Senate Bill No. 528
(By Senators Prezioso, Jenkins, Oliverio, Foster and Kessler)
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[Introduced February 10, 2010; referred to the Committee on
Health and Human Resources; and then to the Committee on
Government Organization.]
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A BILL to amend the Code of West Virginia, 1931, as amended, by
adding thereto a new article, designated §16-29C-1, §16-29C-2,
§16-29C-3, §16-29C-4 and §16-29C-5, all relating to the
creation of the Commission on the Scope of Practice in Health
Care Delivery; setting forth legislative findings;
establishing the membership of the commission; designating a
chairperson for the commission; setting forth the
qualifications of commission members; establishing the purpose
of the commission; setting forth the powers and duties of the
commission; setting forth reporting requirements of the
commission; requiring an annual report; establishing factors
for consideration in making recommendations regarding scope of
practice; setting forth applicability to specific professions
and occupations; and granting legislative rule-making
authority.
Be it enacted by the Legislature of West Virginia:
That the Code of West Virginia, 1931, as amended, be amended
by adding thereto a new article, designated §16-29C-1, §16-29C-2,
§16-29C-3, §16-29C-4 and §16-29C-5, all to read as follows:
ARTICLE 29C. COMMISSION ON SCOPE OF PRACTICE IN HEALTH CARE
DELIVERY.
§16-29C-1. Legislative findings.
The Legislature finds:
(1) That scope of practice issues for health care delivery is
a complex and often contentious process. Factors such as
fluctuations in the health care workforce and specific health
specialities, geographic and economic disparities in access to
health care services, economic incentives for health care
professionals and consumer demand influence the decision making
regarding the scope of practice across all health care disciplines.
(2) Health care is a dynamic industry and is constantly
evolving. Consequently, changes in the scope of practice are
inherent in the health care system. Practitioners do not work in
isolation. Collaboration between disciplines is crucial as most
professions share some skills or procedures with other professions.
The evolution of abilities of each health care discipline should,
therefore, be reflected in scope of practice modifications.
(3) The regulation of health care professions is designed to
protect the public and enhance consumer access to competent health care. Changes to the scope of practice need to be considered with
that in mind. However, changes to the scope of practice should
recognize the established history of the practice scope within the
profession, a recognition of the education and training received by
a particular health care discipline, evidence supporting the need
for a change to the scope of practice and the appropriate
regulatory environment.
(4) It is necessary to seek advice from within the health care
industry when making informed decisions regarding the scope of
practice of health care professions due to the complexities in
examining scope of practice issues. The Legislature needs solid
expert guidance on issues such as education levels, skills
training, adequate evidence supporting a modification and
sufficient regulation.
§16-29C-2. Creation of the Commission on the Scope of Practice in
Health Care Delivery; purpose.
(a) There is created the Commission on the Scope of Practice
in Health Care Delivery. The commission is an independent, self-
sustaining commission and shall have the powers and duties set
forth in this article. The commission is a part-time commission.
The administrative and ministerial duties of the commission shall
be administered and carried out by the Health Care Authority as set
forth in chapter sixteen, article twenty-nine-b of this code.
(b) The purpose of the commission is to make recommendations
to the Legislature regarding changes in scope of practice of any medical provider. The commission shall draw upon its expertise to
conduct an objective review of the existing scope of practice and
conduct an assessment of what, if any, additional expansion or
limitation should be implemented.
(c) Each member appointed to the commission shall devote the
time necessary to carry out the duties and obligations of the
commission. Those nongovernmental members appointed by the
Governor may pursue and engage in another business or occupation or
gainful employment that is not in conflict with the duties of the
commission.
(d) The commission is self-sustaining and independent,
however, it and its members are subject to article nine-a, chapter
six of this code and chapter six-b of this code.
§16-29C-3. Appointment of members of the commission; chairperson;
qualifications and eligibility; reimbursement for
expenses; meeting requirements.
(a) The commission shall be comprised of the chairperson of
the board of the Health Care Authority, the deans of the state's
three medical schools, or their designee, the President of the
State Medical Association, or his or her designee, the President of
the West Virginia Nurses Association, or his or her designee, the
President of the West Virginia Hospital Association, or his or her
designee, the President of the West Virginia Dental Association, or
his or her designee and the President of the West Virginia
Pharmacists Association, or his or her designee. The chairperson of the board of the Health Care Authority shall act as chairperson
of the commission.
(b) Commission members may not be compensated in their
capacity as members but shall be reimbursed for reasonable expenses
incurred in the performance of their duties.
(c) The commission shall meet within the state at such times
as the chair may decide, but at least once annually. The
commission shall also meet upon the call of five or more members
upon seventy-two hours written notice to each member.
(d) Five members of the commission are a quorum for the
transaction of business. A majority vote of the members present is
required for a final determination by the commission. Voting by
proxy is not allowed.
(e) The commission shall keep a complete and accurate record
of all its meetings according to section five, article nine-a,
chapter six of this code.
(f) The commission shall submit an annual report no later than
December 1 of each year to the Legislative Oversight Commission on
Health and Human Resources Accountability as set forth in article
twenty-nine-e, chapter sixteen of this code, on the workings of the
commission along with any recommendations for modification of and
discipline's scope of practice.
§16-29C-4. Powers and duties of the commission; factors for
consideration in making recommendations; rule-
making authority.
(a) The commission has general responsibility to make
recommendations to the Legislature regarding possible changes to
the scope of practice of any health care discipline. Any segment
of the health care field may submit requests to the commission at
any time to request a review and recommendation to the Legislature
on the expansion or limitation of the practice scope. The
commission may also on its own initiative recommend scope of
practice changes to the Legislature. A request to the commission
for review and recommendation of a scope of practice issue made
after the submission of the final report set forth in section three
above shall not be considered by the Legislature until the next
regular session.
(b) Prior to making any recommendation to the Legislature
regarding a scope of practice issue, the commission shall consider
the following factors:
(1) What is the current law regarding the scope of practice,
including legislative or procedural rules and minimum education and
training levels;
(2) Is there a need for scope of practice expansion or
limitation;
(3) Are there alternatives available within the existing
health care system, including a collaborative or supervised
practice option;
(4) What are the underlying factors prompting a change to the
scope of practice;
(5) What evidence exists to support the safety and
effectiveness of the proposed change to the scope of practice;
(6) What are the recommendations of national professional
organizations;
(7) How many practitioners may be affected by the change; and
(8) What are the anticipated outcomes of the proposed
modification to the scope of practice.
(c) In reviewing and making recommendations regarding the
scope of practice of any health care discipline, the commission
shall consult with the appropriate licensing boards to ascertain
any information the commission finds is necessary to render a
decision regarding the scope of practice. This would include
appropriate education and training levels, continuing education
requirements, licensing requirements, other regulatory requirements
of the discipline, the manner in which complaints and disciplinary
actions are conducted and whether there are liability concerns with
the potential expansion or limitation of the scope of practice.
(d) The Legislature is not bound by the recommendation of the
commission. Upon receipt of any recommendation, the Legislature
may adopt the recommendation as presented, reject the
recommendation as presented or amend the recommendation.
(e) The commission shall propose rules for legislative
approval in accordance with the provisions of article three,
chapter twenty-nine-a of this code to set forth the procedure for
review and recommendation of scope of practice issues. These rules shall include, at a minimum:
(1) Notice to the public of any meetings and issues under
consideration by the commission;
(2) A procedure for the solicitation of public input on the
expansion or limitation of the scope of practice of any health care
discipline; and
(3) Appropriate time lines for action by the commission in
making recommendations to the Legislature both while the
Legislature is in session and also during the legislative interim.
§16-29C-5. Applicability.
In addition to the requirements of section two, article one-a,
chapter thirty of this code, all health care professions and
occupations regulated pursuant to the provisions of chapter thirty
of this code shall be subject to the requirements of this article.
These shall include, but are not limited to, physicians, dentists,
dental hygienists, physician assistants, pharmacists, pharmacy
technicians, registered professional nurses, practical nurses,
optometrists, chiropodists, podiatrists, osteopathic physicians and
surgeons, assistants to osteopathic physicians and surgeons, nurse-
midwives, chiropractors, physical therapists, psychologists,
radiologic technologists, respiratory care practitioners,
dietitians, acupuncturists and massage therapists.
NOTE: The purpose of this bill is to establish a commission to
make recommendations to the Legislature on the scope of practice of
health care professions. The bill sets for the commission
membership, powers and duties of the commission and factors for consideration by the commission in making recommendations regarding
expansion or limitation of the scope of practice of any health care
discipline.
This article is new; therefore, strike-throughs and
underscoring have been omitted.
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