SB184: Bill Text

SB184,32,6 (m) Demonstrates a lack of physical or mental ability to safely practice as a physician assistant.

SB184,32,8 (n) Engages in any practice that is outside the scope of his or her experience, education, or training.

SB184,32,10 (o) Is disciplined or has been disciplined by another state or jurisdiction based upon acts or conduct similar to acts or conduct prohibited under pars. (a) to (n).

SB184,32,19 448.9785 Informed consent. Any physician assistant who treats a patient shall inform the patient about the availability of reasonable alternate medical modes of treatment and about the benefits and risks of these treatments. The reasonable physician assistant standard is the standard for informing a patient under this section. The reasonable physician assistant standard requires disclosure only of information that a reasonable physician assistant in the same or a similar medical specialty would know and disclose under the circumstances. The physician assistant's duty to inform the patient under this section does not require disclosure of any of the following:

SB184,32,21 (1) Detailed technical information that in all probability a patient would not understand.

SB184,32,22 (2) Risks apparent or known to the patient.

SB184,32,24 (3) Extremely remote possibilities that might falsely or detrimentally alarm the patient.

SB184,33,2 (4) Information in emergencies where failure to provide treatment would be more harmful to the patient than treatment.

SB184,33,3 (5) Information in cases where the patient is incapable of consenting.

SB184,33,6 (6) Information about alternate medical modes of treatment for any condition the physician assistant has not included in his or her diagnosis at the time the physician informs the patient.

SB184,33,8 448.979 Penalties. Any person who violates this subchapter is subject to a fine not to exceed $10,000 or imprisonment not to exceed 9 months, or both.

SB184,33,14 448.9793 Injunction. If it appears upon complaint to the board by any person or if it is known to the board that any person is violating this subchapter, or rules adopted by the board under this subchapter, the board or the attorney general may investigate and may, in addition to any other remedies, bring action in the name and on behalf of the state against any such person to enjoin such person from such violation. The attorney general shall represent the board in all proceedings.

SB184,33,18 448.9795 Duty to report. (1)  A physician assistant who has reason to believe any of the following about another physician assistant shall promptly submit a written report to the board that includes facts relating to the conduct of the other physician assistant:

SB184,33,20 (a) The other physician assistant is engaging or has engaged in acts that constitute a pattern of unprofessional conduct.

SB184,33,22 (b) The other physician assistant is engaging or has engaged in an act that creates an immediate or continuing danger to one or more patients or to the public.

SB184,33,23 (c) The other physician assistant is or may be medically incompetent.

SB184,33,25 (d) The other physician assistant is or may be mentally or physically unable safely to engage in the practice of a physician assistant.

SB184,34,3 (2) No physician assistant who reports to the board under sub. (1) may be held civilly or criminally liable or be found guilty of unprofessional conduct for reporting in good faith.

SB184,53 Section 53 . Subchapter VIII of chapter 448 [precedes 448.980] of the statutes is renumbered subchapter IX of chapter 448 [precedes 448.980].

SB184,54 Section 54 . Subchapter IX of chapter 448 [precedes 448.985] of the statutes is renumbered subchapter X of chapter 448 [precedes 448.985].

SB184,55 Section 55 . 450.01 (15r) of the statutes is repealed.

SB184,56 Section 56 . 450.01 (16) (hm) 3. of the statutes is amended to read:

SB184,34,11 450.01 (16) (hm) 3. The patient's physician assistant , if the physician assistant is under the supervision of the patient's personal attending physician.

SB184,57 Section 57 . 450.11 (1) of the statutes is amended to read:

SB184,35,3 450.11 (1) Dispensing. Except as provided in sub. (1i) (b) 2., no person may dispense any prescribed drug or device except upon the prescription order of a practitioner. All prescription orders shall, except as provided in sub. (1a), specify the date of issue, the name and address of the practitioner, the name and quantity of the drug product or device prescribed, directions for the use of the drug product or device, the symptom or purpose for which the drug is being prescribed if required under sub. (4) (a) 8., and, if the order is written by the practitioner, the signature of the practitioner. Except as provided in ss. 118.2925 (3), 255.07 (2), 441.18 (2) (a) 1., 448.035 (2), and 448.037 (2) (a) 1., 448.9725 (2), and 448.9727 (2) (a) 1. and except for standing orders issued under s. 441.18 (2) (a) 2. or , 448.037 (2) (a) 2., or 448.9727 (2) (a) 2., all prescription orders shall also specify the name and address of the patient. A prescription order issued under s. 118.2925 (3) shall specify the name and address of the school. A prescription order issued under s. 255.07 (2) shall specify the name and address of the authorized entity or authorized individual. Any oral prescription order shall be immediately reduced to writing by the pharmacist and filed according to sub. (2).

SB184,58 Section 58 . 450.11 (1g) (b) of the statutes is amended to read:

SB184,35,18 450.11 (1g) (b) A pharmacist may, upon the prescription order of a practitioner providing expedited partner therapy, as specified in s. 448.035 or 448.9725, that complies with the requirements of sub. (1), dispense an antimicrobial drug as a course of therapy for treatment of chlamydial infections, gonorrhea, or trichomoniasis to the practitioner's patient or a person with whom the patient has had sexual contact for use by the person with whom the patient has had sexual contact. The pharmacist shall provide a consultation in accordance with rules promulgated by the board for the dispensing of a prescription to the person to whom the antimicrobial drug is dispensed. A pharmacist providing a consultation under this paragraph shall ask whether the person for whom the antimicrobial drug has been prescribed is allergic to the antimicrobial drug and advise that the person for whom the antimicrobial drug has been prescribed must discontinue use of the antimicrobial drug if the person is allergic to or develops signs of an allergic reaction to the antimicrobial drug.

SB184,59 Section 59 . 450.11 (1i) (a) 1. of the statutes is amended to read:

SB184,36,6 450.11 (1i) (a) 1. A pharmacist may, upon and in accordance with the prescription order of an advanced practice nurse prescriber under s. 441.18 (2) (a) 1., or of a physician or physician assistant under s. 448.037 (2) (a) 1., or of a physician assistant under s. 448.9727 (2) (a) 1. that complies with the requirements of sub. (1), deliver an opioid antagonist to a person specified in the prescription order and may, upon and in accordance with the standing order of an advanced practice nurse prescriber under s. 441.18 (2) (a) 2., or of a physician or physician assistant under s. 448.037 (2) (a) 2., or of a physician assistant under s. 448.9727 (2) (a) 2. that complies with the requirements of sub. (1), deliver an opioid antagonist to an individual in accordance with the order. The pharmacist shall provide a consultation in accordance with rules promulgated by the board for the delivery of a prescription to the person to whom the opioid antagonist is delivered.

SB184,60 Section 60 . 450.11 (1i) (b) 2. c. of the statutes is amended to read:

SB184,36,10 450.11 (1i) (b) 2. c. A physician or physician assistant may only deliver or dispense an opioid antagonist in accordance with s. 448.037 (2) or in accordance with his or her other legal authority to dispense prescription drugs.

SB184,61 Section 61 . 450.11 (1i) (b) 2. cm. of the statutes is created to read:

SB184,36,14 450.11 (1i) (b) 2. cm. A physician assistant may only deliver or dispense an opioid antagonist in accordance with s. 448.9727 (2) or in accordance with his or her other legal authority to dispense prescription drugs.

SB184,62 Section 62 . 450.11 (1i) (c) 2. of the statutes is amended to read:

SB184,36,19 450.11 (1i) (c) 2. Subject to par. (a) 2. and ss. 441.18 (3) and, 448.037 (3), and 448.9727 (3), any person who, acting in good faith, delivers or dispenses an opioid antagonist to another person shall be immune from civil or criminal liability for any outcomes resulting from delivering or dispensing the opioid antagonist.

SB184,63 Section 63 . 450.11 (8) (b) of the statutes is amended to read:

SB184,36,22 450.11 (8) (b) The medical examining board, insofar as this section applies to physicians and physician assistants.

SB184,64 Section 64 . 450.11 (8) (f) of the statutes is created to read:

SB184,36,25 450.11 (8) (f) The physician assistant affiliated credentialing board, insofar as this section applies to physician assistants.

SB184,65 Section 65. 462.02 (2) (e) of the statutes is amended to read:

SB184,37,2 462.02 (2) (e) A physician assistant licensed under s. 448.04 (1) (f) 448.974.

