Illinois 2025-2026 Regular Session

Illinois Senate Bill SB0239 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB0239 Introduced 1/22/2025, by Sen. Lakesia Collins SYNOPSIS AS INTRODUCED: See Index Amends the Ambulatory Surgical Treatment Center Act. Removes a provision which provides that, in ambulatory surgical treatment centers, anesthesia service shall be under the direction of a physician who has had specialized preparation or experience in the area or who has completed a residency in anesthesiology. Specifies that with respect to anesthesia service in an ambulatory surgical treatment center, a certified registered nurse anesthetist shall seek consultation regarding development of an anesthesia plan and treatment of patients as is appropriate to the certified registered nurse anesthetist's level of expertise and scope of practice and as is warranted by the needs of the patient. Removes a requirement that an anesthesiologist participate through discussion of and agreement with the anesthesia plan and remain physically present and be available on the premises. Provides that a certified registered nurse anesthetist with clinical privileges may perform acts of advanced assessment and diagnosis and may provide such functions for which the certified registered nurse anesthetist is educationally and experientially prepared. Makes conforming changes to the Hospital Licensing Act. Amends the Medical Practice Act of 1987. Provides that a written collaborative agreement shall be adequate with respect to collaboration with certified registered nurse anesthetists if all of the following apply: (1) the agreement is written to promote exercise of professional judgment by the certified registered nurse anesthetist commensurate with his or her education and experience; (2) the certified registered nurse anesthetist provides service based on a written collaborative agreement with the collaborating physician; and (3) 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. Amends the Nurse Practice Act. Provides that an Illinois-licensed advanced practice registered nurse certified as a certified registered nurse anesthetist shall be deemed by law to possess the ability to practice without a written collaborative agreement. Sets forth requirements of a certified registered nurse anesthetist. Makes conforming changes in the Illinois Dental Practice Act. Effective immediately. LRB104 07525 BAB 17569 b A BILL FOR 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB0239 Introduced 1/22/2025, by Sen. Lakesia Collins SYNOPSIS AS INTRODUCED: See Index See Index Amends the Ambulatory Surgical Treatment Center Act. Removes a provision which provides that, in ambulatory surgical treatment centers, anesthesia service shall be under the direction of a physician who has had specialized preparation or experience in the area or who has completed a residency in anesthesiology. Specifies that with respect to anesthesia service in an ambulatory surgical treatment center, a certified registered nurse anesthetist shall seek consultation regarding development of an anesthesia plan and treatment of patients as is appropriate to the certified registered nurse anesthetist's level of expertise and scope of practice and as is warranted by the needs of the patient. Removes a requirement that an anesthesiologist participate through discussion of and agreement with the anesthesia plan and remain physically present and be available on the premises. Provides that a certified registered nurse anesthetist with clinical privileges may perform acts of advanced assessment and diagnosis and may provide such functions for which the certified registered nurse anesthetist is educationally and experientially prepared. Makes conforming changes to the Hospital Licensing Act. Amends the Medical Practice Act of 1987. Provides that a written collaborative agreement shall be adequate with respect to collaboration with certified registered nurse anesthetists if all of the following apply: (1) the agreement is written to promote exercise of professional judgment by the certified registered nurse anesthetist commensurate with his or her education and experience; (2) the certified registered nurse anesthetist provides service based on a written collaborative agreement with the collaborating physician; and (3) 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. Amends the Nurse Practice Act. Provides that an Illinois-licensed advanced practice registered nurse certified as a certified registered nurse anesthetist shall be deemed by law to possess the ability to practice without a written collaborative agreement. Sets forth requirements of a certified registered nurse anesthetist. Makes conforming changes in the Illinois Dental Practice Act. Effective immediately. LRB104 07525 BAB 17569 b LRB104 07525 BAB 17569 b A BILL FOR
2	2	104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB0239 Introduced 1/22/2025, by Sen. Lakesia Collins SYNOPSIS AS INTRODUCED:
3	3	See Index See Index
4	4	See Index
5	5	Amends the Ambulatory Surgical Treatment Center Act. Removes a provision which provides that, in ambulatory surgical treatment centers, anesthesia service shall be under the direction of a physician who has had specialized preparation or experience in the area or who has completed a residency in anesthesiology. Specifies that with respect to anesthesia service in an ambulatory surgical treatment center, a certified registered nurse anesthetist shall seek consultation regarding development of an anesthesia plan and treatment of patients as is appropriate to the certified registered nurse anesthetist's level of expertise and scope of practice and as is warranted by the needs of the patient. Removes a requirement that an anesthesiologist participate through discussion of and agreement with the anesthesia plan and remain physically present and be available on the premises. Provides that a certified registered nurse anesthetist with clinical privileges may perform acts of advanced assessment and diagnosis and may provide such functions for which the certified registered nurse anesthetist is educationally and experientially prepared. Makes conforming changes to the Hospital Licensing Act. Amends the Medical Practice Act of 1987. Provides that a written collaborative agreement shall be adequate with respect to collaboration with certified registered nurse anesthetists if all of the following apply: (1) the agreement is written to promote exercise of professional judgment by the certified registered nurse anesthetist commensurate with his or her education and experience; (2) the certified registered nurse anesthetist provides service based on a written collaborative agreement with the collaborating physician; and (3) 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. Amends the Nurse Practice Act. Provides that an Illinois-licensed advanced practice registered nurse certified as a certified registered nurse anesthetist shall be deemed by law to possess the ability to practice without a written collaborative agreement. Sets forth requirements of a certified registered nurse anesthetist. Makes conforming changes in the Illinois Dental Practice Act. Effective immediately.
6	6	LRB104 07525 BAB 17569 b LRB104 07525 BAB 17569 b
7	7	LRB104 07525 BAB 17569 b
8	8	A BILL FOR
9	9	SB0239LRB104 07525 BAB 17569 b SB0239 LRB104 07525 BAB 17569 b
10	10	SB0239 LRB104 07525 BAB 17569 b
11	11	1 AN ACT concerning regulation.
12	12	2 Be it enacted by the People of the State of Illinois,
13	13	3 represented in the General Assembly:
14	14	4 Section 5. The Ambulatory Surgical Treatment Center Act is
15	15	5 amended by changing Section 6.5 as follows:
16	16	6 (210 ILCS 5/6.5)
17	17	7 Sec. 6.5. Clinical privileges; advanced practice
18	18	8 registered nurses. All ambulatory surgical treatment centers
19	19	9 (ASTC) licensed under this Act shall comply with the following
20	20	10 requirements:
21	21	11 (1) No ASTC policy, rule, regulation, or practice
22	22	12 shall be inconsistent with the provision of adequate
23	23	13 collaboration and consultation in accordance with Section
24	24	14 54.5 of the Medical Practice Act of 1987.
25	25	15 (2) Operative surgical procedures shall be performed
26	26	16 only by a physician licensed to practice medicine in all
27	27	17 its branches under the Medical Practice Act of 1987, a
28	28	18 dentist licensed under the Illinois Dental Practice Act,
29	29	19 or a podiatric physician licensed under the Podiatric
30	30	20 Medical Practice Act of 1987, with medical staff
31	31	21 membership and surgical clinical privileges granted by the
32	32	22 consulting committee of the ASTC. A licensed physician,
33	33	23 dentist, or podiatric physician may be assisted by a
34	34
35	35
36	36
37	37	104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB0239 Introduced 1/22/2025, by Sen. Lakesia Collins SYNOPSIS AS INTRODUCED:
38	38	See Index See Index
39	39	See Index
40	40	Amends the Ambulatory Surgical Treatment Center Act. Removes a provision which provides that, in ambulatory surgical treatment centers, anesthesia service shall be under the direction of a physician who has had specialized preparation or experience in the area or who has completed a residency in anesthesiology. Specifies that with respect to anesthesia service in an ambulatory surgical treatment center, a certified registered nurse anesthetist shall seek consultation regarding development of an anesthesia plan and treatment of patients as is appropriate to the certified registered nurse anesthetist's level of expertise and scope of practice and as is warranted by the needs of the patient. Removes a requirement that an anesthesiologist participate through discussion of and agreement with the anesthesia plan and remain physically present and be available on the premises. Provides that a certified registered nurse anesthetist with clinical privileges may perform acts of advanced assessment and diagnosis and may provide such functions for which the certified registered nurse anesthetist is educationally and experientially prepared. Makes conforming changes to the Hospital Licensing Act. Amends the Medical Practice Act of 1987. Provides that a written collaborative agreement shall be adequate with respect to collaboration with certified registered nurse anesthetists if all of the following apply: (1) the agreement is written to promote exercise of professional judgment by the certified registered nurse anesthetist commensurate with his or her education and experience; (2) the certified registered nurse anesthetist provides service based on a written collaborative agreement with the collaborating physician; and (3) 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. Amends the Nurse Practice Act. Provides that an Illinois-licensed advanced practice registered nurse certified as a certified registered nurse anesthetist shall be deemed by law to possess the ability to practice without a written collaborative agreement. Sets forth requirements of a certified registered nurse anesthetist. Makes conforming changes in the Illinois Dental Practice Act. Effective immediately.
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42	42	LRB104 07525 BAB 17569 b
43	43	A BILL FOR
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49	49	See Index
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53	53	LRB104 07525 BAB 17569 b
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68	68	1 physician licensed to practice medicine in all its
69	69	2 branches, dentist, dental assistant, podiatric physician,
70	70	3 licensed advanced practice registered nurse, licensed
71	71	4 physician assistant, licensed registered nurse, licensed
72	72	5 practical nurse, surgical assistant, surgical technician,
73	73	6 or other individuals granted clinical privileges to assist
74	74	7 in surgery by the consulting committee of the ASTC.
75	75	8 Payment for services rendered by an assistant in surgery
76	76	9 who is not an ambulatory surgical treatment center
77	77	10 employee shall be paid at the appropriate non-physician
78	78	11 modifier rate if the payor would have made payment had the
79	79	12 same services been provided by a physician.
80	80	13 (2.5) A registered nurse licensed under the Nurse
81	81	14 Practice Act and qualified by training and experience in
82	82	15 operating room nursing shall be present in the operating
83	83	16 room and function as the circulating nurse during all
84	84	17 invasive or operative procedures. For purposes of this
85	85	18 paragraph (2.5), "circulating nurse" means a registered
86	86	19 nurse who is responsible for coordinating all nursing
87	87	20 care, patient safety needs, and the needs of the surgical
88	88	21 team in the operating room during an invasive or operative
89	89	22 procedure.
90	90	23 (3) An advanced practice registered nurse is not
91	91	24 required to possess prescriptive authority or a written
92	92	25 collaborative agreement meeting the requirements of the
93	93	26 Nurse Practice Act to provide advanced practice registered
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96	96
97	97
98	98
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104	104	1 nursing services in an ambulatory surgical treatment
105	105	2 center. An advanced practice registered nurse must possess
106	106	3 clinical privileges granted by the consulting medical
107	107	4 staff committee and ambulatory surgical treatment center
108	108	5 in order to provide services. Individual advanced practice
109	109	6 registered nurses may also be granted clinical privileges
110	110	7 to order, select, and administer medications, including
111	111	8 controlled substances, to provide delineated care. The
112	112	9 attending physician must determine the advanced practice
113	113	10 registered nurse's role in providing care for his or her
114	114	11 patients, except as otherwise provided in the consulting
115	115	12 staff policies. The consulting medical staff committee
116	116	13 shall periodically review the services of advanced
117	117	14 practice registered nurses granted privileges.
118	118	15 (4) (Blank). The anesthesia service shall be under the
119	119	16 direction of a physician licensed to practice medicine in
120	120	17 all its branches who has had specialized preparation or
121	121	18 experience in the area or who has completed a residency in
122	122	19 anesthesiology. An anesthesiologist, Board certified or
123	123	20 Board eligible, is recommended. Anesthesia services may
124	124	21 only be administered pursuant to the order of a physician
125	125	22 licensed to practice medicine in all its branches,
126	126	23 licensed dentist, or licensed podiatric physician.
127	127	24 (A) The individuals who, with clinical privileges
128	128	25 granted by the medical staff and ASTC, may administer
129	129	26 anesthesia services are limited to the following:
130	130
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140	140	1 (i) an anesthesiologist; or
141	141	2 (ii) a physician licensed to practice medicine
142	142	3 in all its branches; or
143	143	4 (iii) a dentist with authority to administer
144	144	5 anesthesia under Section 8.1 of the Illinois
145	145	6 Dental Practice Act; or
146	146	7 (iv) a licensed certified registered nurse
147	147	8 anesthetist; or
148	148	9 (v) a podiatric physician licensed under the
149	149	10 Podiatric Medical Practice Act of 1987.
150	150	11 (B) For anesthesia services, a certified
151	151	12 registered nurse anesthetist shall seek consultation
152	152	13 regarding development of an anesthesia plan and
153	153	14 treatment of patients as is appropriate to the
154	154	15 certified registered nurse anesthetist's level of
155	155	16 expertise and scope of practice and as is warranted by
156	156	17 the needs of the patient an anesthesiologist shall
157	157	18 participate through discussion of and agreement with
158	158	19 the anesthesia plan and shall remain physically
159	159	20 present and be available on the premises during the
160	160	21 delivery of anesthesia services for diagnosis,
161	161	22 consultation, and treatment of emergency medical
162	162	23 conditions. In the absence of 24-hour availability of
163	163	24 anesthesiologists with clinical privileges, an
164	164	25 alternate policy (requiring participation, presence,
165	165	26 and availability of a physician licensed to practice
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176	176	1 medicine in all its branches) shall be developed by
177	177	2 the medical staff consulting committee in consultation
178	178	3 with the anesthesia service and included in the
179	179	4 medical staff consulting committee policies.
180	180	5 (C) A certified registered nurse anesthetist is
181	181	6 not required to possess prescriptive authority or a
182	182	7 written collaborative agreement meeting the
183	183	8 requirements of Section 65-35 of the Nurse Practice
184	184	9 Act to provide anesthesia and related services ordered
185	185	10 by a licensed physician, dentist, or podiatric
186	186	11 physician. Licensed certified registered nurse
187	187	12 anesthetists are authorized to select, order, and
188	188	13 administer drugs and apply the appropriate medical
189	189	14 devices in the provision of anesthesia and related
190	190	15 services under the anesthesia plan agreed with by the
191	191	16 anesthesiologist or, in the absence of an available
192	192	17 anesthesiologist with clinical privileges, agreed with
193	193	18 by the operating physician, operating dentist, or
194	194	19 operating podiatric physician in accordance with the
195	195	20 medical staff consulting committee policies of a
196	196	21 licensed ambulatory surgical treatment center.
197	197	22 (D) In accordance with the medical staff
198	198	23 consulting committee policies of a licensed ambulatory
199	199	24 surgical treatment center, a certified registered
200	200	25 nurse anesthetist with clinical privileges may perform
201	201	26 acts of advanced assessment and diagnosis and may
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212	212	1 provide such functions for which the certified
213	213	2 registered nurse anesthetist is educationally and
214	214	3 experientially prepared. A certified registered nurse
215	215	4 anesthetist shall practice in accordance with the
216	216	5 scope and all standards of the appropriate national
217	217	6 professional nursing association.
218	218	7 (Source: P.A. 99-642, eff. 7-28-16; 100-513, eff. 1-1-18.)
219	219	8 Section 10. The Hospital Licensing Act is amended by
220	220	9 changing Section 10.7 as follows:
221	221	10 (210 ILCS 85/10.7)
222	222	11 Sec. 10.7. Clinical privileges; advanced practice
223	223	12 registered nurses. All hospitals licensed under this Act
224	224	13 shall comply with the following requirements:
225	225	14 (1) No hospital policy, rule, regulation, or practice
226	226	15 shall be inconsistent with the provision of adequate
227	227	16 collaboration and consultation in accordance with Section
228	228	17 54.5 of the Medical Practice Act of 1987.
229	229	18 (2) Operative surgical procedures shall be performed
230	230	19 only by a physician licensed to practice medicine in all
231	231	20 its branches under the Medical Practice Act of 1987, a
232	232	21 dentist licensed under the Illinois Dental Practice Act,
233	233	22 or a podiatric physician licensed under the Podiatric
234	234	23 Medical Practice Act of 1987, with medical staff
235	235	24 membership and surgical clinical privileges granted at the
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246	246	1 hospital. A licensed physician, dentist, or podiatric
247	247	2 physician may be assisted by a physician licensed to
248	248	3 practice medicine in all its branches, dentist, dental
249	249	4 assistant, podiatric physician, licensed advanced practice
250	250	5 registered nurse, licensed physician assistant, licensed
251	251	6 registered nurse, licensed practical nurse, surgical
252	252	7 assistant, surgical technician, or other individuals
253	253	8 granted clinical privileges to assist in surgery at the
254	254	9 hospital. Payment for services rendered by an assistant in
255	255	10 surgery who is not a hospital employee shall be paid at the
256	256	11 appropriate non-physician modifier rate if the payor would
257	257	12 have made payment had the same services been provided by a
258	258	13 physician.
259	259	14 (2.5) A registered nurse licensed under the Nurse
260	260	15 Practice Act and qualified by training and experience in
261	261	16 operating room nursing shall be present in the operating
262	262	17 room and function as the circulating nurse during all
263	263	18 invasive or operative procedures. For purposes of this
264	264	19 paragraph (2.5), "circulating nurse" means a registered
265	265	20 nurse who is responsible for coordinating all nursing
266	266	21 care, patient safety needs, and the needs of the surgical
267	267	22 team in the operating room during an invasive or operative
268	268	23 procedure.
269	269	24 (3) An advanced practice registered nurse is not
270	270	25 required to possess prescriptive authority or a written
271	271	26 collaborative agreement meeting the requirements of the
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282	282	1 Nurse Practice Act to provide advanced practice registered
283	283	2 nursing services in a hospital. An advanced practice
284	284	3 registered nurse must possess clinical privileges
285	285	4 recommended by the medical staff and granted by the
286	286	5 hospital in order to provide services. Individual advanced
287	287	6 practice registered nurses may also be granted clinical
288	288	7 privileges to order, select, and administer medications,
289	289	8 including controlled substances, to provide delineated
290	290	9 care. The attending physician must determine the advanced
291	291	10 practice registered nurse's role in providing care for his
292	292	11 or her patients, except as otherwise provided in medical
293	293	12 staff bylaws. The medical staff shall periodically review
294	294	13 the services of advanced practice registered nurses
295	295	14 granted privileges. This review shall be conducted in
296	296	15 accordance with item (2) of subsection (a) of Section 10.8
297	297	16 of this Act for advanced practice registered nurses
298	298	17 employed by the hospital.
299	299	18 (4) (Blank). The anesthesia service shall be under the
300	300	19 direction of a physician licensed to practice medicine in
301	301	20 all its branches who has had specialized preparation or
302	302	21 experience in the area or who has completed a residency in
303	303	22 anesthesiology. An anesthesiologist, Board certified or
304	304	23 Board eligible, is recommended. Anesthesia services may
305	305	24 only be administered pursuant to the order of a physician
306	306	25 licensed to practice medicine in all its branches,
307	307	26 licensed dentist, or licensed podiatric physician.
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318	318	1 (A) The individuals who, with clinical privileges
319	319	2 granted at the hospital, may administer anesthesia
320	320	3 services are limited to the following:
321	321	4 (i) an anesthesiologist; or
322	322	5 (ii) a physician licensed to practice medicine
323	323	6 in all its branches; or
324	324	7 (iii) a dentist with authority to administer
325	325	8 anesthesia under Section 8.1 of the Illinois
326	326	9 Dental Practice Act; or
327	327	10 (iv) a licensed certified registered nurse
328	328	11 anesthetist; or
329	329	12 (v) a podiatric physician licensed under the
330	330	13 Podiatric Medical Practice Act of 1987.
331	331	14 (B) For anesthesia services, a certified
332	332	15 registered nurse anesthetist shall seek consultation
333	333	16 regarding development of an anesthesia plan and
334	334	17 treatment of patients as is appropriate to the
335	335	18 certified registered nurse anesthetist's level of
336	336	19 expertise and scope of practice and as is warranted by
337	337	20 the needs of the patient an anesthesiologist shall
338	338	21 participate through discussion of and agreement with
339	339	22 the anesthesia plan and shall remain physically
340	340	23 present and be available on the premises during the
341	341	24 delivery of anesthesia services for diagnosis,
342	342	25 consultation, and treatment of emergency medical
343	343	26 conditions. In the absence of 24-hour availability of
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354	354	1 anesthesiologists with medical staff privileges, an
355	355	2 alternate policy (requiring participation, presence,
356	356	3 and availability of a physician licensed to practice
357	357	4 medicine in all its branches) shall be developed by
358	358	5 the medical staff and licensed hospital in
359	359	6 consultation with the anesthesia service.
360	360	7 (C) A certified registered nurse anesthetist is
361	361	8 not required to possess prescriptive authority or a
362	362	9 written collaborative agreement meeting the
363	363	10 requirements of Section 65-35 of the Nurse Practice
364	364	11 Act to provide anesthesia and related services ordered
365	365	12 by a licensed physician, dentist, or podiatric
366	366	13 physician. Licensed certified registered nurse
367	367	14 anesthetists are authorized to select, order, and
368	368	15 administer drugs and apply the appropriate medical
369	369	16 devices in the provision of anesthesia and related
370	370	17 services under the anesthesia plan agreed with by the
371	371	18 anesthesiologist or, in the absence of an available
372	372	19 anesthesiologist with clinical privileges, agreed with
373	373	20 by the operating physician, operating dentist, or
374	374	21 operating podiatric physician in accordance with the
375	375	22 hospital's alternative policy.
376	376	23 (D) In accordance with the hospital's policies, a
377	377	24 certified registered nurse anesthetist with clinical
378	378	25 privileges may perform acts of advanced assessment and
379	379	26 diagnosis and may provide such functions for which the
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390	390	1 CRNA is educationally and experientially prepared. A
391	391	2 certified registered nurse anesthetist shall practice
392	392	3 in accordance with the scope and all standards of the
393	393	4 appropriate national professional nursing association.
394	394	5 (Source: P.A. 99-642, eff. 7-28-16; 100-513, eff. 1-1-18.)
395	395	6 Section 15. The Medical Practice Act of 1987 is amended by
396	396	7 changing Section 54.5 as follows:
397	397	8 (225 ILCS 60/54.5)
398	398	9 (Section scheduled to be repealed on January 1, 2027)
399	399	10 Sec. 54.5. Physician delegation of authority to physician
400	400	11 assistants, advanced practice registered nurses without full
401	401	12 practice authority, and prescribing psychologists.
402	402	13 (a) Physicians licensed to practice medicine in all its
403	403	14 branches may delegate care and treatment responsibilities to a
404	404	15 physician assistant under guidelines in accordance with the
405	405	16 requirements of the Physician Assistant Practice Act of 1987.
406	406	17 A physician licensed to practice medicine in all its branches
407	407	18 may enter into collaborative agreements with no more than 7
408	408	19 full-time equivalent physician assistants, except in a
409	409	20 hospital, hospital affiliate, or ambulatory surgical treatment
410	410	21 center as set forth by Section 7.7 of the Physician Assistant
411	411	22 Practice Act of 1987 and as provided in subsection (a-5).
412	412	23 (a-5) A physician licensed to practice medicine in all its
413	413	24 branches may collaborate with more than 7 physician assistants
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424	424	1 when the services are provided in a federal primary care
425	425	2 health professional shortage area with a Health Professional
426	426	3 Shortage Area score greater than or equal to 12, as determined
427	427	4 by the United States Department of Health and Human Services.
428	428	5 The collaborating physician must keep appropriate
429	429	6 documentation of meeting this exemption and make it available
430	430	7 to the Department upon request.
431	431	8 (b) A physician licensed to practice medicine in all its
432	432	9 branches in active clinical practice may collaborate with an
433	433	10 advanced practice registered nurse in accordance with the
434	434	11 requirements of the Nurse Practice Act. Collaboration is for
435	435	12 the purpose of providing medical consultation, and no
436	436	13 employment relationship is required. A written collaborative
437	437	14 agreement shall conform to the requirements of Section 65-35
438	438	15 of the Nurse Practice Act. The written collaborative agreement
439	439	16 shall be for services for which the collaborating physician
440	440	17 can provide adequate collaboration. A written collaborative
441	441	18 agreement shall be adequate with respect to collaboration with
442	442	19 advanced practice registered nurses if all of the following
443	443	20 apply:
444	444	21 (1) The agreement is written to promote the exercise
445	445	22 of professional judgment by the advanced practice
446	446	23 registered nurse commensurate with his or her education
447	447	24 and experience.
448	448	25 (2) The advanced practice registered nurse provides
449	449	26 services based upon a written collaborative agreement with
450	450
451	451
452	452
453	453
454	454
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456	456
457	457
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459	459	SB0239 - 13 - LRB104 07525 BAB 17569 b
460	460	1 the collaborating physician, except as set forth in
461	461	2 subsection (b-5) of this Section. With respect to labor
462	462	3 and delivery, the collaborating physician must provide
463	463	4 delivery services in order to participate with a certified
464	464	5 nurse midwife.
465	465	6 (3) Methods of communication are available with the
466	466	7 collaborating physician in person or through
467	467	8 telecommunications for consultation, collaboration, and
468	468	9 referral as needed to address patient care needs.
469	469	10 (b-5) An anesthesiologist or physician licensed to
470	470	11 practice medicine in all its branches may collaborate with a
471	471	12 certified registered nurse anesthetist in accordance with
472	472	13 Section 65-35 of the Nurse Practice Act for the provision of
473	473	14 anesthesia and related services. A written collaborative
474	474	15 agreement shall be adequate with respect to collaboration with
475	475	16 certified registered nurse anesthetists if all of the
476	476	17 following apply:
477	477	18 (1) The agreement is written to promote exercise of
478	478	19 professional judgment by the certified registered nurse
479	479	20 anesthetist commensurate with his or her education and
480	480	21 experience.
481	481	22 (2) The certified registered nurse anesthetist
482	482	23 provides service based on a written collaborative
483	483	24 agreement with the collaborating physician.
484	484	25 (3) Methods of communication are available with the
485	485	26 collaborating physician in person or through
486	486
487	487
488	488
489	489
490	490
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492	492
493	493
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495	495	SB0239 - 14 - LRB104 07525 BAB 17569 b
496	496	1 telecommunications for consultation, collaboration, and
497	497	2 referral as needed to address patient care needs. With
498	498	3 respect to the provision of anesthesia services, the
499	499	4 collaborating anesthesiologist or physician shall have
500	500	5 training and experience in the delivery of anesthesia
501	501	6 services consistent with Department rules. Collaboration
502	502	7 shall be adequate if:
503	503	8 (1) an anesthesiologist or a physician participates in
504	504	9 the joint formulation and joint approval of orders or
505	505	10 guidelines and periodically reviews such orders and the
506	506	11 services provided patients under such orders; and
507	507	12 (2) for anesthesia services, the anesthesiologist or
508	508	13 physician participates through discussion of and agreement
509	509	14 with the anesthesia plan and is physically present and
510	510	15 available on the premises during the delivery of
511	511	16 anesthesia services for diagnosis, consultation, and
512	512	17 treatment of emergency medical conditions. Collaboration
513	513	18 with respect to an anesthesia and related Anesthesia
514	514	19 services in a hospital shall be conducted in accordance
515	515	20 with Section 10.7 of the Hospital Licensing Act and in an
516	516	21 ambulatory surgical treatment center in accordance with
517	517	22 Section 6.5 of the Ambulatory Surgical Treatment Center
518	518	23 Act.
