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LRBs0204/1
MED:kjf
2017 - 2018 LEGISLATURE
ASSEMBLY SUBSTITUTE AMENDMENT 1,
TO ASSEMBLY BILL 582
December 19, 2017 - Offered by Representative Murphy.
AB582-ASA1,1,8 1An Act to renumber 448.05 (5) (a) 1. and 2.; to renumber and amend 448.05
2(5) (a) (intro.); to amend 441.16 (6), 448.01 (6), 448.20 (1), 448.21 (1) (d), 448.21
3(2), 448.21 (3) and Med 8.01 (2); and to create 448.015 (1u), 448.015 (1w),
4448.20 (3m), 448.21 (4), 448.62 (2m), 448.62 (7) and 448.695 (4) of the statutes;
5relating to: delegation of the practice of podiatry, practice of a physician
6assistant under the supervision of a podiatrist, modifying administrative rules
7of the Medical Examining Board relating to practice of physician assistants,
8and providing an exemption from emergency rule procedures.
Analysis by the Legislative Reference Bureau
Generally, under current law, no person may practice podiatry unless the
person is licensed as a podiatrist. This substitute amendment creates an exception
to this prohibition for an advanced practice nurse prescriber who is providing
nonsurgical patient services as directed, supervised, and inspected by a podiatrist.
The substitute amendment also modifies various provisions governing the
practice of physician assistants that require a physician assistant to be supervised
by a physician to instead allow for supervision of a physician assistant by a

podiatrist. The substitute amendment allows a physician assistant who is under the
supervision of a podiatrist to engage in the practice of podiatry, except that, like an
advanced practice nurse prescriber, the practice of the physician assistant is limited
to providing nonsurgical patient services. The substitute amendment allows the
Podiatry Affiliated Credentialing Board to promulgate rules regarding the practice
of podiatry by physician assistants.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB582-ASA1,1 1Section 1 . 441.16 (6) of the statutes is amended to read:
AB582-ASA1,2,52 441.16 (6) Nothing in this section prohibits a nurse from issuing a prescription
3order as an act delegated by a physician, and nothing in this section prohibits an
4advanced practice nurse certified under this section from issuing a prescription order
5as an act delegated by a podiatrist
.
AB582-ASA1,2 6Section 2 . 448.01 (6) of the statutes is amended to read:
AB582-ASA1,2,97 448.01 (6) “Physician assistant" means an individual licensed by the medical
8examining board to provide medical care with physician supervision and direction
9or to practice podiatry with podiatrist supervision and direction.
AB582-ASA1,3 10Section 3 . 448.015 (1u) of the statutes is created to read:
AB582-ASA1,2,1111 448.015 (1u) “Podiatrist" has the meaning given in s. 448.60 (3).
AB582-ASA1,4 12Section 4 . 448.015 (1w) of the statutes is created to read:
AB582-ASA1,2,1313 448.015 (1w) “Podiatry" has the meaning given in s. 448.60 (4).
AB582-ASA1,5 14Section 5 . 448.05 (5) (a) (intro.) of the statutes is renumbered 448.05 (5) (a)
15and amended to read:
AB582-ASA1,2,1816 448.05 (5) (a) The Except as provided in s. 448.695 (4), the board shall
17promulgate rules establishing licensing standards and practice standards for
18physician assistants and shall license persons under those rules.
AB582-ASA1,3,2
1(b) The board may not grant a license as a physician assistant to an applicant
2unless the applicant submits evidence satisfactory to the board of all of the following:
AB582-ASA1,6 3Section 6 . 448.05 (5) (a) 1. and 2. of the statutes are renumbered 448.05 (5)
4(b) 1. and 2.
AB582-ASA1,7 5Section 7 . 448.20 (1) of the statutes is amended to read:
AB582-ASA1,3,166 448.20 (1) Recommend licensing and practice standards. The council on
7physician assistants shall develop and recommend to the examining board licensing
8and practice standards for physician assistants practicing under physicians and
9shall develop and recommend to the podiatry affiliated credentialing board practice
10standards for physician assistants practicing under podiatrists
. In developing the
11standards, the council shall consider the following factors: an individual's training,
12wherever given; experience, however acquired, including experience obtained in a
13hospital, a physician's or podiatrist's office, the armed services or the federal health
14service of the United States, or their equivalent as found by the examining board; and
15education, including that offered by a medical school and the technical college system
16board.
