Amendment SSA1-SB515

SB515-SSA1,33 Section 33. 448.03 (2) (a) of the statutes is amended to read:

SB515-SSA1,10,17 448.03 (2) (a) Any person lawfully practicing within the scope of a license, permit, registration, certificate or certification granted to practice midwifery under subch. XIII of ch. 440, to practice professional or practical nursing or nurse-midwifery under ch. 441, to practice chiropractic under ch. 446, to practice dentistry or dental hygiene under ch. 447, to practice optometry under ch. 449, to practice as a physician assistant under subch. VIII, to practice acupuncture under ch. 451 or under any other statutory provision, or as otherwise provided by statute.

SB515-SSA1,34 Section 34. 448.03 (2) (e) of the statutes is amended to read:

SB515-SSA1,10,22 448.03 (2) (e) Any person other than a physician assistant or an anesthesiologist assistant who is providing patient services as directed, supervised and inspected by a physician who has the power to direct, decide and oversee the implementation of the patient services rendered.

SB515-SSA1,35 Section 35. 448.03 (2) (k) of the statutes is amended to read:

SB515-SSA1,10,25 448.03 (2) (k) Any persons, other than physician assistants, anesthesiologist assistants, or perfusionists, who assist physicians.

SB515-SSA1,36 Section 36. 448.03 (3) (e) of the statutes is repealed.

SB515-SSA1,37 Section 37 . 448.03 (5) (b) of the statutes is amended to read:

SB515-SSA1,11,4 448.03 (5) (b) No physician or physician assistant shall be liable for any civil damages for either of the following:

SB515-SSA1,11,8 1. Reporting in good faith to the department of transportation under s. 146.82 (3) a patient's name and other information relevant to a physical or mental condition of the patient which in the physician's or physician assistant's judgment impairs the patient's ability to exercise reasonable and ordinary control over a motor vehicle.

SB515-SSA1,11,13 2. In good faith, not reporting to the department of transportation under s. 146.82 (3) a patient's name and other information relevant to a physical or mental condition of the patient which in the physician's or physician assistant's judgment does not impair the patient's ability to exercise reasonable and ordinary control over a motor vehicle.

SB515-SSA1,38 Section 38 . 448.035 (2) to (4) of the statutes are amended to read:

SB515-SSA1,12,3 448.035 (2) Notwithstanding the requirements of s. 448.30, a physician, physician assistant, or certified advanced practice nurse prescriber may provide expedited partner therapy if the patient is diagnosed as infected with a chlamydial infection, gonorrhea, or trichomoniasis and the patient has had sexual contact with a sexual partner during which the chlamydial infection, gonorrhea, or trichomoniasis may have been transmitted to or from the sexual partner. The physician, physician assistant, or certified advanced practice nurse prescriber shall attempt to obtain the name of the patient's sexual partner. A prescription order for an antimicrobial drug prepared under this subsection shall include the name and address of the patient's sexual partner, if known. If the physician , physician assistant, or certified advanced practice nurse prescriber is unable to obtain the name of the patient's sexual partner, the prescription order shall include, in ordinary bold-faced capital letters, the words, “expedited partner therapy" or the letters “EPT."

SB515-SSA1,12,8 (3) The physician, physician assistant, or certified advanced practice nurse prescriber shall provide the patient with a copy of the information sheet prepared by the department of health services under s. 46.03 (44) and shall request that the patient give the information sheet to the person with whom the patient had sexual contact.

SB515-SSA1,12,13 (4) (a) Except as provided in par. (b), a physician , physician assistant, or certified advanced practice nurse prescriber is immune from civil liability for injury to or the death of a person who takes any antimicrobial drug if the antimicrobial drug is prescribed, dispensed, or furnished under this section and if expedited partner therapy is provided as specified under this section.

SB515-SSA1,12,17 (b) The immunity under par. (a) does not extend to the donation, distribution, furnishing, or dispensing of an antimicrobial drug by a physician , physician assistant, or certified advanced practice nurse prescriber whose act or omission involves reckless, wanton, or intentional misconduct.

SB515-SSA1,39 Section 39 . 448.037 (2) (a) (intro.) and (b) and (3) of the statutes are amended to read:

SB515-SSA1,12,21 448.037 (2) (a) (intro.) A physician or physician assistant may do any of the following:

SB515-SSA1,13,3 (b) A physician or physician assistant who prescribes or delivers an opioid antagonist under par. (a) 1. shall ensure that the person to whom the opioid antagonist is prescribed has or has the capacity to provide the knowledge and training necessary to safely administer the opioid antagonist to an individual undergoing an opioid-related overdose and that the person demonstrates the capacity to ensure that any individual to whom the person further delivers the opioid antagonist has or receives that knowledge and training.

SB515-SSA1,13,9 (3) A physician or physician assistant who, acting in good faith, prescribes or delivers an opioid antagonist in accordance with sub. (2), or who, acting in good faith, otherwise lawfully prescribes or dispenses an opioid antagonist, shall be immune from criminal or civil liability and may not be subject to professional discipline under s. 448.02 for any outcomes resulting from prescribing, delivering, or dispensing the opioid antagonist.

SB515-SSA1,40 Section 40. 448.04 (1) (f) of the statutes is repealed.

SB515-SSA1,41 Section 41. 448.05 (5) of the statutes is repealed.

SB515-SSA1,42 Section 42. 448.20 of the statutes is repealed.

SB515-SSA1,43 Section 43. 448.21 of the statutes is repealed.

SB515-SSA1,44 Section 44. 448.40 (2) (f) of the statutes is repealed.

SB515-SSA1,45 Section 45 . 448.62 (7) of the statutes is amended to read:

SB515-SSA1,13,18 448.62 (7) A physician assistant who is acting under the supervision and direction of a podiatrist, subject to s. 448.21 (4) 448.975 (2) (a) 2m., or an individual to whom the physician assistant delegates a task or order under s. 448.975 (4).

SB515-SSA1,46 Section 46 . 448.695 (4) (a) and (b) of the statutes are amended to read:

SB515-SSA1,13,21 448.695 (4) (a) Practice standards for a physician assistant practicing podiatry as provided in s. 448.21 (4) 448.975 (2) (a) 2m.

SB515-SSA1,13,23 (b) Requirements for a podiatrist who is supervising a physician assistant as provided in s. 448.21 (4) 448.975 (2) (a) 2m.

SB515-SSA1,47 Section 47 . 448.970 of the statutes is renumbered 448.9695.

SB515-SSA1,48 Section 48. Subchapter VIII of chapter 448 [precedes 448.971] of the statutes is created to read:

SB515-SSA1,14,3 CHAPTER 448

SB515-SSA1,14,4 SUBCHAPTER VIII

SB515-SSA1,14,5 Physician assistant affiliated

SB515-SSA1,14,6 credentialing board

SB515-SSA1,14,8 448.971 Definitions. In this subchapter, unless the context requires otherwise:

SB515-SSA1,14,9 (1) “Board" means the physician assistant affiliated credentialing board.

SB515-SSA1,14,12 (2) “Disease” means any pain, injury, deformity, or physical or mental illness or departure from complete health or the proper condition of the human body or any of its parts.

SB515-SSA1,14,13 (3) “Physician assistant” means a person licensed under this subchapter.

SB515-SSA1,14,14 (4) “Podiatrist” has the meaning given in s. 448.60 (3).

SB515-SSA1,14,15 (5) “Podiatry” has the meaning given in s. 448.60 (4).

SB515-SSA1,14,16 (6) “Practice of medicine and surgery” has the meaning given in s. 448.01 (9).

SB515-SSA1,14,22 448.972 License required; exceptions. (1) Except as provided in subs. (2) and (3), no person may represent himself or herself as a “PA” or “physician assistant," use or assume the title “PA” or “physician assistant," or append to the person's name the words or letters “physician assistant," “PA," “PA-C,” or any other titles, letters, or designation that represents or may tend to represent the person as a physician assistant, unless he or she is licensed by the board under this subchapter.

SB515-SSA1,14,23 (2) Subsection (1) does not apply with respect to any of the following:

SB515-SSA1,15,2 (a) An individual employed and duly credentialed as a physician assistant or physician associate by the federal government while performing duties incident to that employment, unless a license under this subchapter is required by the federal government.

SB515-SSA1,15,6 (b) A person who satisfies the requirement under s. 448.974 (1) (a) 3. but who is not licensed under this subchapter. This paragraph does not allow such a person to practice medicine and surgery in violation of s. 448.03 (1) (a) or to practice podiatry in violation of s. 448.61.

SB515-SSA1,15,8 (3) A student who is enrolled in an accredited physician assistant educational program may use the title “physician assistant student,” “PA student,” or “PA-S.”

SB515-SSA1,15,9 448.9725 Expedited partner therapy. (1) In this section:

SB515-SSA1,15,10 (b) “Antimicrobial drug" has the meaning given in s. 448.035 (1) (b).

SB515-SSA1,15,11 (c) “Expedited partner therapy" has the meaning given in s. 448.035 (1) (c).

SB515-SSA1,15,22 (2) Notwithstanding the requirements of s. 448.9785, a physician assistant may provide expedited partner therapy if a patient is diagnosed as infected with a chlamydial infection, gonorrhea, or trichomoniasis and the patient has had sexual contact with a sexual partner during which the chlamydial infection, gonorrhea, or trichomoniasis may have been transmitted to or from the sexual partner. The physician assistant shall attempt to obtain the name of the patient's sexual partner. A prescription order for an antimicrobial drug prepared under this subsection shall include the name and address of the patient's sexual partner, if known. If the physician assistant is unable to obtain the name of the patient's sexual partner, the prescription order shall include, in ordinary, bold-faced capital letters, the words, “expedited partner therapy" or the letters “EPT."

SB515-SSA1,16,2 (3) The physician assistant shall provide the patient with a copy of the information sheet prepared by the department of health services under s. 46.03 (44) and shall request that the patient give the information sheet to the person with whom the patient had sexual contact.

SB515-SSA1,16,6 (4) (a) Except as provided in par. (b), a physician assistant is immune from civil liability for injury to or the death of a person who takes any antimicrobial drug if the antimicrobial drug is prescribed, dispensed, or furnished under this section and if expedited partner therapy is provided as specified under this section.

SB515-SSA1,16,9 (b) The immunity under par. (a) does not extend to the donation, distribution, furnishing, or dispensing of an antimicrobial drug by a physician assistant whose act or omission involves reckless, wanton, or intentional misconduct.

SB515-SSA1,16,11 448.9727 Prescriptions for and delivery of opioid antagonists. (1) In this section:

SB515-SSA1,16,12 (a) “Administer" has the meaning given in s. 450.01 (1).

SB515-SSA1,16,13 (b) “Deliver" has the meaning given in s. 450.01 (5).

SB515-SSA1,16,14 (c) “Dispense" has the meaning given in s. 450.01 (7).

SB515-SSA1,16,15 (d) “Opioid antagonist" has the meaning given in s. 450.01 (13v).

SB515-SSA1,16,16 (e) “Opioid-related drug overdose" has the meaning given in s. 256.40 (1) (d).

SB515-SSA1,16,17 (f) “Standing order" has the meaning given in s. 450.01 (21p).

SB515-SSA1,16,18 (2) (a) A physician assistant may do any of the following:

SB515-SSA1,16,24 1. Prescribe an opioid antagonist to a person in a position to assist an individual at risk of undergoing an opioid-related drug overdose and may deliver the opioid antagonist to that person. A prescription order under this subdivision need not specify the name and address of the individual to whom the opioid antagonist will be administered, but shall instead specify the name of the person to whom the opioid antagonist is prescribed.

SB515-SSA1,17,2 2. Issue a standing order to one or more persons authorizing the dispensing of an opioid antagonist.

SB515-SSA1,17,9 (b) A physician assistant who prescribes or delivers an opioid antagonist under par. (a) 1. shall ensure that the person to whom the opioid antagonist is prescribed has or has the capacity to provide the knowledge and training necessary to safely administer the opioid antagonist to an individual undergoing an opioid-related overdose and that the person demonstrates the capacity to ensure that any individual to whom the person further delivers the opioid antagonist has or receives that knowledge and training.

SB515-SSA1,17,15 (3) A physician assistant who, acting in good faith, prescribes or delivers an opioid antagonist in accordance with sub. (2) or who, acting in good faith, otherwise lawfully prescribes or dispenses an opioid antagonist shall be immune from criminal or civil liability and may not be subject to professional discipline under s. 448.978 for any outcomes resulting from prescribing, delivering, or dispensing the opioid antagonist.