519	519	24 (b-10) For anesthesia services, a certified registered
520	520	25 nurse anesthetist shall consult with the collaborating
521	521	26 physician or other appropriate health care professionals
522	522
523	523
524	524
525	525
526	526
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528	528
529	529
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531	531	SB0239 - 15 - LRB104 07525 BAB 17569 b
532	532	1 regarding development of an anesthesia plan and treatment of a
533	533	2 patient as is appropriate to the certified registered nurse
534	534	3 anesthetist's level of expertise and scope of practice and as
535	535	4 is warranted by the needs of the patient The anesthesiologist
536	536	5 or operating physician must agree with the anesthesia plan
537	537	6 prior to the delivery of services.
538	538	7 (c) The collaborating physician shall have access to the
539	539	8 medical records of all patients attended by a physician
540	540	9 assistant. The collaborating physician shall have access to
541	541	10 the medical records of all patients attended to by an advanced
542	542	11 practice registered nurse.
543	543	12 (d) (Blank).
544	544	13 (e) A physician shall not be liable for the acts or
545	545	14 omissions of a prescribing psychologist, physician assistant,
546	546	15 or advanced practice registered nurse solely on the basis of
547	547	16 having signed a supervision agreement or guidelines or a
548	548	17 collaborative agreement, an order, a standing medical order, a
549	549	18 standing delegation order, or other order or guideline
550	550	19 authorizing a prescribing psychologist, physician assistant,
551	551	20 or advanced practice registered nurse to perform acts, unless
552	552	21 the physician has reason to believe the prescribing
553	553	22 psychologist, physician assistant, or advanced practice
554	554	23 registered nurse lacked the competency to perform the act or
555	555	24 acts or commits willful and wanton misconduct.
556	556	25 (f) A collaborating physician may, but is not required to,
557	557	26 delegate prescriptive authority to an advanced practice
558	558
559	559
560	560
561	561
562	562
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564	564
565	565
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568	568	1 registered nurse as part of a written collaborative agreement,
569	569	2 and the delegation of prescriptive authority shall conform to
570	570	3 the requirements of Section 65-40 of the Nurse Practice Act.
571	571	4 (g) A collaborating physician may, but is not required to,
572	572	5 delegate prescriptive authority to a physician assistant as
573	573	6 part of a written collaborative agreement, and the delegation
574	574	7 of prescriptive authority shall conform to the requirements of
575	575	8 Section 7.5 of the Physician Assistant Practice Act of 1987.
576	576	9 (h) (Blank).
577	577	10 (i) A collaborating physician shall delegate prescriptive
578	578	11 authority to a prescribing psychologist as part of a written
579	579	12 collaborative agreement, and the delegation of prescriptive
580	580	13 authority shall conform to the requirements of Section 4.3 of
581	581	14 the Clinical Psychologist Licensing Act.
582	582	15 (j) As set forth in Section 22.2 of this Act, a licensee
583	583	16 under this Act may not directly or indirectly divide, share,
584	584	17 or split any professional fee or other form of compensation
585	585	18 for professional services with anyone in exchange for a
586	586	19 referral or otherwise, other than as provided in Section 22.2.
587	587	20 (Source: P.A. 103-228, eff. 1-1-24.)
588	588	21 Section 20. The Nurse Practice Act is amended by changing
589	589	22 Sections 65-35 and 65-45 and by adding Section 65-70 as
590	590	23 follows:
591	591	24 (225 ILCS 65/65-35) (was 225 ILCS 65/15-15)
592	592
593	593
594	594
595	595
596	596
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598	598
599	599
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601	601	SB0239 - 17 - LRB104 07525 BAB 17569 b
602	602	1 (Section scheduled to be repealed on January 1, 2028)
603	603	2 Sec. 65-35. Written collaborative agreements.
604	604	3 (a) A written collaborative agreement is required for all
605	605	4 advanced practice registered nurses engaged in clinical
606	606	5 practice prior to meeting the requirements of Section 65-43,
607	607	6 except for advanced practice registered nurses who are
608	608	7 privileged to practice in a hospital, hospital affiliate, or
609	609	8 ambulatory surgical treatment center.
610	610	9 (a-5) If an advanced practice registered nurse engages in
611	611	10 clinical practice outside of a hospital, hospital affiliate,
612	612	11 or ambulatory surgical treatment center in which he or she is
613	613	12 privileged to practice, the advanced practice registered nurse
614	614	13 must have a written collaborative agreement, except as set
615	615	14 forth in Section 65-43 and 65-70.
616	616	15 (b) A written collaborative agreement shall describe the
617	617	16 relationship of the advanced practice registered nurse with
618	618	17 the collaborating physician and shall describe the categories
619	619	18 of care, treatment, or procedures to be provided by the
620	620	19 advanced practice registered nurse. A collaborative agreement
621	621	20 with a podiatric physician must be in accordance with
622	622	21 subsection (c-5) or (c-15) of this Section. A collaborative
623	623	22 agreement with a dentist must be in accordance with subsection
624	624	23 (c-10) of this Section. A collaborative agreement with a
625	625	24 podiatric physician must be in accordance with subsection
626	626	25 (c-5) of this Section. Collaboration does not require an
627	627	26 employment relationship between the collaborating physician
628	628
629	629
630	630
631	631
632	632
633	633	SB0239 - 17 - LRB104 07525 BAB 17569 b
634	634
635	635
636	636	SB0239- 18 -LRB104 07525 BAB 17569 b SB0239 - 18 - LRB104 07525 BAB 17569 b
637	637	SB0239 - 18 - LRB104 07525 BAB 17569 b
638	638	1 and the advanced practice registered nurse.
639	639	2 The collaborative relationship under an agreement shall
640	640	3 not be construed to require the personal presence of a
641	641	4 collaborating physician at the place where services are
642	642	5 rendered. Methods of communication shall be available for
643	643	6 consultation with the collaborating physician in person or by
644	644	7 telecommunications or electronic communications as set forth
645	645	8 in the written agreement.
646	646	9 (b-5) Absent an employment relationship, a written
647	647	10 collaborative agreement may not (1) restrict the categories of
648	648	11 patients of an advanced practice registered nurse within the
649	649	12 scope of the advanced practice registered nurses training and
650	650	13 experience, (2) limit third party payors or government health
651	651	14 programs, such as the medical assistance program or Medicare
652	652	15 with which the advanced practice registered nurse contracts,
653	653	16 or (3) limit the geographic area or practice location of the
654	654	17 advanced practice registered nurse in this State.
655	655	18 (c) In the case of anesthesia services provided by a
656	656	19 certified registered nurse anesthetist, a certified registered
657	657	20 nurse anesthetist shall seek consultation regarding
658	658	21 development of an anesthesia plan and treatment of patients as
659	659	22 is appropriate to the certified registered nurse anesthetist's
660	660	23 level of expertise and scope of practice and as is warranted by
661	661	24 the needs of the patient an anesthesiologist, a physician, a
662	662	25 dentist, or a podiatric physician must participate through
663	663	26 discussion of and agreement with the anesthesia plan and
664	664
665	665
666	666
667	667
668	668
669	669	SB0239 - 18 - LRB104 07525 BAB 17569 b
670	670
671	671
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673	673	SB0239 - 19 - LRB104 07525 BAB 17569 b
674	674	1 remain physically present and available on the premises during
675	675	2 the delivery of anesthesia services for diagnosis,
676	676	3 consultation, and treatment of emergency medical conditions.
677	677	4 (c-5) A certified registered nurse anesthetist, who
678	678	5 provides anesthesia and related services outside of a hospital
679	679	6 or ambulatory surgical treatment center shall enter into a
680	680	7 written collaborative agreement with an anesthesiologist or
681	681	8 the physician licensed to practice medicine in all its
682	682	9 branches or the podiatric physician performing the procedure.
683	683	10 The collaborative agreement may, but is not required to,
684	684	11 include the following terms: (i) that the certified registered
685	685	12 nurse anesthetist providing anesthesia services and the
686	686	13 anesthesiologist, physician, or podiatric physician
687	687	14 participate through discussion of and reach agreement on the
688	688	15 anesthesia plan or (ii) that anesthesia services shall only be
689	689	16 delivered when the anesthesiologist, physician, or podiatric
690	690	17 physician is present and available on the premises for
691	691	18 diagnosis, consultation, and treatment of emergency medical
692	692	19 conditions. Outside of a hospital or ambulatory surgical
693	693	20 treatment center, the certified registered nurse anesthetist
694	694	21 may provide only those services that the collaborating
695	695	22 podiatric physician is authorized to provide pursuant to the
696	696	23 Podiatric Medical Practice Act of 1987 and rules adopted
697	697	24 thereunder. A certified registered nurse anesthetist may
698	698	25 select, order, and administer medication, including controlled
699	699	26 substances, and apply appropriate medical devices for delivery
700	700
701	701
702	702
703	703
704	704
705	705	SB0239 - 19 - LRB104 07525 BAB 17569 b
706	706
707	707
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709	709	SB0239 - 20 - LRB104 07525 BAB 17569 b
710	710	1 of anesthesia and related services under the anesthesia plan
711	711	2 agreed with by the anesthesiologist or the operating physician
712	712	3 or operating podiatric physician.