AB582-ASA1,8 17Section 8 . 448.20 (3m) of the statutes is created to read:
AB582-ASA1,3,2018 448.20 (3m) Advise podiatry affiliated credentialing board. The council
19shall advise the podiatry affiliated credentialing board on revising practice
20standards for physician assistants practicing podiatry.
AB582-ASA1,9 21Section 9 . 448.21 (1) (d) of the statutes is amended to read:
AB582-ASA1,3,2422 448.21 (1) (d) The practice of podiatry within the meaning of s. 448.60 (4),
23except when the physician assistant is acting under the supervision and direction of
24a podiatrist, subject to sub. (4) and the rules promulgated under s. 448.695 (4)
.
AB582-ASA1,10 25Section 10 . 448.21 (2) of the statutes is amended to read:
AB582-ASA1,4,6
1448.21 (2) Employee status. No physician assistant may be self-employed.
2The employer of a physician assistant shall assume legal responsibility for any
3medical care, including the practice of podiatry, provided by the physician assistant
4during the employment. The employer of a physician assistant, if other than a
5licensed physician or podiatrist, shall provide for and not interfere with supervision
6of the physician assistant by a licensed physician or podiatrist.
AB582-ASA1,11 7Section 11 . 448.21 (3) of the statutes is amended to read:
AB582-ASA1,4,128 448.21 (3) Prescriptive authority. A physician assistant may issue a
9prescription order for a drug or device in accordance with guidelines established by
10a supervising physician or podiatrist and the physician assistant and with rules
11promulgated by the board. If any conflict exists between the guidelines and the rules,
12the rules shall control.
AB582-ASA1,12 13Section 12 . 448.21 (4) of the statutes is created to read:
AB582-ASA1,4,1614 448.21 (4) Practice of podiatry. A physician assistant who is acting under the
15supervision and direction of a podiatrist shall be limited to providing nonsurgical
16patient services.
AB582-ASA1,13 17Section 13. 448.62 (2m) of the statutes is created to read:
AB582-ASA1,4,2118 448.62 (2m) An advanced practice nurse who is certified to issue prescription
19orders under s. 441.16 and who is providing nonsurgical patient services as directed,
20supervised, and inspected by a podiatrist who has the power to direct, decide, and
21oversee the implementation of the patient services rendered.
AB582-ASA1,14 22Section 14 . 448.62 (7) of the statutes is created to read:
AB582-ASA1,4,2423 448.62 (7) A physician assistant who is acting under the supervision and
24direction of a podiatrist, subject to s. 448.21 (4).
AB582-ASA1,15 25Section 15 . 448.695 (4) of the statutes is created to read:
AB582-ASA1,5,2
1448.695 (4) The affiliated credentialing board shall promulgate rules
2establishing all of the following:
AB582-ASA1,5,43 (a) Practice standards for a physician assistant practicing podiatry as provided
4in s. 448.21 (4).
AB582-ASA1,5,65 (b) Requirements for a podiatrist who is supervising a physician assistant as
6provided in s. 448.21 (4).
AB582-ASA1,16 7Section 16 . Med 8.01 (2) of the statutes is amended to read:
AB582-ASA1,5,178 Med 8.01 (2) Physician assistants provide health care services as part of
9physician-led or podiatrist-led teams, the objectives of which include safe, efficient,
10and economical health care. The realities of the modern practice of medicine and
11surgery require supervising physicians and podiatrists and physician assistants to
12use discretion in delivering health care services, typically at the level of general
13supervision. The constant physical presence of a supervising physician or podiatrist
14is often unnecessary. The supervising physician or podiatrist and the physician
15assistant are jointly responsible for employing more intensive supervision when
16circumstances require direct observation or hands-on assistance from the
17supervising physician.
AB582-ASA1,17 18Section 17 . Med 8.02 (5x) of the administrative code is created to read:
AB582-ASA1,5,1919 Med 8.02 (5x) “Podiatrist” has the meaning given in s. 448.60 (3), Stats.
AB582-ASA1,18 20Section 18 . Med 8.05 (4) of the administrative code is amended to read:
AB582-ASA1,5,2421 Med 8.05 (4) Licensure; renewal. At the time of licensure and each biennial
22registration of licensure thereafter, a physician assistant shall list with the board the
23name and address of the supervising physician or podiatrist and shall notify the
24board within 20 days of any change of a supervising physician or podiatrist.
AB582-ASA1,19
1Section 19. Med 8.07 (1), (2) (i) and (3) of the administrative code are amended
2to read:
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