SB515-SSA1,17,17 448.973 Powers and duties of board. (1) (a) The board shall promulgate rules implementing s. 448.9785.

SB515-SSA1,17,19 (b) The board shall promulgate rules establishing continuing education requirements for physician assistants.

SB515-SSA1,17,21 (c) The board may promulgate other rules to carry out the purposes of this subchapter, including any of the following:

SB515-SSA1,17,23 1. Rules defining what constitutes unprofessional conduct for physician assistants for purposes of s. 448.978 (2) (d).

SB515-SSA1,17,24 2. Rules under s. 448.977 (2).

SB515-SSA1,18,4 (2) The board shall include in the register the board maintains under s. 440.035 (1m) (d) the names of all persons whose licenses issued under this subchapter were suspended or revoked within the past 2 years. The register shall be available for purchase at cost.

SB515-SSA1,18,8 448.974 License; renewal. (1) (a) Except as provided in par. (b), the board shall grant an initial license to practice as a physician assistant to any applicant who is found qualified by three-fourths of the members of the board and satisfies all of the following requirements, as determined by the board:

SB515-SSA1,18,11 1. The applicant submits an application on a form provided by the department and pays the initial credential fee determined by the department under s. 440.03 (9) (a).

SB515-SSA1,18,12 2. The applicant is at least 18 years of age.

SB515-SSA1,18,13 3. The applicant provides evidence of one of the following:

SB515-SSA1,18,18 a. That the applicant has successfully completed an educational program for physician assistants or physician associates that is accredited by the Accreditation Review Commission on Education for the Physician Assistant or its successor or, prior to 2001, by the Committee on Allied Health Education and Accreditation or the Commission on Accreditation of Allied Health Education Programs.

SB515-SSA1,18,22 b. If the applicant does not satisfy subd. 3. a., that the applicant, prior to January 1, 1986, successfully passed the Physician Assistant National Certifying Examination administered by the National Commission on Certification of Physician Assistants.

SB515-SSA1,18,24 4. The applicant passes the National Commission on Certification of Physician Assistants examination or an equivalent national examination adopted by the board.

SB515-SSA1,19,2 5. The applicant provides a listing with all employers, practice settings, internships, residencies, fellowships, and other employment for the past 7 years.

SB515-SSA1,19,4 6. Subject to ss. 111.321, 111.322, and 111.335, the applicant does not have an arrest or conviction record.

SB515-SSA1,19,11 (b) Paragraph (a) 3. does not apply to an applicant if the applicant provides evidence that he or she is licensed as a physician assistant or physician associate in another state, the District of Columbia, Puerto Rico, the United States Virgin Islands, or any territory or insular possession subject to the jurisdiction of the United States and the board determines that the requirements for obtaining the license in that state or territory are substantially equivalent to the requirements under par. (a).

SB515-SSA1,19,14 (2) (a) The renewal date for a license issued under this subchapter is specified under s. 440.08 (2) (a), and the renewal fees for such licenses are determined by the department under s. 440.03 (9) (a). Renewal of a license is subject to par. (b).

SB515-SSA1,19,19 (b) An applicant for the renewal of a license under this subchapter shall submit with his or her application for renewal proof of having satisfied the continuing education requirements imposed by the board under s. 448.973 (1) (b). This paragraph does not apply to an applicant for renewal of a license that expires on the first renewal date after the date on which the board initially granted the license.

SB515-SSA1,19,23 (3) Notwithstanding sub. (1), an individual who, on the effective date of this subsection .... [LRB inserts date], was licensed by the medical examining board as a physician assistant under subch. II of ch. 448, 2017 stats., shall be considered to have been licensed under sub. (1) for purposes of this subchapter.

SB515-SSA1,20,2 448.975 Practice and employment. (1) (a) Subject to the limitations and requirements under sub. (2); the physician assistant's experience, education, and training; and any rules promulgated under sub. (5), a physician assistant may do any of the following:

SB515-SSA1,20,4 1. Examine into the fact, condition, or cause of human health or disease, or treat, operate, prescribe, or advise for the same, by any means or instrumentality.

SB515-SSA1,20,6 2. Apply principles or techniques of medical sciences in the diagnosis or prevention of any of the conditions described in subd. 1. and in s. 448.971 (2).