713	713	4 (c-10) A certified registered nurse anesthetist who
714	714	5 provides anesthesia services in a dental office shall enter
715	715	6 into a written collaborative agreement with an
716	716	7 anesthesiologist or the physician licensed to practice
717	717	8 medicine in all its branches or the operating dentist
718	718	9 performing the procedure. The agreement shall describe the
719	719	10 working relationship of the certified registered nurse
720	720	11 anesthetist and dentist and shall authorize the categories of
721	721	12 care, treatment, or procedures to be performed by the
722	722	13 certified registered nurse anesthetist. The collaborative
723	723	14 agreement may, but is not required to, include the following
724	724	15 terms: (i) that the certified registered nurse anesthetist
725	725	16 providing anesthesia services and the anesthesiologist,
726	726	17 physician, or podiatric physician participate through
727	727	18 discussion of and reach agreement on the anesthesia plan or
728	728	19 (ii) that anesthesia services shall only be delivered when the
729	729	20 anesthesiologist, physician, or podiatric physician is present
730	730	21 and available on the premises for diagnosis, consultation, and
731	731	22 treatment of emergency medical conditions. In a collaborating
732	732	23 dentist's office, the certified registered nurse anesthetist
733	733	24 may only provide those services that the operating dentist
734	734	25 with the appropriate permit is authorized to provide pursuant
735	735	26 to the Illinois Dental Practice Act and rules adopted
736	736
737	737
738	738
739	739
740	740
741	741	SB0239 - 20 - LRB104 07525 BAB 17569 b
742	742
743	743
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745	745	SB0239 - 21 - LRB104 07525 BAB 17569 b
746	746	1 thereunder. For anesthesia services, a certified registered
747	747	2 nurse anesthetist shall seek consultation regarding
748	748	3 development of an anesthesia plan and treatment of patients as
749	749	4 is appropriate to the certified registered nurse anesthetist's
750	750	5 level of expertise and scope of practice and as is warranted by
751	751	6 the needs of the patient an anesthesiologist, physician, or
752	752	7 operating dentist shall participate through discussion of and
753	753	8 agreement with the anesthesia plan and shall remain physically
754	754	9 present and be available on the premises during the delivery
755	755	10 of anesthesia services for diagnosis, consultation, and
756	756	11 treatment of emergency medical conditions. A certified
757	757	12 registered nurse anesthetist may select, order, and administer
758	758	13 medication, including controlled substances, and apply
759	759	14 appropriate medical devices for delivery of anesthesia and
760	760	15 related services under the anesthesia plan agreed with by the
761	761	16 operating dentist.
762	762	17 (c-15) An advanced practice registered nurse who had a
763	763	18 written collaborative agreement with a podiatric physician
764	764	19 immediately before the effective date of Public Act 100-513
765	765	20 may continue in that collaborative relationship or enter into
766	766	21 a new written collaborative relationship with a podiatric
767	767	22 physician under the requirements of this Section and Section
768	768	23 65-40, as those Sections existed immediately before the
769	769	24 amendment of those Sections by Public Act 100-513 with regard
770	770	25 to a written collaborative agreement between an advanced
771	771	26 practice registered nurse and a podiatric physician.
772	772
773	773
774	774
775	775
776	776
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778	778
779	779
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781	781	SB0239 - 22 - LRB104 07525 BAB 17569 b
782	782	1 (d) A copy of the signed, written collaborative agreement
783	783	2 must be available to the Department upon request from both the
784	784	3 advanced practice registered nurse and the collaborating
785	785	4 physician, dentist, or podiatric physician.
786	786	5 (e) Nothing in this Act shall be construed to limit the
787	787	6 delegation of tasks or duties by a physician to a licensed
788	788	7 practical nurse, a registered professional nurse, or other
789	789	8 persons in accordance with Section 54.2 of the Medical
790	790	9 Practice Act of 1987. Nothing in this Act shall be construed to
791	791	10 limit the method of delegation that may be authorized by any
792	792	11 means, including, but not limited to, oral, written,
793	793	12 electronic, standing orders, protocols, guidelines, or verbal
794	794	13 orders.
795	795	14 (e-5) Nothing in this Act shall be construed to authorize
796	796	15 an advanced practice registered nurse to provide health care
797	797	16 services required by law or rule to be performed by a
798	798	17 physician. The scope of practice of an advanced practice
799	799	18 registered nurse does not include operative surgery. Nothing
800	800	19 in this Section shall be construed to preclude an advanced
801	801	20 practice registered nurse from assisting in surgery.
802	802	21 (f) An advanced practice registered nurse shall inform
803	803	22 each collaborating physician, dentist, or podiatric physician
804	804	23 of all collaborative agreements he or she has signed and
805	805	24 provide a copy of these to any collaborating physician,
806	806	25 dentist, or podiatric physician upon request.
807	807	26 (g) (Blank).
808	808
809	809
810	810
811	811
812	812
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814	814
815	815
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817	817	SB0239 - 23 - LRB104 07525 BAB 17569 b
818	818	1 (Source: P.A. 100-513, eff. 1-1-18; 100-577, eff. 1-26-18;
819	819	2 100-1096, eff. 8-26-18; 101-13, eff. 6-12-19.)
820	820	3 (225 ILCS 65/65-45) (was 225 ILCS 65/15-25)
821	821	4 (Section scheduled to be repealed on January 1, 2028)
822	822	5 Sec. 65-45. Advanced practice registered nursing in
823	823	6 hospitals, hospital affiliates, or ambulatory surgical
824	824	7 treatment centers.
825	825	8 (a) An advanced practice registered nurse may provide
826	826	9 services in a hospital or a hospital affiliate as those terms
827	827	10 are defined in the Hospital Licensing Act or the University of
828	828	11 Illinois Hospital Act or a licensed ambulatory surgical
829	829	12 treatment center without a written collaborative agreement
830	830	13 pursuant to Section 65-35 of this Act. An advanced practice
831	831	14 registered nurse must possess clinical privileges recommended
832	832	15 by the hospital medical staff and granted by the hospital or
833	833	16 the consulting medical staff committee and ambulatory surgical
834	834	17 treatment center in order to provide services. The medical
835	835	18 staff or consulting medical staff committee shall periodically
836	836	19 review the services of all advanced practice registered nurses
837	837	20 granted clinical privileges, including any care provided in a
838	838	21 hospital affiliate. Authority may also be granted when
839	839	22 recommended by the hospital medical staff and granted by the
840	840	23 hospital or recommended by the consulting medical staff
841	841	24 committee and ambulatory surgical treatment center to
842	842	25 individual advanced practice registered nurses to select,
843	843
844	844
845	845
846	846
847	847
848	848	SB0239 - 23 - LRB104 07525 BAB 17569 b
849	849
850	850
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853	853	1 order, and administer medications, including controlled
854	854	2 substances, to provide delineated care. In a hospital,
855	855	3 hospital affiliate, or ambulatory surgical treatment center,
856	856	4 the attending physician shall determine an advanced practice
857	857	5 registered nurse's role in providing care for his or her
858	858	6 patients, except as otherwise provided in the medical staff
859	859	7 bylaws or consulting committee policies.
860	860	8 (a-2) An advanced practice registered nurse privileged to
861	861	9 order medications, including controlled substances, may
862	862	10 complete discharge prescriptions provided the prescription is
863	863	11 in the name of the advanced practice registered nurse and the
864	864	12 attending or discharging physician.
865	865	13 (a-3) Advanced practice registered nurses practicing in a
866	866	14 hospital or an ambulatory surgical treatment center are not
867	867	15 required to obtain a mid-level controlled substance license to
868	868	16 order controlled substances under Section 303.05 of the
869	869	17 Illinois Controlled Substances Act.
870	870	18 (a-4) An advanced practice registered nurse meeting the
871	871	19 requirements of Section 65-43 or 65-70 may be privileged to
872	872	20 complete discharge orders and prescriptions under the advanced
873	873	21 practice registered nurse's name.
874	874	22 (a-5) For anesthesia services provided by a certified
875	875	23 registered nurse anesthetist, certified registered nurse
876	876	24 anesthetist shall seek consultation regarding development of
877	877	25 an anesthesia plan and treatment of patients as is appropriate
878	878	26 to the certified registered nurse anesthetist's level of
879	879
880	880
881	881
882	882
883	883
884	884	SB0239 - 24 - LRB104 07525 BAB 17569 b
885	885
886	886
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888	888	SB0239 - 25 - LRB104 07525 BAB 17569 b
889	889	1 expertise and scope of practice and as is warranted by the
890	890	2 needs of the patient an anesthesiologist, physician, dentist,
891	891	3 or podiatric physician shall participate through discussion of
892	892	4 and agreement with the anesthesia plan and shall remain
893	893	5 physically present and be available on the premises during the
894	894	6 delivery of anesthesia services for diagnosis, consultation,
895	895	7 and treatment of emergency medical conditions, unless hospital
896	896	8 policy adopted pursuant to clause (B) of subdivision (3) of
897	897	9 Section 10.7 of the Hospital Licensing Act or ambulatory
898	898	10 surgical treatment center policy adopted pursuant to clause
899	899	11 (B) of subdivision (3) of Section 6.5 of the Ambulatory
900	900	12 Surgical Treatment Center Act provides otherwise. A certified
901	901	13 registered nurse anesthetist may select, order, and administer
902	902	14 medication for anesthesia and related services under the
903	903	15 anesthesia plan agreed to by the anesthesiologist or the
904	904	16 physician, in accordance with hospital alternative policy or
905	905	17 the medical staff consulting committee policies of a licensed
906	906	18 ambulatory surgical treatment center.
907	907	19 (b) An advanced practice registered nurse who provides
908	908	20 services in a hospital shall do so in accordance with Section
909	909	21 10.7 of the Hospital Licensing Act and, in an ambulatory
910	910	22 surgical treatment center, in accordance with Section 6.5 of
911	911	23 the Ambulatory Surgical Treatment Center Act. Nothing in this
912	912	24 Act shall be construed to require an advanced practice
913	913	25 registered nurse to have a collaborative agreement to practice
914	914	26 in a hospital, hospital affiliate, or ambulatory surgical
915	915
916	916
917	917
918	918
919	919
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921	921
922	922
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925	925	1 treatment center.
926	926	2 (c) Advanced practice registered nurses certified as nurse
927	927	3 practitioners, nurse midwives, or clinical nurse specialists
928	928	4 practicing in a hospital affiliate may be, but are not
929	929	5 required to be, privileged to prescribe Schedule II through V
930	930	6 controlled substances when such authority is recommended by
931	931	7 the appropriate physician committee of the hospital affiliate
932	932	8 and granted by the hospital affiliate. This authority may, but
933	933	9 is not required to, include prescription of, selection of,
934	934	10 orders for, administration of, storage of, acceptance of
935	935	11 samples of, and dispensing over-the-counter medications,
936	936	12 legend drugs, medical gases, and controlled substances
937	937	13 categorized as Schedule II through V controlled substances, as
938	938	14 defined in Article II of the Illinois Controlled Substances
939	939	15 Act, and other preparations, including, but not limited to,
940	940	16 botanical and herbal remedies.
941	941	17 To prescribe controlled substances under this subsection
942	942	18 (c), an advanced practice registered nurse certified as a
943	943	19 nurse practitioner, nurse midwife, or clinical nurse
944	944	20 specialist must obtain a controlled substance license.
945	945	21 Medication orders shall be reviewed periodically by the
946	946	22 appropriate hospital affiliate physicians committee or its
947	947	23 physician designee.
948	948	24 The hospital affiliate shall file with the Department
949	949	25 notice of a grant of prescriptive authority consistent with
950	950	26 this subsection (c) and termination of such a grant of
951	951
952	952
953	953
954	954
955	955
956	956	SB0239 - 26 - LRB104 07525 BAB 17569 b
957	957
958	958
959	959	SB0239- 27 -LRB104 07525 BAB 17569 b SB0239 - 27 - LRB104 07525 BAB 17569 b
960	960	SB0239 - 27 - LRB104 07525 BAB 17569 b
961	961	1 authority, in accordance with rules of the Department. Upon
962	962	2 receipt of this notice of grant of authority to prescribe any
963	963	3 Schedule II through V controlled substances, the licensed
964	964	4 advanced practice registered nurse certified as a nurse
965	965	5 practitioner, nurse midwife, or clinical nurse specialist may
966	966	6 register for a mid-level practitioner controlled substance
967	967	7 license under Section 303.05 of the Illinois Controlled
968	968	8 Substances Act.
969	969	9 In addition, a hospital affiliate may, but is not required
970	970	10 to, privilege an advanced practice registered nurse certified
971	971	11 as a nurse practitioner, nurse midwife, or clinical nurse
972	972	12 specialist to prescribe any Schedule II controlled substances,
973	973	13 if all of the following conditions apply:
974	974	14 (1) specific Schedule II controlled substances by oral
975	975	15 dosage or topical or transdermal application may be
976	976	16 designated, provided that the designated Schedule II
977	977	17 controlled substances are routinely prescribed by advanced
978	978	18 practice registered nurses in their area of certification;
979	979	19 the privileging documents must identify the specific
980	980	20 Schedule II controlled substances by either brand name or
981	981	21 generic name; privileges to prescribe or dispense Schedule
982	982	22 II controlled substances to be delivered by injection or
983	983	23 other route of administration may not be granted;
984	984	24 (2) any privileges must be controlled substances
985	985	25 limited to the practice of the advanced practice
986	986	26 registered nurse;
987	987
988	988
989	989
990	990
991	991
992	992	SB0239 - 27 - LRB104 07525 BAB 17569 b
993	993
994	994
995	995	SB0239- 28 -LRB104 07525 BAB 17569 b SB0239 - 28 - LRB104 07525 BAB 17569 b
996	996	SB0239 - 28 - LRB104 07525 BAB 17569 b
997	997	1 (3) any prescription must be limited to no more than a
998	998	2 30-day supply;
999	999	3 (4) the advanced practice registered nurse must
1000	1000	4 discuss the condition of any patients for whom a
1001	1001	5 controlled substance is prescribed monthly with the
1002	1002	6 appropriate physician committee of the hospital affiliate
1003	1003	7 or its physician designee; and
1004	1004	8 (5) the advanced practice registered nurse must meet
1005	1005	9 the education requirements of Section 303.05 of the
1006	1006	10 Illinois Controlled Substances Act.
1007	1007	11 (d) An advanced practice registered nurse meeting the
1008	1008	12 requirements of Section 65-43 may be privileged to prescribe
1009	1009	13 controlled substances categorized as Schedule II through V in
1010	1010	14 accordance with Section 65-43.
1011	1011	15 (Source: P.A. 99-173, eff. 7-29-15; 100-513, eff. 1-1-18.)
1012	1012	16 (225 ILCS 65/65-70 new)
1013	1013	17 Sec. 65-70. Conditions under which a written collaborative
1014	1014	18 agreement not required.
1015	1015	19 (a) An Illinois-licensed advanced practice registered
1016	1016	20 nurse certified as a certified registered nurse anesthetist
1017	1017	21 shall be deemed by law to possess the ability to practice
1018	1018	22 without a written collaborative agreement as set forth in this
1019	1019	23 Act.
1020	1020	24 (b) An advanced practice registered nurse certified as a
1021	1021	25 certified registered nurse anesthetist who (i) has attained
1022	1022
1023	1023
1024	1024
1025	1025
1026	1026
1027	1027	SB0239 - 28 - LRB104 07525 BAB 17569 b
1028	1028
1029	1029
1030	1030	SB0239- 29 -LRB104 07525 BAB 17569 b SB0239 - 29 - LRB104 07525 BAB 17569 b
1031	1031	SB0239 - 29 - LRB104 07525 BAB 17569 b
1032	1032	1 national certification and completed a professional practice
1033	1033	2 doctorate or (ii) files with the Department a notarized
1034	1034	3 attestation of completion of at least 250 hours of continuing
1035	1035	4 education or training and at least 4,000 hours of clinical
1036	1036	5 experience after first attaining national certification, shall
1037	1037	6 not require a written collaborative agreement. Documentation
1038	1038	7 of successful completion shall be provided to the Department
1039	1039	8 upon request. Continuing education or training hours required
1040	1040	9 by this subsection shall be in the certified registered nurse
1041	1041	10 anesthetist's area of certification as set forth by Department
1042	1042	11 rule.
1043	1043	12 The clinical experience must be in the certified
1044	1044	13 registered nurse anesthetist's area of certification. The
1045	1045	14 clinical experience shall be in collaboration with a physician
1046	1046	15 or physicians or a certified registered nurse anesthetist with
1047	1047	16 full practice authority. Completion of the clinical experience
1048	1048	17 must be attested to by the collaborating physician or
1049	1049	18 physicians or employer, collaborating certified registered
1050	1050	19 nurse anesthetist and the certified registered nurse
1051	1051	20 anesthetist. If the collaborating physician or physicians
1052	1052	21 collaborating certified nurse anesthetist, or employer is
1053	1053	22 unable to attest to the completion of the clinical experience,
1054	1054	23 the Department may accept other evidence of clinical
1055	1055	24 experience as established by rule.
1056	1056	25 (c) The scope of practice of a certified registered nurse
1057	1057	26 anesthetist with full practice authority includes:
1058	1058
1059	1059
1060	1060
1061	1061
1062	1062
1063	1063	SB0239 - 29 - LRB104 07525 BAB 17569 b
1064	1064
1065	1065
1066	1066	SB0239- 30 -LRB104 07525 BAB 17569 b SB0239 - 30 - LRB104 07525 BAB 17569 b
1067	1067	SB0239 - 30 - LRB104 07525 BAB 17569 b
1068	1068	1 (1) all matters included in subsection (c) of Section
1069	1069	2 65-30 of this Act;
1070	1070	3 (2) practicing without a written collaborative
1071	1071	4 agreement in all practice settings consistent with
1072	1072	5 national certification;
1073	1073	6 (3) authority to prescribe both legend drugs and
1074	1074	7 Schedule II through V controlled substances; this
1075	1075	8 authority includes prescription of, selection of, orders
1076	1076	9 for, administration of, storage of, acceptance of samples
1077	1077	10 of, and dispensing over the counter medications, legend
1078	1078	11 drugs, and controlled substances categorized as any
1079	1079	12 Schedule II through V controlled substances, as defined in
1080	1080	13 Article II of the Illinois Controlled Substances Act, and
1081	1081	14 other preparations, including, but not limited to,
1082	1082	15 botanical and herbal remedies;
1083	1083	16 (4) prescribing benzodiazepines or Schedule II
1084	1084	17 narcotic drugs, such as opioids; and
1085	1085	18 (5) authority to obtain an Illinois controlled
1086	1086	19 substance license and a federal Drug Enforcement
1087	1087	20 Administration number.
1088	1088	21 (d) The Department may adopt rules necessary to administer
1089	1089	22 this Section, including, but not limited to, requiring the
1090	1090	23 completion of forms and the payment of fees.
1091	1091	24 (e) Nothing in this Act shall be construed to authorize a
1092	1092	25 certified registered nurse anesthetist with full practice
1093	1093	26 authority to provide health care services required by law or
1094	1094
1095	1095
1096	1096
1097	1097
1098	1098
1099	1099	SB0239 - 30 - LRB104 07525 BAB 17569 b
1100	1100
1101	1101
1102	1102	SB0239- 31 -LRB104 07525 BAB 17569 b SB0239 - 31 - LRB104 07525 BAB 17569 b
1103	1103	SB0239 - 31 - LRB104 07525 BAB 17569 b
1104	1104	1 rule to be performed by a physician.
1105	1105	2 Section 25. The Illinois Dental Practice Act is amended by
1106	1106	3 changing Section 8.1 as follows:
1107	1107	4 (225 ILCS 25/8.1) (from Ch. 111, par. 2308.1)
1108	1108	5 (Section scheduled to be repealed on January 1, 2026)
1109	1109	6 Sec. 8.1. Permit for the administration of anesthesia and
1110	1110	7 sedation.
1111	1111	8 (a) No licensed dentist shall administer general
1112	1112	9 anesthesia, deep sedation, or moderate sedation without first
1113	1113	10 applying for and obtaining a permit for such purpose from the
1114	1114	11 Department. The Department shall issue such permit only after
1115	1115	12 ascertaining that the applicant possesses the minimum
1116	1116	13 qualifications necessary to protect public safety. A person
1117	1117	14 with a dental degree who administers anesthesia, deep
1118	1118	15 sedation, or moderate sedation in an approved hospital
1119	1119	16 training program under the supervision of either a licensed
1120	1120	17 dentist holding such permit or a physician licensed to
1121	1121	18 practice medicine in all its branches shall not be required to
1122	1122	19 obtain such permit.
1123	1123	20 (b) The minimum requirements for a permit to administer
1124	1124	21 moderate sedation issued after the effective date of this
1125	1125	22 amendatory Act of the 103rd General Assembly shall include the
1126	1126	23 completion of a minimum of 75 hours of didactic and supervised
1127	1127	24 clinical study in either:
1128	1128
1129	1129
1130	1130
1131	1131
1132	1132
1133	1133	SB0239 - 31 - LRB104 07525 BAB 17569 b
1134	1134
1135	1135
1136	1136	SB0239- 32 -LRB104 07525 BAB 17569 b SB0239 - 32 - LRB104 07525 BAB 17569 b
1137	1137	SB0239 - 32 - LRB104 07525 BAB 17569 b
1138	1138	1 (1) an American Dental Association Commission on
1139	1139	2 Dental Accreditation accredited dental specialty program,
1140	1140	3 general practice residency, or advanced education in
1141	1141	4 general dentistry residency that includes training and
1142	1142	5 documentation in moderate sedation techniques appropriate
1143	1143	6 for each specialty or an American Dental Association
1144	1144	7 Commission on Dental Accreditation accredited dental
1145	1145	8 anesthesiology residency program and proof of completion
1146	1146	9 of 20 individually managed patients utilizing appropriate
1147	1147	10 routes of administration, in which the applicant is the
1148	1148	11 sole provider, which can include, but are not limited to,
1149	1149	12 intravenous, oral, intranasal, or intramuscular or
1150	1150	13 combinations thereof; or
1151	1151	14 (2) a structured course of study provided by an
1152	1152	15 approved continuing education provider that includes
1153	1153	16 training and documentation in moderate sedation, physical
1154	1154	17 evaluation, venipuncture, advanced airway management,
1155	1155	18 technical administration, recognition and management of
1156	1156	19 complications and emergencies and monitoring with
1157	1157	20 additional supervised experience and documentation
1158	1158	21 demonstrating competence in providing moderate sedation
1159	1159	22 utilizing enteral and parenteral routes of administration
1160	1160	23 of medications to competency to 20 individual patient
1161	1161	24 experiences on a 1 to 1 ratio with an instructor, in which
1162	1162	25 the applicant is the sole provider of sedation over a
1163	1163	26 continuous time frame as set by the Department and as
1164	1164
1165	1165
1166	1166
1167	1167
1168	1168
1169	1169	SB0239 - 32 - LRB104 07525 BAB 17569 b
1170	1170
1171	1171
1172	1172	SB0239- 33 -LRB104 07525 BAB 17569 b SB0239 - 33 - LRB104 07525 BAB 17569 b
1173	1173	SB0239 - 33 - LRB104 07525 BAB 17569 b
1174	1174	1 provided in the American Dental Association's Guidelines
1175	1175	2 for Teaching Pain Control and Sedation to Dentists and
1176	1176	3 Dental Students.
1177	1177	4 (b-5) The minimum requirements for a permit to administer
1178	1178	5 deep sedation and general anesthesia issued after the
1179	1179	6 effective date of this amendatory Act of the 103rd General
1180	1180	7 Assembly shall include:
1181	1181	8 (1) the completion of a minimum of 2 years of advanced
1182	1182	9 training in anesthesiology beyond the pre-doctoral level
1183	1183	10 in a training program approved by the American Dental
1184	1184	11 Association's Council on Dental Education and Licensure,
1185	1185	12 as outlined in Guidelines for Teaching Pain Control and
1186	1186	13 Sedation to Dentists and Dental Students, as published by
1187	1187	14 the American Dental Association's Council on Dental
1188	1188	15 Education and Licensure;
1189	1189	16 (2) a specialty license in oral and maxillofacial
1190	1190	17 surgery;
1191	1191	18 (3) completion of an accredited oral or maxillofacial
1192	1192	19 surgery residency program; or
1193	1193	20 (4) the completion of an American Dental Association
1194	1194	21 Commission on Dental Accreditation accredited dental
1195	1195	22 anesthesiology residency program.
1196	1196	23 (b-10) The Department may establish, by rule, additional
1197	1197	24 training programs and training requirements consistent with
1198	1198	25 this Section to ensure patient safety in dental offices
1199	1199	26 administering anesthesia, which shall include, but not be
1200	1200
1201	1201
1202	1202
1203	1203
1204	1204
1205	1205	SB0239 - 33 - LRB104 07525 BAB 17569 b
1206	1206
1207	1207
1208	1208	SB0239- 34 -LRB104 07525 BAB 17569 b SB0239 - 34 - LRB104 07525 BAB 17569 b
1209	1209	SB0239 - 34 - LRB104 07525 BAB 17569 b
1210	1210	1 limited to the following:
1211	1211	2 (1) (blank);
1212	1212	3 (2) establish the standards for properly equipped
1213	1213	4 dental facilities (other than licensed hospitals and
1214	1214	5 ambulatory surgical treatment centers) in which general
1215	1215	6 anesthesia, deep sedation, or moderate sedation is
1216	1216	7 administered, as necessary to protect public safety;
1217	1217	8 (3) establish minimum requirements for all persons who
1218	1218	9 assist the dentist in the administration of general
1219	1219	10 anesthesia, deep sedation, or moderate sedation, including
1220	1220	11 minimum training requirements for each member of the
1221	1221	12 dental team, monitoring requirements, recordkeeping
1222	1222	13 requirements, and emergency procedures;
1223	1223	14 (4) ensure that the dentist has completed and
1224	1224	15 maintains current certification in advanced cardiac life
1225	1225	16 support or pediatric advanced life support and all persons
1226	1226	17 assisting the dentist or monitoring the administration of
1227	1227	18 general anesthesia, deep sedation, or moderate sedation
1228	1228	19 maintain current certification in Basic Life Support
1229	1229	20 (BLS); and
1230	1230	21 (5) establish continuing education requirements in
1231	1231	22 sedation techniques and airway management for dentists who
1232	1232	23 possess a permit under this Section.
1233	1233	24 The Department shall adopt rules that ensure that a
1234	1234	25 continuing education course designed to meet the permit
1235	1235	26 requirements for moderate sedation training is reviewed and
1236	1236
1237	1237
1238	1238
1239	1239
1240	1240
1241	1241	SB0239 - 34 - LRB104 07525 BAB 17569 b
1242	1242
1243	1243
1244	1244	SB0239- 35 -LRB104 07525 BAB 17569 b SB0239 - 35 - LRB104 07525 BAB 17569 b
1245	1245	SB0239 - 35 - LRB104 07525 BAB 17569 b
1246	1246	1 certified by the Department if the course is not accredited by
1247	1247	2 the American Dental Association Commission on Dental
1248	1248	3 Accreditation.
1249	1249	4 When establishing requirements under this Section, the
1250	1250	5 Department shall consider the current American Dental
1251	1251	6 Association guidelines on sedation and general anesthesia, the
1252	1252	7 current "Guidelines for Monitoring and Management of Pediatric
1253	1253	8 Patients During and After Sedation for Diagnostic and
1254	1254	9 Therapeutic Procedures" established by the American Academy of
1255	1255	10 Pediatrics and the American Academy of Pediatric Dentistry,
1256	1256	11 and the current parameters of care and Office Anesthesia
1257	1257	12 Evaluation (OAE) Manual established by the American
1258	1258	13 Association of Oral and Maxillofacial Surgeons.
1259	1259	14 (c) A licensed dentist must hold an appropriate permit
1260	1260	15 issued under this Section in order to perform dentistry while
1261	1261	16 a nurse anesthetist administers moderate sedation, and a valid
1262	1262	17 written collaborative agreement must exist between the dentist
1263	1263	18 and the nurse anesthetist, in accordance with the Nurse
1264	1264	19 Practice Act, unless the nurse anesthetist has full practice
1265	1265	20 authority under the requirements of Section 65-70.
1266	1266	21 A licensed dentist must hold an appropriate permit issued
1267	1267	22 under this Section in order to perform dentistry while a nurse
1268	1268	23 anesthetist administers deep sedation or general anesthesia,
1269	1269	24 and a valid written collaborative agreement must exist between
1270	1270	25 the dentist and the nurse anesthetist, in accordance with the
1271	1271	26 Nurse Practice Act, unless the nurse anesthetist has full
1272	1272
1273	1273
1274	1274
1275	1275
1276	1276
1277	1277	SB0239 - 35 - LRB104 07525 BAB 17569 b
1278	1278
1279	1279
1280	1280	SB0239- 36 -LRB104 07525 BAB 17569 b SB0239 - 36 - LRB104 07525 BAB 17569 b
1281	1281	SB0239 - 36 - LRB104 07525 BAB 17569 b
1282	1282	1 practice authority under the requirements of Section 65-70.
1283	1283	2 For the purposes of this subsection (c), "nurse
1284	1284	3 anesthetist" means a licensed certified registered nurse
1285	1285	4 anesthetist who holds a license as an advanced practice
1286	1286	5 registered nurse.
1287	1287	6 (Source: P.A. 103-628, eff. 7-1-24.)
1288	1288	7 Section 30. The Podiatric Medical Practice Act of 1987 is
1289	1289	8 amended by changing Section 20.5 as follows:
1290	1290	9 (225 ILCS 100/20.5)
1291	1291	10 (Section scheduled to be repealed on January 1, 2028)
1292	1292	11 Sec. 20.5. Delegation of authority to advanced practice
1293	1293	12 registered nurses.
1294	1294	13 (a) A podiatric physician in active clinical practice may
1295	1295	14 collaborate with an advanced practice registered nurse in
1296	1296	15 accordance with the requirements of the Nurse Practice Act.
1297	1297	16 Collaboration shall be for the purpose of providing podiatric
1298	1298	17 care and no employment relationship shall be required. A
1299	1299	18 written collaborative agreement shall conform to the
1300	1300	19 requirements of Section 65-35 of the Nurse Practice Act. A
1301	1301	20 written collaborative agreement and podiatric physician
1302	1302	21 collaboration and consultation shall be adequate with respect
1303	1303	22 to advanced practice registered nurses if all of the following
1304	1304	23 apply:
1305	1305	24 (1) With respect to the provision of anesthesia
1306	1306
1307	1307
1308	1308
1309	1309
1310	1310
1311	1311	SB0239 - 36 - LRB104 07525 BAB 17569 b
1312	1312
1313	1313
1314	1314	SB0239- 37 -LRB104 07525 BAB 17569 b SB0239 - 37 - LRB104 07525 BAB 17569 b
1315	1315	SB0239 - 37 - LRB104 07525 BAB 17569 b
1316	1316	1 services by a certified registered nurse anesthetist, the
1317	1317	2 collaborating podiatric physician must have training and
1318	1318	3 experience in the delivery of anesthesia consistent with
1319	1319	4 Department rules unless the certified registered nurse
1320	1320	5 anesthetist has full practice authority under the
1321	1321	6 requirements of Section 65-70.
1322	1322	7 (2) Methods of communication are available with the
1323	1323	8 collaborating podiatric physician in person or through
1324	1324	9 telecommunications or electronic communications for
1325	1325	10 consultation, collaboration, and referral as needed to
1326	1326	11 address patient care needs.
1327	1327	12 (3) With respect to the provision of anesthesia
1328	1328	13 services by a certified registered nurse anesthetist,
1329	1329	14 certified registered nurse anesthetist shall seek
1330	1330	15 consultation regarding development of an anesthesia plan
1331	1331	16 and treatment of patients as is appropriate to the
1332	1332	17 certified registered nurse anesthetist's level of
1333	1333	18 expertise and scope of practice and as is warranted by the
1334	1334	19 needs of the patient an anesthesiologist, physician, or
1335	1335	20 podiatric physician shall participate through discussion
1336	1336	21 of and agreement with the anesthesia plan and shall remain
1337	1337	22 physically present and be available on the premises during
1338	1338	23 the delivery of anesthesia services for diagnosis,
1339	1339	24 consultation, and treatment of emergency medical
1340	1340	25 conditions. The anesthesiologist or operating podiatric
1341	1341	26 physician must agree with the anesthesia plan prior to the
1342	1342
1343	1343
1344	1344
1345	1345
1346	1346
1347	1347	SB0239 - 37 - LRB104 07525 BAB 17569 b
1348	1348
1349	1349
1350	1350	SB0239- 38 -LRB104 07525 BAB 17569 b SB0239 - 38 - LRB104 07525 BAB 17569 b
1351	1351	SB0239 - 38 - LRB104 07525 BAB 17569 b
1352	1352	1 delivery of services.
1353	1353	2 (b) The collaborating podiatric physician shall have
1354	1354	3 access to the records of all patients attended to by an
1355	1355	4 advanced practice registered nurse.
1356	1356	5 (c) Nothing in this Section shall be construed to limit
1357	1357	6 the delegation of tasks or duties by a podiatric physician to a
1358	1358	7 licensed practical nurse, a registered professional nurse, or
1359	1359	8 other appropriately trained persons.
1360	1360	9 (d) A podiatric physician shall not be liable for the acts
1361	1361	10 or omissions of an advanced practice registered nurse solely
1362	1362	11 on the basis of having signed guidelines or a collaborative
1363	1363	12 agreement, an order, a standing order, a standing delegation
1364	1364	13 order, or other order or guideline authorizing an advanced
1365	1365	14 practice registered nurse to perform acts, unless the
1366	1366	15 podiatric physician has reason to believe the advanced
1367	1367	16 practice registered nurse lacked the competency to perform the
1368	1368	17 act or acts or commits willful or wanton misconduct.
1369	1369	18 (e) A podiatric physician, may, but is not required to
1370	1370	19 delegate prescriptive authority to an advanced practice
1371	1371	20 registered nurse as part of a written collaborative agreement
1372	1372	21 and the delegation of prescriptive authority shall conform to
1373	1373	22 the requirements of Section 65-40 of the Nurse Practice Act.
1374	1374	23 (Source: P.A. 99-173, eff. 7-29-15; 100-513, eff. 1-1-18.)
1375	1375	24 Section 99. Effective date. This Act takes effect upon
1376	1376	25 becoming law.
1377	1377	SB0239- 39 -LRB104 07525 BAB 17569 b 1 INDEX 2 Statutes amended in order of appearance SB0239- 39 -LRB104 07525 BAB 17569 b SB0239 - 39 - LRB104 07525 BAB 17569 b 1 INDEX 2 Statutes amended in order of appearance
1378	1378	SB0239- 39 -LRB104 07525 BAB 17569 b SB0239 - 39 - LRB104 07525 BAB 17569 b
1379	1379	SB0239 - 39 - LRB104 07525 BAB 17569 b
1380	1380	1 INDEX
1381	1381	2 Statutes amended in order of appearance
1382	1382
1383	1383
1384	1384
1385	1385
1386	1386
1387	1387	SB0239 - 38 - LRB104 07525 BAB 17569 b
1388	1388
1389	1389
1390	1390
1391	1391	SB0239- 39 -LRB104 07525 BAB 17569 b SB0239 - 39 - LRB104 07525 BAB 17569 b
1392	1392	SB0239 - 39 - LRB104 07525 BAB 17569 b
1393	1393	1 INDEX
1394	1394	2 Statutes amended in order of appearance
1395	1395
1396	1396
1397	1397
1398	1398
1399	1399
1400	1400	SB0239 - 39 - LRB104 07525 BAB 17569 b