Legislative Update May 2017

ISMS SECURES NEEDED PROTECTIONS FOR PHYSICIANS AND PATIENTS AS APRN’S SEEK INDEPENDENT PRACTICE AUTHORITY

The Illinois State Medical Society prevented the Illinois Society for Advanced Practice Nursing (ISAPN) from moving its top priority this year i.e., to allow APRNs to practice completely independent of a physician.  After numerous negotiating sessions and intense advocacy from physicians throughout Illinois an agreement has been reached on this topic.

ISAPN introduced legislation that would have granted APRNs full independent practice, including full prescriptive authority, after completing additional clinical training under the supervision of either another APRN or physician. ISMS opposed this legislation.

There is strong support within the Illinois legislature for bills that would grant APRNs independent practice. Instead of voting against us, legislators asked ISMS to draft an alternative.

ISMS offered alternative language that was eventually accepted by the APRNs. Our language:

Maintains the requirement that APRNs have a written collaborative agreement, unless the APRN receives substantial post-graduate training under the direct supervision of a physician (4,000 clinical training and 250 hours in additional educational/training components). The physician then must sign a written attestation confirming that the training was completed.

Does not change current practice within a hospital setting; APRNs must still be recommended for credentialing by the hospital medical staff.

Requires APRNs to maintain a formalized relationship with a physician that must be noted in the state’s prescription monitoring program (PMP) if that APRN wishes to prescribe schedule II opioids and benzodiazepines. The opioids to be prescribed must be specifically noted in the PMP and APRNs and the consulting physician must meet at least monthly to discuss the patient’s care.

Says that APRNs are prohibited from administering opiates via injection. APRNs are also prohibited from performing operative surgery.

Prohibits APRNs from advertising as “Dr.,” which is extremely misleading to patients. APRNs who have doctorate degrees must tell patients that they are not medical doctors or physicians.

Makes clear that CRNAs are not included in the agreement; nothing changes as to how CRNAs currently must practice.
In most other states, advanced practice nurses already have full practice authority to diagnose and treat patients including full prescriptive authority. Some 24 states and the District of Columbia don't require any physician involvement for APRNs to diagnose, treat, or prescribe. In addition to those, eight states allow APRNs to diagnose and treat independently but require physician involvement for APRNs to prescribe.

ISMS physicians are committed to ensuring that care is centered on each patient’s needs and that each patient receives high-quality care by a well-trained team of professionals. These important provisions will be amended to HB 313 in the Senate this week. We would not have been able to make these important changes without all of your assistance.

Please call Erin O’Brien at 217-757-3011 or email her at This email address is being protected from spambots. You need JavaScript enabled to view it. with questions about this matter.

Legislative Alert May 2017

PLEASE CALL YOUR STATE REPRESENTATIVE AND STATE SENATOR TODAY

AND URGE A THEM TO VOTE NO ON SENATE BILL 642
INDEPENDENT PRACTICE FOR ADVANCED PRACTICE NURSES

The Illinois Society for Advanced Practice Nursing has introduced and is lobbying for Senate Bill 642, which would remove the requirement that most APNs (does not include CRNAs) practicing outside of a hospital or ASTC maintain a collaborative agreement with a physician. Attached to this alert is our position paper, which has been distributed to every legislator.

Legislators asked ISMS to try to negotiate with the APNs. ISMS offered alternative language that would have provided for greater independence for APNs after meeting additional education and training requirements, but still would have a required a written practice agreement with a physician for prescriptions of Schedule II opioids and benzodiazepines as these drugs are extremely dangerous and highly abused. The ISMS alternative would have also prohibited from APNs from advertising as “Dr.,” which is extremely misleading to patients. The APNs rejected the proposal. They believe they should practice without any restrictions.

This bill would allow advanced practice nurses to provide the same level of care, completely independent from any physician collaboration, as family physicians, pediatricians, obstetricians, and other specialists.

Under their bill, APNs gain full prescriptive authority, including dangerous Schedule II drugs like opioids and benzodiazepines, without any physician input. This is not in the best interest of patients, particularly those who suffer from multiple medical conditions or require specialty care.

Allowing non-physician practitioners to expand their scope of practice through legislation rather than through education and training is not good public policy for improving access to quality care.

APNs will argue that they can fill a health care void in areas that suffer from physician shortages. This is not true. Research shows that in states where nurses practice independently, physicians and nurses continue to work in the same areas. Allowing the independent practice of APNs will not help solve the problem of health professional shortages in rural areas.

ISMS physicians are committed to ensuring that care is centered on each patient’s needs and that each patient receives high-quality care by a well-trained team of professionals. The APNs walked away from negotiations with ISMS. Please take time to contact your legislators and urge them to reject full independent practice for APNs. Urge them to vote NO on SB 642.


President Donald Trump
(202) 456-1111 (Capitol)

Vice President Mike Pence
(202) 456-1111 (Capitol)

Senator Dick Durbin
(202) 224-2152 (Capitol)

Senator Tammy Duckworth
(202) 224-2854 (Capitol)

Representative Peter Roskam
(202) 225-4561 (Capitol)

Governor Bruce Rauner
(217) 782-0244 (Capitol)

Lt. Governor Evelyn Sanguinetti
(217) 558-3085 (Capitol)

Secretary of State Jesse White
(217) 785-3000 (Capitol)

Attorney General Lisa Madigan
(217) 782-1090 (Capitol)

Treasurer Mike Frerichs
(217) 782-2211 (Capitol)

Comptroller Susana Mendoza
(217) 782-6000 (Capitol)

Senator Michael Connelly
(217) 782-8192 (Capitol)

Senator Chris Nybo
(217) 782-8148 (Capitol)

Representative Jeanne Ives
(217) 558-1037 (Capitol)

Representative Peter Breen
(217) 782-8037 (Capitol)

2017 Resolutions

DuPage County Medical Society Resolutions
2017 Illinois State Medical Society Annual Meeting

ADOPTED

Resolution C313 Lawsuit Transparency
Compels ISMS to urge legislation requiring that any party to a lawsuit must disclose financial transactions related to the suit from third-party sources.


Resolution C315 15-Month Prescriptions
Seeks change to Illinois law to allow prescriptions for non-controlled substances to be refilled for 15 months rather than the current 12 months.

ADOPTED AS AMENDED

Resolution C317 Amusement Park Rides
Directs ISMS to advocate for comprehensive oversight and regulation of amusement park and carnival rides in Illinois.

REAFFIRMS EXISTING POLICY

Resolution B207 Abolish Illinois Health Facilities and Services Review Board
ISMS policy already supports abolishing the Board and repealing all Certificate of Need laws.

Resolution C318 Substance Abuse Treatment
Called on ISMS to support treatment rather than punishment for persons struggling with substance abuse issues.

REFERRED FOR BOARD STUDY

Resolution B206 Transparency About Cost of Medical Services 
Asks ISMS to advocate for medical service price disclosures to patients so they can make better informed health and financial decisions.

Resolution C311 Bicycle Safety
Asks ISMS to advocate for improved biking safety measures, including helmet use, separation of bike lanes and better enforcement of traffic laws.

Resolution A100 House of Delegates Meeting Length
Directs ISMS to rethink the approach to the House of Delegates meeting to find ways to efficiently and effectively complete required business during a shortened session.

REFERRED FOR BOARD DECISION

Resolution C312 Hand Sanitizer Effectiveness
Directs ISMS to encourage studies to determine effectiveness and safety of anti-germ ingredients in topical hand sanitizers.

Resolution C314 For-Profit Medical Schools or Colleges
Calls on ISMS to conduct a study on the long-term viability of for-profit medical schools and the outlook for non-traditional medical education.



NOT ADOPTED

Resolution C309 Tax Exemption for Surviving Spouse of Disabled Veterans
Sought ISMS support for law to assure that property tax exemptions available to qualified disabled veterans extend to surviving spouses. Thought to be outside the scope of ISMS priorities.

Resolution C310 Reporting Acute Flaccid Myelitis
Called for mandatory reporting of Acute Flaccid Myelitis in Illinois and, nationally, to the CDC. Felt to be addressed by the CDC already.

Resolution C316 Railway Safety
Asked ISMS and the AMA to urge prompt implementation of the automatic electronically controlled braking system mandate for all trains. Felt there was little ISMS could do to further address this unfunded mandate.


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