SB184: Bill Text

SB184,11,12 Witness signature ....   Date signed ....

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SB184,11,14 Witness signature ....   Date signed ....

SB184,11,15 Print name ....

SB184,11,16 DIRECTIVES TO ATTENDING PHYSICIAN,

SB184,11,17 PHYSICIAN ASSISTANT, OR ADVANCED

SB184,11,18 PRACTICE REGISTERED NURSE

SB184,11,23 1. This document authorizes the withholding or withdrawal of life-sustaining procedures or of feeding tubes when a physician and another physician, physician assistant, or advanced practice registered nurse, one of whom is the attending health care professional, have personally examined and certified in writing that the patient has a terminal condition or is in a persistent vegetative state.

SB184,12,4 2. The choices in this document were made by a competent adult. Under the law, the patient's stated desires must be followed unless you believe that withholding or withdrawing life-sustaining procedures or feeding tubes would cause the patient pain or reduced comfort and that the pain or discomfort cannot be alleviated through pain relief measures. If the patient's stated desires are that life-sustaining procedures or feeding tubes be used, this directive must be followed.

SB184,12,8 3. If you feel that you cannot comply with this document, you must make a good faith attempt to transfer the patient to another physician, physician assistant, or advanced practice registered nurse who will comply. Refusal or failure to make a good faith attempt to do so constitutes unprofessional conduct.

SB184,12,10 4. If you know that the patient is pregnant, this document has no effect during her pregnancy.

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SB184,12,14 The person making this living will may use the following space to record the names of those individuals and health care providers to whom he or she has given copies of this document:

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SB184,26 Section 26 . 154.07 (1) (a) (intro.) of the statutes is amended to read:

SB184,12,23 154.07 (1) (a) (intro.) No health care professional, inpatient health care facility or person licensed, certified, or registered under ch. 441, 448, or 455, or a person who holds a compact privilege under subch. IX X of ch. 448 acting under the direction of a health care professional may be held criminally or civilly liable, or charged with unprofessional conduct, for any of the following:

SB184,27 Section 27 . 165.77 (1) (a) of the statutes is amended to read:

SB184,13,3 165.77 (1) (a) “Health care professional" means a person licensed, certified, or registered under ch. 441, 448, or 455 or a person who holds a compact privilege under subch. IX X of ch. 448.

SB184,28 Section 28 . 252.01 (5) of the statutes is repealed.

SB184,29 Section 29 . 255.07 (1) (d) of the statutes is amended to read:

SB184,13,8 255.07 (1) (d) “Health care practitioner" means a physician, a physician assistant licensed under s. 448.04 (1) (f), or an advanced practice nurse who is certified to issue prescription orders under s. 441.16.

SB184,30 Section 30 . 343.16 (5) (a) of the statutes is amended to read:

SB184,14,7 343.16 (5) (a) The secretary may require any applicant for a license or any licensed operator to submit to a special examination by such persons or agencies as the secretary may direct to determine incompetency, physical or mental disability, disease, or any other condition that might prevent such applicant or licensed person from exercising reasonable and ordinary control over a motor vehicle. If the department requires the applicant to submit to an examination, the applicant shall pay for the examination. If the department receives an application for a renewal or duplicate license after voluntary surrender under s. 343.265 or receives a report from a physician, physician assistant, as defined in s. 448.01 (6), advanced practice nurse prescriber certified under s. 441.16 (2), or optometrist under s. 146.82 (3), or if the department has a report of 2 or more arrests within a one-year period for any combination of violations of s. 346.63 (1) or (5) or a local ordinance in conformity with s. 346.63 (1) or (5) or a law of a federally recognized American Indian tribe or band in this state in conformity with s. 346.63 (1) or (5), or s. 346.63 (1m), 1985 stats., or s. 346.63 (2) or (6) or 940.25, or s. 940.09 where the offense involved the use of a vehicle, the department shall determine, by interview or otherwise, whether the operator should submit to an examination under this section. The examination may consist of an assessment. If the examination indicates that education or treatment for a disability, disease or condition concerning the use of alcohol, a controlled substance or a controlled substance analog is appropriate, the department may order a driver safety plan in accordance with s. 343.30 (1q). If there is noncompliance with assessment or the driver safety plan, the department shall revoke the person's operating privilege in the manner specified in s. 343.30 (1q) (d).

SB184,31 Section 31 . 440.035 (2m) (b) of the statutes is amended to read:

SB184,14,14 440.035 (2m) (b) The medical examining board, the physician assistant affiliated credentialing board, the podiatry affiliated credentialing board, the board of nursing, the dentistry examining board, or the optometry examining board may issue guidelines regarding best practices in prescribing controlled substances for persons credentialed by that board who are authorized to prescribe controlled substances.

SB184,32 Section 32 . 440.035 (2m) (c) 1. (intro.) of the statutes is amended to read:

SB184,14,20 440.035 (2m) (c) 1. (intro.) The medical examining board, the physician assistant affiliated credentialing board, the podiatry affiliated credentialing board, the board of nursing, the dentistry examining board, and the optometry examining board shall, by November 1, 2018, and annually thereafter of each year, submit a report to the persons specified in subd. 2. that does all of the following:

SB184,33 Section 33 . 448.01 (6) of the statutes is repealed.

SB184,34 Section 34 . 448.015 (4) (am) 2. of the statutes is amended to read:

SB184,14,24 448.015 (4) (am) 2. Any act by a physician or physician assistant in violation of ch. 450 or 961.

SB184,35 Section 35 . 448.02 (1) of the statutes is amended to read:

SB184,15,4 448.02 (1) License. The board may grant licenses, including various classes of temporary licenses, to practice medicine and surgery, to practice as an administrative physician, to practice perfusion, and to practice as an anesthesiologist assistant, and to practice as a physician assistant.

SB184,36 Section 36 . 448.03 (1) (b) of the statutes is repealed.

SB184,37 Section 37 . 448.03 (2) (a) of the statutes is amended to read:

SB184,15,13 448.03 (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.

SB184,38 Section 38 . 448.03 (2) (e) of the statutes is amended to read:

SB184,15,18 448.03 (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.

SB184,39 Section 39 . 448.03 (2) (k) of the statutes is amended to read:

SB184,15,21 448.03 (2) (k) Any persons, other than physician assistants, anesthesiologist assistants, or perfusionists, who assist physicians.

SB184,40 Section 40 . 448.03 (3) (e) of the statutes is repealed.

SB184,41 Section 41 . 448.03 (5) (b) of the statutes is amended to read:

SB184,15,25 448.03 (5) (b) No physician or physician assistant shall be liable for any civil damages for either of the following:

SB184,16,4 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.

SB184,16,9 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.

SB184,42 Section 42 . 448.035 (2) to (4) of the statutes are amended to read:

SB184,16,24 448.035 (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."

SB184,17,5 (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.

SB184,17,10 (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.

SB184,17,14 (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.

SB184,43 Section 43 . 448.037 (2) (a) (intro.) and (b) and (3) of the statutes are amended to read:

SB184,17,18 448.037 (2) (a) (intro.) A physician or physician assistant may do any of the following:

SB184,17,25 (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.

SB184,18,6 (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.

SB184,44 Section 44 . 448.04 (1) (f) of the statutes is repealed.

SB184,45 Section 45 . 448.05 (5) of the statutes is repealed.

SB184,46 Section 46 . 448.20 of the statutes is repealed.

SB184,47 Section 47 . 448.21 of the statutes is repealed.

SB184,48 Section 48 . 448.40 (2) (f) of the statutes is repealed.

SB184,49 Section 49 . 448.62 (7) of the statutes is amended to read:

SB184,18,15 448.62 (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).

SB184,50 Section 50 . 448.695 (4) (a) and (b) of the statutes are amended to read:

SB184,18,18 448.695 (4) (a) Practice standards for a physician assistant practicing podiatry as provided in s. 448.21 (4) 448.975 (2) (a) 2m.

SB184,18,20 (b) Requirements for a podiatrist who is supervising a physician assistant as provided in s. 448.21 (4) 448.975 (2) (a) 2m.

SB184,51 Section 51 . 448.970 of the statutes is renumbered 448.9695.

SB184,52 Section 52 . Subchapter VIII of chapter 448 [precedes 448.971] of the statutes is created to read:

SB184,18,24 chapter 448

SB184,18,25 subchapter viii

SB184,19,1 physician assistant affiliated

SB184,19,2 credentialing board

SB184,19,4 448.971 Definitions. In this subchapter, unless the context requires otherwise:

SB184,19,5 (1) “Board" means the physician assistant affiliated credentialing board.

SB184,19,6 (2) “Physician assistant” means a person licensed under this subchapter.

SB184,19,7 (3) “Podiatrist” has the meaning given in s. 448.60 (3).

SB184,19,8 (4) “Podiatry” has the meaning given in s. 448.60 (4).

SB184,19,14 448.972 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.

SB184,19,15 (2) Subsection (1) does not apply with respect to any of the following:

SB184,19,19 (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.

SB184,19,23 (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.

SB184,19,25 (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.”

SB184,20,1 448.9725 Expedited partner therapy. (1) In this section:

SB184,20,2 (b) “Antimicrobial drug" has the meaning given in s. 448.035 (1) (b).

SB184,20,3 (c) “Expedited partner therapy" has the meaning given in s. 448.035 (1) (c).

SB184,20,14 (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."

SB184,20,18 (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.

SB184,20,22 (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.

SB184,20,25 (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.

SB184,21,2 448.9727 Prescriptions for and delivery of opioid antagonists. (1) In this section: