Rep. Norm Thurston — Voting Record

Bill

Number

S.B. 162 (2017GS)

Sponsor

Sen. Shiozawa, B.

Final action

Governor Signed 3/23/2017

Outcome

Became law — signed by Gov. Gary R. Herbert

Summary

What it does

• This bill:
• amends the requirements of a delegation of services agreement;
• removes the requirement that a physician assistant obtain a co-signature on a chart medical record of a prescription from the supervising physician to prescribe certain controlled substances;
• amends requirements for licensure; and
• makes technical changes.

Every vote on this bill

Bill text

PHYSICIAN ASSISTANT AMENDMENTS
GENERAL SESSION
STATE OF UTAH
Chief Sponsor: Brian E. Shiozawa
House Sponsor: 
Michael S. Kennedy
LONG TITLE
General Description:
This bill amends the Physician Assistant Act.
Highlighted Provisions:
This bill:
▸ amends the requirements of a delegation of services agreement;
▸ removes the requirement that a physician assistant obtain a co-signature on a chart
medical record of a prescription from the supervising physician to prescribe certain
controlled substances;
▸ amends requirements for licensure; and
▸ makes technical changes.
Money Appropriated in this Bill:
None
Other Special Clauses:
None
Utah Code Sections Affected:
AMENDS:
58-70a-102
, as enacted by Laws of Utah 1997, Chapter 229
58-70a-301
, as enacted by Laws of Utah 1997, Chapter 229
58-70a-302
, as last amended by Laws of Utah 2010, Chapter 37
58-70a-501
, as last amended by Laws of Utah 1998, Chapter 38
58-70a-503
, as last amended by Laws of Utah 2014, Chapter 72
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 
58-70a-102
 is amended to read:
58-70a-102.
Definitions.
In addition to the definitions in Section 
58-1-102
, as used in this chapter:
(1) "Board" means the Physician Assistant Licensing Board created in Section
58-70a-201
.
(2) (a) "Delegation of services agreement" means written criteria jointly developed by a
physician assistant's supervising physician and [
any
] substitute supervising physicians and the
physician assistant, that permits a physician assistant, working under the direction or review of
the supervising physician, to assist in the management of common illnesses and injuries.
(b) The agreement defines the working relationship and delegation of duties between
the supervising physician and the physician assistant as specified by division rule and shall
include:
(i) the prescribing of controlled substances;
(ii) the degree and means of supervision;
(iii) the frequency and mechanism of [
chart review
] 
quality review, including the
mechanism for review of patient data and documentation of the review, as determined by the
supervising physician and the physician assistant
;
(iv) procedures addressing situations outside the scope of practice of the physician
assistant; and
(v) procedures for providing backup for the physician assistant in emergency situations.
(3) "Direct supervision" means the supervising physician is:
(a) physically present at the point of patient treatment on site where the physician
assistant he is supervising is practicing; and
(b) immediately available for consultation with the physician assistant.
(4) "Practice as a physician assistant" means:
(a) the professional activities and conduct of a physician assistant
, also known as a PA,
in diagnosing, treating, advising, or prescribing for any human disease, ailment, injury, infirmity,
deformity, pain, or other condition, dependent upon and under the supervision of a supervising
physician or substitute supervising physician in accordance with a delegation of services
agreement; and
(b) the physician assistant acts as the agent of the supervising physician or substitute
supervising physician when acting in accordance with a delegation of services agreement.
(5) "Substitute supervising physician" means an individual who meets the requirements
of a supervising physician under this chapter and acts as the supervising physician in the absence
of the supervising physician.
(6) "Supervising physician" means an individual who:
(a) is currently licensed to practice under Title 58, Chapter 67, Utah Medical Practice
Act, or Title 58, Chapter 68, Utah Osteopathic Medical Practice Act;
(b) acts as the primary supervisor of a physician assistant and takes responsibility for the
professional practice and conduct of a physician assistant in accordance with this chapter; and
(c) is not an employee of the physician assistant [
he
] 
whom the individual
 supervises.
(7) "Supervision" means the supervising physician is available for consultation with the
physician assistant, either personally or by other means permitting direct verbal communication
between the physician and 
the
 physician assistant.
(8) "Unlawful conduct" is as defined in Sections 
58-1-501
 and 
58-70a-502
.
(9) "Unprofessional conduct" is as defined in Sections 
58-1-501
 and 
58-70a-503
 and as
may be further defined by rule.
Section 2. Section 
58-70a-301
 is amended to read:
58-70a-301.
Licensure required -- License classifications.
(1) A license is required to engage in practice as a physician assistant, except as
specifically provided in Section 
58-70a-305
 or 
58-1-307
.
(2) The division shall issue to [
a person
] 
an individual
 who qualifies under this chapter a
license in the classification of physician assistant.
Section 3. Section 
58-70a-302
 is amended to read:
58-70a-302.
Qualifications for licensure.
Each applicant for licensure as a physician assistant shall:
(1) submit an application in a form prescribed by the division;
(2) pay a fee determined by the department under Section 
63J-1-504
;
(3) be of good moral character;
(4) have successfully completed a physician assistant program accredited by the:
(a) Accreditation Review Commission on Education for the Physician Assistant; or
(b) if prior to January 1, 2001, either the:
(i) Committee on Accreditation of Allied Health Education Programs; or
(ii) Committee on Allied Health Education and Accreditation;
(5) have passed the licensing examinations required by division rule made in
collaboration with the board;
(6) meet with the board and representatives of the division, if requested, for the purpose
of evaluating the applicant's qualifications for licensure; and
(7) (a) if the applicant desires to practice in Utah, complete a form provided by the
division indicating:
(i) the applicant has completed a delegation of services agreement signed by the
physician assistant[
,
] 
and the
 supervising physician[
, and substitute supervising physicians
]; and
(ii) the agreement is on file at the Utah practice sites; or
(b) complete a form provided by the division indicating the applicant is not practicing in
Utah and, prior to practicing in Utah, the applicant will meet the requirements of Subsection
(7)(a).
Section 4. Section 
58-70a-501
 is amended to read:
58-70a-501.
Scope of practice.
(1) A physician assistant may provide any medical services that are not specifically
prohibited under this chapter or rules adopted under this chapter, and that are:
(a) within the physician assistant's skills and scope of competence;
(b) within the usual scope of practice of the physician assistant's supervising physician;
and
(c) provided under the supervision of a supervising physician and in accordance with a
delegation of services agreement.
(2) A physician assistant, in accordance with a delegation of services agreement, may
prescribe or administer an appropriate controlled substance if:
(a) the physician assistant holds a Utah controlled substance license and a DEA
registration; 
and
(b) the prescription or administration of the controlled substance is within the
prescriptive practice of the supervising physician and also within the delegated prescribing
stated in the delegation of services agreement[
; and
]
.
[
(c) the supervising physician cosigns any medical chart record of a prescription of a
Schedule 2 or Schedule 3 controlled substance made by the physician assistant.
]
(3) A physician assistant shall, while practicing as a physician assistant, wear an
identification badge showing [
his
] 
the physician assistant's
 license classification as a [
practicing
]
physician assistant.
(4) A physician assistant may not:
(a) independently charge or bill a patient, or others on behalf of the patient, for services
rendered;
(b) identify himself 
or herself
 to any person in connection with activities allowed under
this chapter other than as a physician assistant; or
(c) use the title "doctor" or "physician," or by any knowing act or omission lead or
permit anyone to believe [
he
] 
the physician assistant
 is a physician.
Section 5. Section 
58-70a-503
 is amended to read:
58-70a-503.
Unprofessional conduct.
"Unprofessional conduct" includes:
(1) violation of a patient confidence to any person who does not have a legal right and a
professional need to know the information concerning the patient;
(2) knowingly prescribing, selling, giving away, or directly or indirectly administering,
or offering to prescribe, sell, furnish, give away, or administer any prescription drug except for a
legitimate medical purpose upon a proper diagnosis indicating use of that drug in the amounts
prescribed or provided;
(3) prescribing prescription drugs for [
himself
] 
oneself
 or administering prescription
drugs to [
himself
] 
oneself
, except those that have been legally prescribed for [
him
] 
the physician
assistant
 by a licensed practitioner and that are used in accordance with the prescription order
for the condition diagnosed;
(4) failure to maintain at the practice site a delegation of services agreement that
accurately reflects current practices;
(5) failure to make the delegation of services agreement available to the division for
review upon request;
(6) in a practice that has physician assistant ownership interests, failure to allow the
supervising physician the independent final decision making authority on patient treatment
decisions, as set forth in the delegation of services agreement or as defined by rule; and
(7) violating the dispensing requirements of Chapter 17b, Part 8, Dispensing Medical
Practitioner and Dispensing Medical Practitioner Clinic Pharmacy, if applicable.