ENROLLED
COMMITTEE SUBSTITUTE
FOR
H. B. 4108
(By Delegates Browning, Staton, Long and Michael)
[Passed March 11, 2006; in effect ninety days from passage.]
AN ACT
to amend and reenact §30-14A-1 of the Code of West Virginia,
1931 as amended, relating to osteopathic physician assistants;
allowing an osteopathic physician and surgeon to supervise up
to three physician assistants generally; and providing for
legislative and emergency rule-making authority.
Be it enacted by the Legislature of West Virginia:
That
§30-14A-1 of the Code of West Virginia, 1931, as amended,
be amended and reenacted to read as follows:
ARTICLE 14A. ASSISTANTS TO OSTEOPATHIC PHYSICIANS AND SURGEONS.
§30-14A-1. Osteopathic physician assistant to osteopathic
physicians and surgeons; definitions; board of
osteopathy rules; certification; temporary
certification; recertification; job description
required; revocation or suspension of certification;
responsibilities of the supervising physician; legal responsibility for osteopathic physician assistants;
reporting of disciplinary procedures;
identification; limitation on employment and duties;
fees; unlawful use of the title of "osteopathic
physician assistant"; unlawful representation of an
osteopathic physician assistant as a physician;
criminal penalties.
(a) As used in this section:
(1) "Osteopathic physician assistant" means an assistant to an
osteopathic physician who is a graduate of an approved program of
instruction in primary care or surgery, has passed the national
certification examination and is qualified to perform direct
patient care services under the supervision of an osteopathic
physician;
(2) "Supervising physician" means a doctor of osteopathy
permanently licensed in this state who assumes legal and
supervising responsibility for the work or training of any
osteopathic physician assistant under his or her supervision;
(3) "Approved program" means an educational program for
osteopathic physician assistants approved and accredited by the
committee on allied health education and accreditation or its
successor;
(4) "Health care facility" means any licensed hospital,
nursing home, extended care facility, state health or mental
institution, clinic or physician's office; and
(5) "Direct supervision" means the presence of the supervising
physician at the site where the osteopathic physician assistant
performs medical duties.
(b) The board shall promulgate legislative and emergency rules
governing the extent to which osteopathic physician assistants may
function in this state. Such rules shall provide that the
osteopathic physician assistant is limited to the performance of
those services for which he or she is trained and that he or she
performs only under the supervision and control of an osteopathic
physician permanently licensed in this state, but such supervision
and control does not require the personal presence of the
supervising physician at the place or places where services are
rendered if the osteopathic physician assistant's normal place of
employment is on the premises of the supervising physician. The
supervising physician may send the osteopathic physician assistant
off the premises to perform duties under his or her direction, but
a separate place of work for the osteopathic physician assistant
shall not be established. In promulgating such rules, the board
may allow the osteopathic physician assistant to perform those
procedures and examinations and in the case of authorized
osteopathic physician assistants to prescribe at the direction of
his or her supervising physician in accordance with subsection (o)
of this section those categories of drugs submitted to it in the
job description required by subsection (e) of this section. The
board shall compile and publish an annual report that includes a
list of currently certified osteopathic physician assistants and their employers and location in the state.
(c) The board shall certify as an osteopathic physician
assistant any person who files an application and furnishes
satisfactory evidence to it that he or she has met the following
standards:
(1) He or she is a graduate of an approved program of
instruction in primary health care or surgery;
(2) He or she has passed the examination for a primary care
physician assistant or surgery administered by the national board
of medical examiners on behalf of the national commission on
certification of physician assistants; and
(3) He or she is of good moral character.
(d) When any graduate of an approved program submits an
application to the board, accompanied by a job description in
conformity with subsection (e) of this section, for an osteopathic
physician assistant certificate, the board may issue to such
applicant a temporary certificate allowing such applicant to
function as an osteopathic physician assistant for the period of
one year. Said temporary certificate may be renewed for one
additional year upon the request of the supervising physician. An
osteopathic physician assistant who has not been certified as such
by the national board of medical examiners on behalf of the
national commission on certification of physician assistants will
be restricted to work under the direct supervision of the
supervising physician.
(e) Any osteopathic physician applying to the board to supervise an osteopathic physician assistant shall provide a job
description that sets forth the range of medical services to be
provided by such assistant. Before an osteopathic physician
assistant can be employed or otherwise use his or her skills, the
supervising physician must obtain approval of the job description
from the board. The board may revoke or suspend any certification
of an assistant to a physician for cause, after giving such person
an opportunity to be heard in the manner provided by sections eight
and nine, article one of this chapter.
(f) The supervising physician is responsible for observing,
directing and evaluating the work records and practices of each
osteopathic physician assistant performing under his or her
supervision. He or she shall notify the board in writing of any
termination of his or her supervisory relationship with an
osteopathic physician assistant within ten days of his or her
termination. The legal responsibility for any osteopathic
physician assistant remains with the supervising physician at all
times, including occasions when the assistant, under his or her
direction and supervision, aids in the care and treatment of a
patient in a health care facility. In his or her absence, a
supervising physician must designate an alternate supervising
physician; however, the legal responsibility remains with the
supervising physician at all times. A health care facility is not
legally responsible for the actions or omissions of an osteopathic
physician assistant unless the osteopathic physician assistant is
an employee of the facility.
(g) The acts or omissions of an osteopathic physician
assistant employed by health care facilities providing inpatient
services shall be the legal responsibility of said facilities.
Osteopathic physician assistants employed by such facilities in
staff positions shall be supervised by a permanently licensed
physician.
(h) A health care facility shall report in writing to the
board within sixty days after the completion of the facility's
formal disciplinary procedure, and also after the commencement, and
again after the conclusion, of any resulting legal action, the name
of any osteopathic physician assistant practicing in the facility
whose privileges at the facility have been revoked, restricted,
reduced or terminated for any cause including resignation, together
with all pertinent information relating to such action. The health
care facility shall also report any other formal disciplinary
action taken against any osteopathic physician assistant by the
facility relating to professional ethics, medical incompetence,
medical malpractice, moral turpitude or drug or alcohol abuse.
Temporary suspension for failure to maintain records on a timely
basis or failure to attend staff or section meetings need not be
reported.
(i) When functioning as an osteopathic physician assistant,
the osteopathic physician assistant shall wear a name tag that
identifies him or her as a physician assistant.
(j) (1) A supervising physician shall not supervise at any
time more than three osteopathic physician assistants, except that a physician may supervise up to four hospital-employed osteopathic
physician assistants: Provided, That an alternative supervisor has
been designated for each.
(2) An osteopathic physician assistant shall not perform any
service that his or her supervising physician is not qualified to
perform.
(3) An osteopathic physician assistant shall not perform any
service that is not included in his or her job description and
approved by the board as provided for in this section.
(4) The provisions of this section do not authorize an
osteopathic physician assistant to perform any specific function or
duty delegated by this code to those persons licensed as
chiropractors, dentists, registered nurses, licensed practical
nurses, dental hygienists, optometrists or pharmacists or certified
as nurse anesthetists.
(k) Each job description submitted by a licensed osteopathic
supervising physician shall be accompanied by a fee of one hundred
dollars. A fee of fifty dollars shall be charged for the annual
renewal of the certificate. A fee of twenty-five dollars shall be
charged for any change of supervising physician.
(l) As a condition of renewal of osteopathic physician
assistant certification, each osteopathic physician assistant shall
provide written documentation satisfactory to the board of
participation in and successful completion of continuing education
in courses approved by the board of osteopathy for the purposes of
continuing education of osteopathic physician assistants.
The osteopathy board shall promulgate legislative rules for minimum
continuing hours necessary for certification renewal. These rules
shall provide for minimum hours equal to or more than the hours
necessary for national certification.
Notwithstanding any provision
of this chapter to the contrary, failure to timely submit such
required written documentation shall result in the automatic
suspension of any certification as an osteopathic physician
assistant until such time as the written documentation is submitted
to and approved by the board.
(m) It is unlawful for any person who is not certified by the
board as an osteopathic physician assistant to use the title of
"osteopathic physician assistant" or to represent to any other
person that he or she is an osteopathic physician assistant. Any
person who violates the provisions of this subsection is guilty of
a misdemeanor, and, upon conviction thereof, shall be fined not
more than two thousand dollars.
(n) It is unlawful for any osteopathic physician assistant to
represent to any person that he or she is a physician. Any person
who violates the provisions of this subsection is guilty of a
felony, and, upon conviction thereof, shall be imprisoned in the
penitentiary for not less than one, nor more than two years, or be
fined not more than two thousand dollars, or both fined and
imprisoned.
(o) An osteopathic physician assistant providing primary care
outpatient services in a medically underserved area or other area
of need, both as defined by the board, may write or sign prescriptions or transmit prescriptions by word of mouth, telephone
or other means of communication at the direction of his or her
supervising physician. The board shall promulgate rules and
regulations governing the eligibility and extent to which such an
osteopathic physician assistant may prescribe at the direction of
the supervising physician. The regulations shall provide for a
state formulary classifying pharmacologic categories of drugs which
may be prescribed by such an osteopathic physician assistant. In
classifying such pharmacologic categories, those categories of
drugs which shall be excluded shall include, but not be limited to,
Schedules I and II of the uniform controlled substances act,
anticoagulants, antineoplastics, antipsychotics,
radiopharmaceuticals, general anesthetics and radiographic contrast
materials. Drugs listed under Schedule III shall be limited to a
forty-eight hour supply without refill. The regulations shall
provide that all pharmacological categories of drugs to be
prescribed by an osteopathic physician assistant shall be listed in
each job description submitted to the board as required in
subsection (e) of this section. The regulations shall provide the
maximum dosage an osteopathic physician assistant may prescribe.
The regulations shall also provide that to be eligible for
such prescription privileges, an osteopathic physician assistant
must submit an application to the board for such privileges. The
regulations shall also provide that an osteopathic physician
assistant shall have performed patient care services for a minimum
of two years immediately preceding the submission to the board of said application for prescription privileges and shall have
successfully completed an accredited course of instruction in
clinical pharmacology approved by the board. The regulations shall
also provide that to maintain prescription privileges, an
osteopathic physician assistant shall continue to maintain national
certification as an osteopathic physician assistant, and in
meeting such national certification requirements shall complete a
minimum of ten hours of continuing education in rational drug
therapy in each certification period. Nothing in this subsection
shall be construed to permit an osteopathic physician assistant to
independently prescribe or dispense drugs.