2019 - 2020 LEGISLATURE
October 25, 2019 - Introduced by Representatives VanderMeer, Edming,
Considine, Anderson, Dittrich, Doyle, Felzkowski, James, Krug, Kulp,
Mursau, Oldenburg, Quinn, Ramthun, Rohrkaste, Sortwell, Spiros,
Summerfield, Tittl, Vruwink and Tauchen, cosponsored by Senators
Bernier, Kooyenga, Hansen, Tiffany, Schachtner and Bewley. Referred to
Committee on Regulatory Licensing Reform.
1An Act to repeal
15.407 (2), 50.01 (4p), 252.01 (5), 448.01 (6), 448.03 (1) (b), 2
448.03 (3) (e), 448.04 (1) (f), 448.05 (5), 448.20, 448.21, 448.40 (2) (f), 448.695 (4) 3
and 450.01 (15r); to renumber
448.038; to amend
15.08 (1m) (b), 16.417 (1) 4
(e) 3m., 46.03 (44), 48.981 (2m) (b) 1., 49.45 (9r) (a) 7. a., 50.08 (2), 50.39 (3), 5
50.60 (1), 55.14 (8) (b), 69.01 (6g), 70.47 (8) (intro.), 97.67 (5m) (a) 3., 118.2925 6
(1) (f), 146.38 (1) (b) 1., 146.81 (1) (d), 146.81 (1) (i), 146.81 (1) (j), 146.82 (3) (a), 7
146.89 (1) (r) 1., 146.997 (1) (d) 5., 155.01 (7), 252.15 (1) (am), 252.15 (1) (ar) 1., 8
255.07 (1) (d), 255.07 (7), 257.01 (5) (a), 257.01 (5) (b), 343.16 (5) (a), 440.035 9
(2m) (b), 440.035 (2m) (c) 1. (intro.), 448.015 (4) (am) 2., 448.02 (1), 448.03 (2) 10
(a), 448.03 (2) (e), 448.03 (2) (k), 448.03 (5) (b), 448.035 (2) to (4), 448.037 (2) (a) 11
(intro.) and (b) and (3), 448.62 (7), 450.01 (16) (hm) 3., 450.10 (3) (a) 5., 450.11 12
(1), 450.11 (1g) (b), 450.11 (1i) (a) 1., 450.11 (1i) (b) 2. c., 450.11 (1i) (c) 2., 450.11 13
(8) (b), 462.02 (2) (e), 462.04, 895.48 (1m) (a) (intro.), 961.01 (19) (a) and 971.14 14
(4) (a); and to create
15.405 (4), 49.45 (9r) (a) 7. am., 69.18 (1) (ck), 146.81 (1)
(hr), 146.997 (1) (d) 13m., 180.1901 (1m) (h), 450.10 (3) (a) 12., 450.11 (1i) (b) 2. 2
cm., 450.11 (8) (f), chapter 461 and 990.01 (27s) of the statutes; relating to:
3regulation of physician assistants, creating a Physician Assistant Examining
4Board, extending the time limit for emergency rule procedures, providing an
5exemption from emergency rule procedures, granting rule-making authority,
6and providing a penalty.
Analysis by the Legislative Reference Bureau
This bill makes changes with respect to the licensure, regulation, and practice
of physician assistants (PAs).
Under current law, PAs are defined as individuals who are licensed to provide
medical care with physician supervision and direction. The Medical Examining
Board licenses and regulates PAs as well as physicians and certain other professions.
The Medical Examining Board is composed of ten physicians and three public
members and is authorized to promulgate rules establishing licensing and practice
standards for PAs.
This bill transfers licensure and regulation of PAs to the newly created
Physician Assistant Examining Board. The new board is composed of seven PAs, one
member who may be either a physician or a PA, and one public member. In addition,
the bill makes various changes to the licensure, regulation, and practice of PAs,
including all of the following:
1. Instead of requiring that a PA practice under the supervision and direction
of a physician, requires, subject to certain exceptions, that a PA who provides care
to patients maintain and provide to the board upon request either 1) evidence that,
pursuant to the physician assistant's employment, there is a physician who is
primarily responsible for the overall direction and management of the physician
assistant's professional activities and for assuring that the services provided by the
physician assistant are medically appropriate or 2) a written collaborative
agreement with a physician or, if the physician assistant's practice is limited to the
practice of podiatry, a podiatrist, which must describe the PA's scope of practice and
include other information as required by the board. However, the bill provides that
a PA is individually and independently responsible for the quality of the care he or
2. Defines a PA's practice similarly to the definition of the practice of medicine
and surgery. The bill also explicitly provides that a PA may prescribe, dispense, and
administer drugs and may serve as a primary or specialty care provider. The bill
requires a PA to limit his or her practice to the scope of his or her experience,
education, and training, and retains a number of limitations on the practice of PAs.
3. Includes a number of additional provisions with respect to the obligations
of PAs. These include a requirement that a PA have in effect malpractice liability
insurance coverage when practicing, subject to certain exceptions and other
4. Establishes licensure requirements for PAs, which differ in a number of
respects from the requirements under current law, including that PAs submit
additional information, including an employment history, with a licensure
application. Under the bill, the board must require continuing education for PAs.
Currently, PAs are not required to complete continuing education.