SB184,66 Section 66 . 462.04 of the statutes is amended to read:

SB184,37,12 462.04 Prescription or order required. A person who holds a license or limited X-ray machine operator permit under this chapter may not use diagnostic X-ray equipment on humans for diagnostic purposes unless authorized to do so by prescription or order of a physician licensed under s. 448.04 (1) (a), a dentist licensed under s. 447.04 (1), a podiatrist licensed under s. 448.63, a chiropractor licensed under s. 446.02, an advanced practice nurse certified under s. 441.16 (2), a physician assistant licensed under s. 448.04 (1) (f) 448.974, or, subject to s. 448.56 (7) (a), a physical therapist who is licensed under s. 448.53 or who holds a compact privilege under subch. IX X of ch. 448.

SB184,67 Section 67 . 961.01 (19) (a) of the statutes is amended to read:

SB184,37,19 961.01 (19) (a) A physician, advanced practice nurse, dentist, veterinarian, podiatrist, optometrist, scientific investigator or, subject to s. 448.21 (3) 448.975 (1) (b), a physician assistant, or other person licensed, registered, certified or otherwise permitted to distribute, dispense, conduct research with respect to, administer or use in teaching or chemical analysis a controlled substance in the course of professional practice or research in this state.

SB184,68 Section 68 . 971.14 (4) (a) of the statutes is amended to read:

SB184,38,7 971.14 (4) (a) The court shall cause copies of the report to be delivered forthwith to the district attorney and the defense counsel, or the defendant personally if not represented by counsel. Upon the request of the sheriff or jailer charged with care and control of the jail in which the defendant is being held pending or during a trial or sentencing proceeding, the court shall cause a copy of the report to be delivered to the sheriff or jailer. The sheriff or jailer may provide a copy of the report to the person who is responsible for maintaining medical records for inmates of the jail, or to a nurse licensed under ch. 441, or to a physician or physician assistant licensed under subch. II of ch. 448, or to a physician assistant licensed under subch. VIII of ch. 448 who is a health care provider for the defendant or who is responsible for providing health care services to inmates of the jail. The report shall not be otherwise disclosed prior to the hearing under this subsection.

SB184,69 Section 69 . 990.01 (27s) of the statutes is created to read:

SB184,38,10 990.01 (27s) Physician assistant. “ Physician assistant” means a person licensed as a physician assistant under subch. VIII of ch. 448.

SB184,70 Section 70 . Chapter Med 8 of the administrative code is repealed.

SB184,71 Section 71 . Cross-reference changes. In ss. 49.45 (9r) (a) 7. b., 146.81 (1) (dg), 146.997 (1) (d) 4., 155.01 (7), 252.14 (1) (ar) 4e., 446.01 (1v) (d), 448.956 (1m) and (4), 450.10 (3) (a) 5., and 451.02 (1), the cross-references to “subch. IX of ch. 448” are changed to “subch. X of ch. 448.”

SB184,72 Section 72 . Nonstatutory provisions.

SB184,38,17 (1) Board; appointments.

SB184,38,23 (a) Notwithstanding the length of terms specified for the members of the physician assistant affiliated credentialing board under s. 15.406 (7), 4 of the initial members under s. 15.406 (7) (a) shall be appointed for terms expiring on July 1, 2023; 3 of the initial members under s. 15.406 (7) (a) and the initial member under s. 15.406 (7) (b) shall be appointed for terms expiring on July 1, 2024; and the remaining initial member under s. 15.406 (7) (a) shall be appointed for a term expiring on July 1, 2025.

SB184,39,6 (b) Notwithstanding s. 15.08 (1), the governor may provisionally appoint initial members of the physician assistant affiliated credentialing board under s. 15.406 (7). Those provisional appointments remain in force until withdrawn by the governor or acted upon by the senate and if confirmed by the senate, shall continue for the remainder of the unexpired term, if any, of the member and until a successor is chosen and qualifies. A provisional appointee may exercise all the powers and duties of board membership to which the person is appointed during the time in which the appointee qualifies.

SB184,39,11 (c) Notwithstanding s. 15.406 (7) (a), for purposes of an initial appointment to the physician assistant affiliated credentialing board made before the date specified in Section 73 (intro.) of this act, including any provisional appointment made under par. (b), the governor may appoint physician assistants licensed under subch. II of ch. 448 to the positions on the board specified under s. 15.406 (7) (a).

SB184,39,12 (2) Emergency rules.

SB184,39,18 (a) Using the procedure under s. 227.24, the physician assistant affiliated credentialing board may promulgate initial rules under ss. 448.973 (1) and 448.975 (5) (a) as emergency rules under s. 227.24 to allow for the licensure, discipline, and practice of physician assistants. The authority granted under this subsection applies only to rules described in this paragraph, and any other emergency rules promulgated by the board shall be as provided in, and subject to, s. 227.24.

SB184,39,23 (b) Notwithstanding s. 227.24 (1) (a) and (3), the physician assistant affiliated credentialing board is not required to provide evidence that promulgating a rule under this subsection as an emergency rule is necessary for the preservation of the public peace, health, safety, or welfare and is not required to provide a finding of emergency for a rule promulgated under this subsection.

SB184,39,25 (c) Emergency rules promulgated under this subsection may not take effect prior to the date specified in Section 73 (intro.) of this act.

SB184,40,3 (d) Notwithstanding s. 227.24 (1) (c), emergency rules promulgated under this subsection remain in effect for one year, subject to extension under par. (e), or until the date on which permanent rules take effect, whichever is sooner.

SB184,40,15 (e) Notwithstanding s. 227.24 (2) (a), the joint committee for review of administrative rules may, at any time prior to the expiration date of the emergency rule promulgated under this subsection, extend the effective period of the emergency rule at the request of the physician assistant affiliated credentialing board for a period specified by the committee not to exceed 180 days. Any number of extensions may be granted under this paragraph, but the total period for all extensions may not extend beyond the expiration date of the emergency rule's statement of scope under s. 227.135 (5). Notwithstanding s. 227.24 (2) (b) 1., the physician assistant affiliated credentialing board is not required to provide evidence that there is a threat to the public peace, health, safety, or welfare that can be avoided only by extension of the emergency rule when making a request for an extension under this subsection, but s. 227.24 (2) (am) to (c) shall otherwise apply to extensions under this paragraph.

SB184,40,18 (f) If the physician assistant affiliated credentialing board promulgates emergency rules under this subsection, the board shall submit a single statement of scope for both permanent and emergency rules.

SB184,40,19 (3) Board; transfers.

SB184,40,24 (a) Tangible personal property. On the effective date of this paragraph, all tangible personal property, including records, of the medical examining board that the secretary of safety and professional services determines to be primarily related to the regulation of physician assistants is transferred to the physician assistant affiliated credentialing board.

SB184,41,7 (b) Pending matters. Any matter pending with the medical examining board on the effective date of this paragraph that is primarily related to the regulation of physician assistants, as determined by the secretary of safety and professional services, is transferred to the physician assistant affiliated credentialing board. All materials submitted to or actions taken by the medical examining board with respect to the pending matter are considered as having been submitted to or taken by the physician assistant affiliated credentialing board.

SB184,41,15 (c) Contracts. All contracts entered into by the medical examining board in effect on the effective date of this paragraph that are primarily related to the regulation of physician assistants, as determined by the secretary of safety and professional services, remain in effect and are transferred to the physician assistant affiliated credentialing board. The physician assistant affiliated credentialing board shall carry out any obligations under such a contract until the contract is modified or rescinded by the physician assistant affiliated credentialing board to the extent allowed under the contract.

SB184,41,20 (d) Assets and liabilities. On the effective date of this paragraph, the assets and liabilities of the medical examining board that are primarily related to the regulation of physician assistants, as determined by the secretary of safety and professional services, become the assets and liabilities of the physician assistant affiliated credentialing board.

SB184,41,24 (e) Orders. All orders issued by the medical examining board in effect on the effective date of this paragraph that are primarily related to the regulation of physician assistants remain in effect until their specified expiration dates or until modified or rescinded by the physician assistant affiliated credentialing board.

SB184,73 Section 73 . Effective dates. This act takes effect on the first day of the 13th month beginning after publication, except as follows:

SB184,42,4 (1) The treatment of s. 15.406 (7) and Section 72 (1) and (2) of this act take effect on the day after publication.

SB184,42,7 (2) Notwithstanding s. 227.265, the treatment of ch. Med 8 of the administrative code takes effect on the first day of the 13th month beginning after publication.

SB184,42,8 (End)