse. 25 (d) Nothing in this Act shall be construed to limit the 26 delegation of tasks or duties by a physician licensed to 27 practice medicine in all its branches to a licensed practical 28 nurse, a registered professional nurse, or other personnel. 29 (e) A physician shall not be liable for the acts or 30 omissions of a physician assistant or advanced practice nurse 31 solely on the basis of having signed a supervision agreement 32 or guidelines or a collaborative agreement, an order, a 33 standing medical order, a standing delegation order, or other 34 order or guideline authorizing a physician assistant or HB0553 Engrossed -8- LRB9100682ACcd 1 advanced practice nurse to perform acts, unless the physician 2 has reason to believe the physician assistant or advanced 3 practice nurse lacked the competency to perform the act or 4 acts or commits willful and wanton misconduct. 5 (Source: P.A. 90-742, eff. 8-13-98.) 6 Section 20. The Nursing and Advanced Practice Nursing 7 Act is amended by changing Sections 10-25, 15-5, 15-10, 8 15-15, 15-30, and 15-35 and by adding 15-25 as follows: 9 (225 ILCS 65/10-25) 10 Sec. 10-25. Board. 11 (a) The Director shall appoint the Board of Nursing 12 which, beginning January 1, 2000, shall be composed of 7913 registered professional nurses, 2 licensed practical nurses 14 and one public member who shall also be a voting member and 15 who is not a licensed health care provider. Two registered 16 nurses shall hold at least a master's degree in nursing and 17 be educators in professional nursing programs, one 18 representing baccalaureate nursing education, one 19 representing associate degree nursing education; one 20 registered nurse shall hold at least a bachelor's degree with 21 a major in nursing and be an educator in a licensed practical 22 nursing program; one registered nurse shall hold a master's 23 degree in nursing and shall represent nursing service 24 administration; 2 registered nurses shall represent clinical 25 nursing practice, one of whom shall have at least a master's 26 degree in nursing; and, until January 1, 2000, 2 registered 27 nurses shall represent advanced specialty practice. Each of 28 the11nurses shall have had a minimum of 5 years experience 29 in nursing, 3 of which shall be in the area they represent on 30 the Board and be actively engaged in the area of nursing they 31 represent at the time of appointment and during their tenure 32 on the Board. Members shall be appointed for a term of 3 HB0553 Engrossed -9- LRB9100682ACcd 1 years. No member shall be eligible for appointment to more 2 than 2 consecutive terms and any appointment to fill a 3 vacancy shall be for the unexpired portion of the term. In 4 making Board appointments, the Director shall give 5 consideration to recommendations submitted by nursing 6 organizations. Consideration shall be given to equal 7 geographic representation. The Board shall receive actual 8 and necessary expenses incurred in the performance of their 9 duties. 10 In making the initial appointments, the Director shall 11 appoint all new members for terms of 2, 3, and 4 years and 12 such terms shall be staggered as follows: 3 shall be 13 appointed for terms of 2 years; 3 shall be appointed for 14 terms of 3 years; and 3 shall be appointed for terms of 4 15 years. 16 The Director may remove any member of the Board for 17 misconduct, incapacity, or neglect of duty. The Director 18 shall reduce to writing any causes for removal. 19 The Board shall meet annually to elect a chairperson and 20 vice chairperson. The Board may hold such other meetings 21 during the year as may be necessary to conduct its business. 22 Six voting members of the Board shall constitute a quorum at 23 any meeting. Any action taken by the Board must be on the 24 affirmative vote of 6 members. Voting by proxy shall not be 25 permitted. 26 The Board shall submit an annual report to the Director. 27 The members of the Board shall be immune from suit in any 28 action based upon any disciplinary proceedings or other acts 29 performed in good faith as members of the Board. 30 (b) The Board is authorized to: 31 (1) recommend the adoption and, from time to time, 32 the revision of such rules that may be necessary to carry 33 out the provisions of this Act; 34 (2) conduct hearings and disciplinary conferences HB0553 Engrossed -10- LRB9100682ACcd 1 upon charges calling for discipline of a licensee as 2 provided in Section 10-45; 3 (3) report to the Department, upon completion of a 4 hearing, the disciplinary actions recommended to be taken 5 against persons violating this Act; 6 (4) recommend the approval, denial of approval, 7 withdrawal of approval, or discipline of nursing 8 education programs; 9 (5) participate in a national organization of state 10 boards of nursing; and 11 (6) recommend a list of the registered nurses to 12 serve as Nursing Act Coordinator and Assistant Nursing 13 Act Coordinator, respectively. 14 (Source: P.A. 90-61, eff. 12-30-97; 90-742, eff. 8-13-98.) 15 (225 ILCS 65/15-5) 16 Sec. 15-5. Definitions. As used in this Title: 17 "APN Board" means the Advanced Practice Nursing Board. 18 "Advanced practice nurse" or "APN" means a person who: 19 (1) is licensed as a registered professional nurse under 20 this Act; (2) meets the requirements for licensure as an 21 advanced practice nurse under Section 15-10; (3) except as 22 provided in Section 15-25, has a written collaborative 23 agreement with a collaborating physician in the diagnosis of 24 illness and management of wellness and other conditions as 25 appropriate to the level and area of his or her practice in 26 accordance with Section 15-15; and (4) cares for patients 27 (A) by using advanced diagnostic skills, the results of 28 diagnostic tests and procedures ordered by the advanced 29 practice nurse, a physician assistant, a dentist, a 30 podiatrist, or a physician, and professional judgment to 31 initiate and coordinate the care of patients; (B) by ordering 32 diagnostic tests, prescribing medications and drugs in 33 accordance with Section 15-20, and administering medications HB0553 Engrossed -11- LRB9100682ACcd 1 and drugs; and (C) by using medical, therapeutic, and 2 corrective measures to treat illness and improve health 3 status. Categories include certified nurse midwife (CNM), 4 certified nurse practitioner (CNP), certified registered 5 nurse anesthetist (CRNA), or certified clinical nurse 6 specialist (CNS). 7 "Collaborating physician" means a physician who works 8 with an advanced practice nurse and provides medical 9 direction as documented in a written collaborative agreement 10 required under Section 15-15. 11 "Licensed hospital" means a hospital licensed under the 12 Hospital Licensing Act or organized under the University of 13 Illinois Hospital Act. 14 "Physician" means a person licensed to practice medicine 15 in all its branches under the Medical Practice Act of 1987. 16 (Source: P.A. 90-742, eff. 8-13-98.) 17 (225 ILCS 65/15-10) 18 Sec. 15-10. Advanced practice nurse; qualifications; 19 roster. 20 (a) A person shall be qualified for licensure as an 21 advanced practice nurse if that person: 22 (1) has applied in writing in form and substance 23 satisfactory to the Department and has not violated a 24 provision of this Act or the rules adopted under this 25 Act. The Department may take into consideration any 26 felony conviction of the applicant but a conviction shall 27 not operate as an absolute bar to licensure; 28 (2) holds a current license to practice as a 29 registered nurse in Illinois; 30 (3) has successfully completed requirements to 31 practice as, and holds a current, national certification 32 as, a nurse midwife, clinical nurse specialist,ornurse 33 practitioner, or certified registered nurse anesthetist HB0553 Engrossed -12- LRB9100682ACcd 1 from the appropriate national certifying body as 2 determined by rule of the Department; 3 (4) has paid the required fees as set by rule; and 4 (5) has successfully completed a post-basic 5 advanced practice formal education program in the area of 6 his or her nursing specialty. 7 (b) In addition to meeting the requirements of 8 subsection (a), except item (5) of that subsection, beginning 9 July 1, 2001 or 12 months after the adoption of final rules 10 to implement this Section, whichever is sooner, applicants 11 for initial licensure shall have a graduate degree 12 appropriate for national certification in a clinical advanced 13 practice nursing specialty. 14 (c) The Department shall provide by rule for APN 15 licensure of registered professional nurses who (1) apply for 16 licensure before July 1, 2001 and (2) submit evidence of 17 completion of a program described in item (5) of subsection 18 (a) or in subsection (b) and evidence of practice for at 19 least 10 years as a nurse practitioner. 20 (d) The Department shall maintain a separate roster of 21 advanced practice nurses licensed under this Title and their 22 licenses shall indicate "Registered Nurse/Advanced Practice 23 Nurse". 24 (Source: P.A. 90-742, eff. 8-13-98.) 25 (225 ILCS 65/15-15) 26 Sec. 15-15. Written collaborative agreements. 27 (a) Except as provided in Section 15-25, no person shall 28 engage in the practice of advanced practice nursing except 29 when licensed under this Title and pursuant to a written 30 collaborative agreement with a collaborating physician. 31 (b) A written collaborative agreement shall describe the 32 working relationship of the advanced practice nurse with the 33 collaborating physician and shall authorize the categories of HB0553 Engrossed -13- LRB9100682ACcd 1 care, treatment, or procedures to be performed by the 2 advanced practice nurse. Collaboration does not require an 3 employment relationship between the collaborating physician 4 and advanced practice nurse. Collaboration means the 5 relationship under which an advanced practice nurse works 6 with a collaborating physician in an active clinical practice 7 to deliver health care services in accordance with (i) the 8 advanced practice nurse's training, education, and experience 9 and (ii) medical direction as documented in a jointly 10 developed written collaborative agreement. 11 The agreement shall be defined to promote the exercise of 12 professional judgment by the advanced practice nurse 13 commensurate with his or her education and experience. The 14 services to be provided by the advanced practice nurse shall 15 be services that the collaborating physician generally 16 provides to his or her patients in the normal course of his 17 or her clinical medical practice. The agreement need not 18 describe the exact steps that an advanced practice nurse must 19 take with respect to each specific condition, disease, or 20 symptom but must specify which authorized procedures require 21 a physician's presence as the procedures are being performed. 22 The collaborative relationship under an agreement shall not 23 be construed to require the personal presence of a physician 24 at all times at the place where services are rendered. 25 Methods of communication shall be available for consultation 26 with the collaborating physician in person or by 27 telecommunications in accordance with established written 28 guidelines as set forth in the written agreement. 29 (c) Physician medical direction under an agreement shall 30 be adequate if a collaborating physician: 31 (1) participates in the joint formulation and joint 32 approval of orders or guidelines with the APN and he or 33 she periodically reviews such orders and the services 34 provided patients under such orders in accordance with HB0553 Engrossed -14- LRB9100682ACcd 1 accepted standards of medical practice and advanced 2 practice nursing practice; 3 (2) is on site at least once a month to provide 4 medical direction and consultation; and 5 (3) is available through telecommunications for 6 consultation on medical problems, complications, or 7 emergencies or patient referral. 8 (d) A copy of the signed, written collaborative 9 agreement must be available to the Department upon request 10 from both the advanced practice nurse and the collaborating 11 physician and shall be annually updated. An advanced 12 practice nurse shall inform each collaborating physician of 13 all collaborative agreements he or she has signed and provide 14 a copy of these to any collaborating physician, upon request. 15 (Source: P.A. 90-742, eff. 8-13-98.) 16 (225 ILCS 65/15-25 new) 17 Sec. 15-25. Certified registered nurse anesthetists. 18 (a) A licensed certified registered nurse anesthetist 19 may provide anesthesia services pursuant to the order of a 20 licensed physician, licensed dentist, or licensed podiatrist 21 in a licensed hospital, a licensed ambulatory surgical 22 treatment center, or the office of a licensed physician, the 23 office of a licensed dentist, or the office of a licensed 24 podiatrist. For anesthesia services, an anesthesiologist, 25 physician, dentist, or podiatrist shall participate through 26 discussion of and agreement with the anesthesia plan and 27 shall remain physically present and be available on the 28 premises during the delivery of anesthesia services for 29 diagnosis, consultation, and treatment of emergency medical 30 conditions, unless hospital policy adopted pursuant to clause 31 (B) of subdivision (3) of Section 10.7 of the Hospital 32 Licensing Act or ambulatory surgical treatment center policy 33 adopted pursuant to clause (B) of subdivision (3) of Section HB0553 Engrossed -15- LRB9100682ACcd 1 6.5 of the Ambulatory Surgical Treatment Center Act provides 2 otherwise. 3 (b) A certified registered nurse anesthetist who 4 provides anesthesia services in a hospital shall do so in 5 accordance with Section 10.7 of the Hospital Licensing Act 6 and, in an ambulatory surgical treatment center, in 7 accordance with Section 6.5 of the Ambulatory Surgical 8 Treatment Center Act. 9 (c) A certified registered nurse anesthetist who 10 provides anesthesia services in a physician office, dental 11 office, or podiatric office shall enter into a written 12 practice agreement with an anesthesiologist or the physician 13 licensed to practice medicine in all its branches, the 14 dentist, or the podiatrist performing the procedure. The 15 agreement shall describe the working relationship of the 16 certified registered nurse anesthetist and anesthesiologist, 17 physician, dentist, or podiatrist and shall authorize the 18 categories of care, treatment, or procedures to be performed 19 by the certified registered nurse anesthetist. In a 20 dentist's office, the certified registered nurse anesthetist 21 may only provide those services the dentist is authorized to 22 provide pursuant to the Illinois Dental Practice Act and 23 rules. In a podiatrist's office, the certified registered 24 nurse anesthetist may only provide those services the 25 podiatrist is authorized to provide pursuant to the Podiatric 26 Medical Practice Act of 1987 and rules. For anesthesia 27 services, an anesthesiologist, physician, dentist, or 28 podiatrist shall participate through discussion of and 29 agreement with the anesthesia plan and shall remain 30 physically present and be available on the premises during 31 the delivery of anesthesia services for diagnosis, 32 consultation, and treatment of emergency medical conditions. 33 (d) A certified registered nurse anesthetist is not 34 required to possess prescriptive authority or a written HB0553 Engrossed -16- LRB9100682ACcd 1 collaborative agreement meeting the requirements of Section 2 15-15 to provide anesthesia services ordered by a licensed 3 physician, dentist, or podiatrist. Certified registered 4 nurse anesthetists are authorized to select, order, and 5 administer drugs and apply the appropriate medical devices in 6 the provision of anesthesia services under the anesthesia 7 plan agreed with by the anesthesiologist or the physician in 8 accordance with hospital alternative policy or the medical 9 staff consulting committee policies of a licensed ambulatory 10 surgical treatment center. In a physician's office, 11 dentist's office, or podiatrist's office, the 12 anesthesiologist, operating physician, operating dentist, or 13 operating podiatrist shall agree with the anesthesia plan, in 14 accordance with the written practice agreement. 15 (e) A certified registered nurse anesthetist may be 16 delegated limited prescriptive authority under Section 15-20 17 in a written collaborative agreement meeting the requirements 18 of Section 15-15. 19 (225 ILCS 65/15-30) 20 Sec. 15-30. Title. 21 (a) No person shall use any words, abbreviations, 22 figures, letters, title, sign, card, or device tending to 23 imply that he or she is an advanced practice nurse, including 24 but not limited to using the titles or initials "Advanced 25 Practice Nurse", "Certified Nurse Midwife", "Certified Nurse 26 Practitioner", "Certified Registered Nurse Anesthetist", 27 "Clinical Nurse Specialist", "A.P.N.", "C.N.M.", "C.N.P.", 28 "C.R.N.A.", "C.N.S.", or similar titles or initials, with the 29 intention of indicating practice as an advanced practice 30 nurse without meeting the requirements of this Act. No 31 advanced practice nurse shall use the title of doctor or 32 associate with his or her name or any other term to indicate 33 to other persons that he or she is qualified to engage in the HB0553 Engrossed -17- LRB9100682ACcd 1 general practice of medicine. 2 (b) An advanced practice nurse shall verbally identify 3 himself or herself as an advanced practice nurse including 4 specialty certification to each patient. 5 (c) Nothing in this Act shall be construed to relieve a 6 physician of professional or legal responsibility for the 7 care and treatment of persons attended by him or her or to 8 relieve an advanced practice nurse of the professional or 9 legal responsibility for the care and treatment of persons 10 attended by him or her. 11 (Source: P.A. 90-742, eff. 8-13-98.) 12 (225 ILCS 65/15-35) 13 Sec. 15-35. Advanced Practice Nursing Board. 14 (a) There is hereby established an Advanced Practice 15 Nursing Board, hereinafter referred to as the "APN Board". 16 The APN Board shall review and make recommendations to the 17 Department regarding matters relating to licensure and 18 discipline of advanced practice nurses. The APN Board shall 19 be composed of 9 members to be appointed by the Governor, 4 20 of whom shall be advanced practice nurses and 3 of whom shall 21 becollaboratingphysicians licensed to practice medicine in 22 all its branches. The 4 advanced practice nurses shall have 23 collaborative agreements, except that any certified 24 registered nurse anesthetist is not required to have a 25 collaborative agreement. The 3 physicians shall have 26 collaborative agreements, except that an anesthesiologist is 27 not required to have a collaborative agreement. In making 28 appointments to the APN Board, the Governor shall give due 29 consideration to recommendations by statewide professional 30 associations or societies representing nurses and physicians 31 in Illinois. Two members, not employed or having any 32 material interest in any health care field, shall represent 33 the public. The chairperson of the APN Board shall be a HB0553 Engrossed -18- LRB9100682ACcd 1 member elected by a majority vote of the APN Board. The APN 2 Board shall meet and report to the Department quarterly and 3 as advanced practice nurse issues arise. 4 Initial appointments to the APN Board shall be made 5 within 90 days after the effective date of this amendatory 6 Act of 1998. The terms of office of each of the original 7 members shall be at staggered intervals. One physician and 8 one advanced practice nurse shall serve one-year terms. One 9 physician and one advanced practice nurse shall serve 2-year 10 terms. One physician and one advanced practice nurse shall 11 serve 3-year terms. One advanced practice nurse and the 12 public members shall serve 4-year terms. Upon the expiration 13 of the term of an initial member, his or her successor shall 14 be appointed for a term of 4 years. No member shall serve 15 more than 2 consecutive terms, excluding initial appointment 16 terms. An appointment to fill a vacancy shall be for the 17 unexpired portion of the term. Members of the APN Board 18 shall be reimbursed for all authorized legitimate and 19 necessary expenses incurred in attending the meetings of the 20 APN Board. A majority of the APN Board members appointed 21 shall constitute a quorum. A vacancy in the membership of 22 the APN Board shall not impair the right of a quorum to 23 perform all of the duties of the APN Board. A member of the 24 APN Board shall have no liability in an action based upon a 25 disciplinary proceeding or other activity performed in good 26 faith as a member of the APN Board. 27 (b) Complaints received concerning advanced practice 28 nurses shall be reviewed by the APN Board. Complaints 29 received concerning collaborating physicians shall be 30 reviewed by the Medical Disciplinary Board. 31 (Source: P.A. 90-742, eff. 8-13-98.) 32 (225 ILCS 65/15-100 rep.) 33 Section 25. The Nursing and Advanced Practice Nursing HB0553 Engrossed -19- LRB9100682ACcd 1 Act is amended by repealing Section 15-100. 2 Section 99. Effective date. This Act takes effect upon 3 becoming law.