5. Specifies various grounds for professional discipline of a PA by the board and
allows the board to impose professional discipline consistent with other professions.
Because this bill creates a new crime or revises a penalty for an existing crime,
the Joint Review Committee on Criminal Penalties may be requested to prepare a
For further information see the state fiscal estimate, which will be printed as
an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
15.08 (1m) (b) of the statutes is amended to read:
(b) The public members of the chiropractic examining board, the 3
dentistry examining board, the hearing and speech examining board, the medical 4
examining board, the physical therapy examining board, the
examining council, the
respiratory care practitioners examining council and council
assistant examining board
, the board of nursing, the 7
nursing home administrator examining board, the veterinary examining board, the 8
optometry examining board, the pharmacy examining board, the marriage and 9
family therapy, professional counseling, and social work examining board, the 10
psychology examining board, and the radiography examining board shall not be 11
engaged in any profession or occupation concerned with the delivery of physical or 12
mental health care.
15.405 (4) of the statutes is created to read:
15.405 (4) Physician assistant examining board.
(a) There is created in the 2
department of safety and professional services a physician assistant examining 3
board consisting of the following members appointed for staggered 4-year terms:
1. Seven physician assistants licensed under ch. 461.
2. One individual who is either a physician licensed under subch. II of ch. 448 6
or a physician assistant licensed under ch. 461.
3. One public member.
(b) The governor may appoint a physician assistant to the physician assistant 9
examining board under par. (a) 2. only if the governor has determined that there is 10
no suitable physician who is willing to serve on the board.
15.407 (2) of the statutes is repealed.
16.417 (1) (e) 3m. of the statutes is amended to read:
(e) 3m. A physician assistant who is licensed under s. 448.04 (1) (f) 14461.07
46.03 (44) of the statutes is amended to read:
46.03 (44) Sexually transmitted disease treatment information.
Prepare and 17
keep current an information sheet to be distributed to a patient by a physician, 18
physician assistant, or certified advanced practice nurse prescriber providing 19
expedited partner therapy to that patient under s. 448.035 or 461.035
. The 20
information sheet shall include information about sexually transmitted diseases and 21
their treatment and about the risk of drug allergies. The information sheet shall also 22
include a statement advising a person with questions about the information to 23
contact his or her physician, pharmacist, or local health department, as defined in 24
s. 250.01 (4).
48.981 (2m) (b) 1. of the statutes is amended to read:
(b) 1. “Health care provider" means a physician, as defined under 2
s. 448.01 (5), a physician assistant, as defined under s. 448.01 (6) 461.01 (3)
, or a 3
nurse holding a license under s. 441.06 (1) or a license under s. 441.10.
49.45 (9r) (a) 7. a. of the statutes is amended to read:
(a) 7. a. A physician or physician assistant
licensed under subch. II 6
of ch. 448.
49.45 (9r) (a) 7. am. of the statutes is created to read:
(a) 7. am. A physician assistant licensed under ch. 461.
50.01 (4p) of the statutes is repealed.
50.08 (2) of the statutes is amended to read:
A physician, an advanced practice nurse prescriber certified under 12
s. 441.16 (2), or a physician assistant licensed under ch. 448,
who prescribes a 13
psychotropic medication to a nursing home resident who has degenerative brain 14
disorder shall notify the nursing home if the prescribed medication has a boxed 15
warning under 21 CFR 201.57
50.39 (3) of the statutes is amended to read:
Facilities governed by ss. 45.50, 48.62, 49.70, 49.72, 50.02, 51.09, and 18
252.10, juvenile correctional facilities as defined in s. 938.02 (10p), correctional 19
institutions governed by the department of corrections under s. 301.02, and the 20
offices and clinics of persons licensed to treat the sick under chs. 446, 447, and 448 21
are exempt from ss. 50.32 to 50.39. Sections 50.32 to 50.39 do not abridge the rights 22
of the medical examining board, physician assistant examining board,
therapy examining board, podiatry affiliated credentialing board, dentistry 24
examining board, pharmacy examining board, chiropractic examining board, and 25
board of nursing in carrying out their statutory duties and responsibilities.
50.60 (1) of the statutes is amended to read:
“Health care provider" has the meaning given in s. 146.81 (1) (a) to 3(hp) (hr)
55.14 (8) (b) of the statutes is amended to read:
(b) Order the individual to comply with the treatment plan under par. 6
(a). The order shall provide that if the individual fails to comply with provisions of 7
the treatment plan that require the individual to take psychotropic medications, the 8
medications may be administered involuntarily with consent of the guardian. The 9
order shall specify the methods of involuntary administration of psychotropic 10
medication to which the guardian may consent. An order authorizing the forcible 11
restraint of an individual shall specify that a person licensed under s. 441.06, 441.10, 12or
448.05 (2) or (5), or 461.07
shall be present at all times that psychotropic 13
medication is administered in this manner and shall require the person or facility 14
using forcible restraint to maintain records stating the date of each administration, 15
the medication administered, and the method of forcible restraint utilized.
69.01 (6g) of the statutes is amended to read:
“Date of death" means the date that a person is pronounced dead by 18
a physician, coroner, deputy coroner, medical examiner, deputy medical examiner, 19physician assistant,
or hospice nurse.
69.18 (1) (ck) of the statutes is created to read: