SB400: Bill Text

SB400,,1 2023 SENATE BILL 400

August 25, 2023 - Introduced by Senators Stafsholt, Ballweg, Cabral-Guevara, Felzkowski, Hutton, Marklein, Quinn, Spreitzer and Tomczyk, cosponsored by Representatives VanderMeer, Magnafici, Considine, Armstrong, Baldeh, Callahan, Dittrich, Doyle, Goeben, Green, Gundrum, Joers, Kitchens, Maxey, O’Connor, Penterman, Rettinger, Schmidt, Spiros, Stubbs, Tittl, Wichgers, Summerfield and Plumer. Referred to Committee on Health.

SB400,,2 An Act to renumber 252.14 (1) (ar) 14., 448.978 (1) and 448.978 (2) (d) 1. and 2.; to renumber and amend 440.03 (13) (c), 448.015 (4) (am) 2m., 448.974 (2) and 448.978 (2) (d) (intro.); to amend 49.45 (9r) (a) 7. e., 97.67 (5m) (a) 3., 118.2925 (1) (f), 146.81 (1) (eu), 146.997 (1) (d) 4., 154.01 (3) (b), 155.01 (1g) (c), 155.01 (7), 440.03 (9) (a) (intro.), 440.03 (9) (a) 2., 440.03 (13) (b) (intro.), 440.094 (1) (c) 4., 440.15, 448.971 (2), 448.972 (1), 448.973 (2), 448.974 (title), 448.978 (2) (intro.), 448.978 (2) (a), 448.978 (2) (g), 450.10 (3) (a) 5., 462.02 (2) (e), 462.04, 895.48 (1m) (a) (intro.), 971.14 (4) (a) and 990.01 (27s); to repeal and recreate 16.417 (1) (e) 3m. and 252.15 (1) (am); and to create 14.835, 111.335 (4) (jm), 440.03 (11m) (c) 2c., 440.03 (13) (c) 1. i., 440.094 (1) (c) 9m., 448.971 (1L), 448.971 (1m), 448.974 (1m), 448.974 (2) (bm) and subchapter XIII of chapter 448 [precedes 448.988] of the statutes; relating to: ratification of the PA Licensure Compact.

SB400,,3 Analysis by the Legislative Reference Bureau

This bill ratifies and enters Wisconsin into the PA Licensure Compact, which provides for the ability of a physician assistant (PA) to become eligible to practice in other compact states. Significant provisions of the compact include the following:

1. The creation of a PA Licensure Compact Commission, which includes one member or administrator of the licensure boards of each member state. The commission has various powers and duties granted in the compact, including establishing bylaws, promulgating binding rules for the compact, appointing officers and hiring employees, and establishing and electing an executive committee. The commission may levy on and collect an annual assessment from each member state or impose fees on licensees who receive compact privileges to cover the cost of the operations and activities of the commission and its staff.

2. The ability for a PA to obtain a “compact privilege,” which allows a PA who satisfies certain criteria to practice as a PA to provide medical services and other licensed activity to a patient located in another member state (remote state) under the remote state’s laws and regulations. The compact specifies a number of requirements in order for a PA to exercise a compact privilege, including holding a PA license in a member state, not having a felony or misdemeanor conviction, having had no revocation of a license or limitation or restriction on any license currently held due to an adverse action, and paying any fees and meeting any jurisprudence requirements that may be imposed by a remote state, though the bill does not impose any jurisprudence requirement. A remote state may, in accordance with that state’s laws, take adverse action against a PA’s compact privilege in the remote state and take any other necessary actions to protect the health and safety of its citizens. If the state in which a PA is licensed (home state) takes adverse action against a PA’s license, the PA loses the compact privilege in all remote states until certain criteria are satisfied. A member state may not impose discipline against a PA’s compact privilege or deny an application for a compact privilege in that member state for the individual’s otherwise lawful practice in another state.

3. The ability of member states to issue subpoenas that are enforceable in other states provided, however, that subpoenas may not be issued by a member state to gather evidence of conduct in another state that is lawful in that other state for the purpose of taking adverse action against a compact privilege or application for a compact privilege in that member state.

4. The creation of a coordinated data and reporting system containing licensure, adverse action, and the reporting of the existence of significant investigative information on PAs and applicants denied a PA license. The compact requires all adverse actions to be reported to the administrator of the data system. A member state must submit a uniform data set to the data system on all individuals to whom the compact is applicable as required by the rules of the commission.

5. Provisions regarding resolutions of disputes among member states and between member and nonmember states, including a process for termination of a state’s membership in the compact if the state defaults on its obligations under the compact.

The compact becomes effective upon enactment by seven states. The compact provides that it may be amended upon enactment of an amendment by all member states. A state may withdraw from the compact by repealing the statute authorizing the compact, but the compact provides that a withdrawal does not take effect until 180 days after the enactment of that repeal.

For further information see the state and local fiscal estimate, which will be printed as an appendix to this bill.

SB400,,4 The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:

SB400,1 Section 1. 14.835 of the statutes is created to read:

SB400,,6 14.835 PA licensure compact. There is created a PA licensure compact commission as specified in s. 448.988. The delegate on the commission representing this state shall be appointed by the physician assistant affiliated credentialing board as provided in s. 448.988 (7) (b) 1. and shall be an individual described in s. 448.988 (7) (b) 2. a. or b. The commission has the powers and duties granted and imposed under s. 448.988.

SB400,2 Section 2. 16.417 (1) (e) 3m. of the statutes is repealed and recreated to read:

SB400,,8 16.417 (1) (e) 3m. A physician assistant who is licensed under subch. IX of ch. 448 or who holds a compact privilege under subch. XIII of ch. 448.

SB400,3 Section 3. 49.45 (9r) (a) 7. e. of the statutes is amended to read:

SB400,,10 49.45 (9r) (a) 7. e. A physician assistant who is licensed under subch. IX of ch. 448 or who holds a compact privilege under subch. XIII of ch. 448.

SB400,4 Section 4. 97.67 (5m) (a) 3. of the statutes is amended to read:

SB400,,12 97.67 (5m) (a) 3. A physician assistant who is licensed under subch. IX of ch. 448 or who holds a compact privilege under subch. XIII of ch. 448.

SB400,5 Section 5. 111.335 (4) (jm) of the statutes is created to read:

SB400,,14 111.335 (4) (jm) Notwithstanding s. 111.322, it is not employment discrimination because of conviction record for the physician assistant affiliated credentialing board to refuse to grant to an individual a compact privilege, as defined in s. 448.988 (2) (b), in accordance with s. 448.988 (4) (a) 3.

SB400,6 Section 6. 118.2925 (1) (f) of the statutes is amended to read:

SB400,,16 118.2925 (1) (f) “Physician assistant” means a person who is licensed under s. 448.974 subch. IX of ch. 448 or who holds a compact privilege under subch. XIII of ch. 448.

SB400,7 Section 7. 146.81 (1) (eu) of the statutes is amended to read:

SB400,,18 146.81 (1) (eu) A physician assistant who is licensed under subch. IX of ch. 448 or who holds a compact privilege under subch. XIII of ch. 448.

SB400,8 Section 8. 146.997 (1) (d) 4. of the statutes, as affected by 2021 Wisconsin Act 251, is amended to read:

SB400,,20 146.997 (1) (d) 4. A physician, physician assistant, podiatrist, perfusionist, physical therapist, physical therapist assistant, occupational therapist, occupational therapy assistant, or genetic counselor licensed under ch. 448; a physical therapist or physical therapist assistant who holds a compact privilege under subch. XI of ch. 448; or an occupational therapist or occupational therapy assistant who holds a compact privilege under subch. XII of ch. 448; or a physician assistant who holds a compact privilege under subch. XIII of ch. 448;.

SB400,9 Section 9. 154.01 (3) (b) of the statutes is amended to read:

SB400,,22 154.01 (3) (b) A physician assistant licensed under ch. 448.

SB400,10 Section 10. 155.01 (1g) (c) of the statutes is amended to read:

SB400,,24 155.01 (1g) (c) A physician assistant licensed under ch. 448 who a physician responsible for overseeing the physician assistant’s practice affirms is competent to conduct evaluations of the capacity of patients to manage health care decisions.

SB400,11 Section 11. 155.01 (7) of the statutes, as affected by 2021 Wisconsin Act 251, is amended to read:

SB400,,26 155.01 (7) “Health care provider” means a nurse licensed or permitted under ch. 441, a chiropractor licensed under ch. 446, a dentist licensed under ch. 447, a physician, physician assistant, perfusionist, podiatrist, physical therapist, physical therapist assistant, occupational therapist, occupational therapy assistant, or genetic counselor licensed under ch. 448, a naturopathic doctor licensed under ch. 466, a person practicing Christian Science treatment, an optometrist licensed under ch. 449, a psychologist who is licensed under ch. 455, who is exercising the temporary authorization to practice, as defined in s. 455.50 (2) (o), in this state, or who is practicing under the authority to practice interjurisdictional telepsychology, as defined in s. 455.50 (2) (b), a physical therapist or physical therapist assistant who holds a compact privilege under subch. XI of ch. 448, an occupational therapist or occupational therapy assistant who holds a compact privilege under subch. XII of ch. 448, a physician assistant who holds a compact privilege under subch. XIII of ch. 448, a partnership thereof, a corporation or limited liability company thereof that provides health care services, a cooperative health care association organized under s. 185.981 that directly provides services through salaried employees in its own facility, or a home health agency, as defined in s. 50.49 (1) (a).

SB400,12 Section 12. 252.14 (1) (ar) 14. of the statutes is renumbered 252.14 (1) (ar) 4rm.

SB400,13 Section 13. 252.15 (1) (am) of the statutes is repealed and recreated to read:

SB400,,29 252.15 (1) (am) “Health care professional” means a physician, physician assistant, or nurse.

SB400,14 Section 14. 440.03 (9) (a) (intro.) of the statutes is amended to read:

SB400,,31 440.03 (9) (a) (intro.) Subject to pars. (b) and (c) and s. 458.33 (2) (b) and (5), the department shall, biennially, determine each fee for an initial credential for which no examination is required, for a reciprocal credential, and for a credential renewal and any fees imposed under ss. 448.986 (2) and, 448.9875 (2), and 448.9885 (2) by doing all of the following:

SB400,15 Section 15. 440.03 (9) (a) 2. of the statutes is amended to read:

SB400,,33 440.03 (9) (a) 2. Not later than January 31 of each odd-numbered year, adjusting for the succeeding fiscal biennium each fee for an initial credential for which an examination is not required, for a reciprocal credential, and, subject to s. 440.08 (2) (a), for a credential renewal, and any fees imposed under ss. 448.986 (2) and, 448.9875 (2), and 448.9885 (2), if an adjustment is necessary to reflect the approximate administrative and enforcement costs of the department that are attributable to the regulation of the particular occupation or business during the period in which the initial or reciprocal credential, credential renewal, or compact privilege is in effect and, for purposes of each fee for a credential renewal, to reflect an estimate of any additional moneys available for the department’s general program operations as a result of appropriation transfers that have been or are estimated to be made under s. 20.165 (1) (i) during the fiscal biennium in progress at the time of the deadline for an adjustment under this subdivision or during the fiscal biennium beginning on the July 1 immediately following the deadline for an adjustment under this subdivision.

SB400,16 Section 16. 440.03 (11m) (c) 2c. of the statutes is created to read:

SB400,,35 440.03 (11m) (c) 2c. The coordinated data and reporting system under s. 448.988 (8), if such disclosure is required under the PA licensure compact under s. 448.988.

SB400,17 Section 17. 440.03 (13) (b) (intro.) of the statutes is amended to read:

SB400,,37 440.03 (13) (b) (intro.) The department may investigate whether an applicant for or holder of any of the following credentials has been charged with or convicted of a crime only pursuant to rules promulgated by the department under this paragraph, including rules that establish the criteria that the department will use to determine whether an investigation under this paragraph is necessary, except as provided in par. (c) and ss. 441.51 (5) (a) 5., 448.980 (5) (b) 3., 448.985 (3) (a) 4., 448.987 (3) (a) 5. a. and (5) (b) 2. a., 448.988 (3) (a) 5., and 455.50 (3) (e) 4. and (f) 4.:

SB400,18 Section 18. 440.03 (13) (c) of the statutes is renumbered 440.03 (13) (c) 1. (intro.) and amended to read:

SB400,,39 440.03 (13) (c) 1. (intro.) The department shall require an all of the following to be photographed and fingerprinted on 2 fingerprint cards, each bearing a complete set of the person’s fingerprints:

SB400,,40 a. An applicant for a private detective license or a private security permit under s. 440.26, an.

SB400,,41 b. An applicant for a juvenile martial arts instructor permit under sub. (17), an.

SB400,,42 c. An applicant for a real estate appraiser certification under s. 458.06 or license under s. 458.08, an.

SB400,,43 d. An applicant for a multistate license under s. 441.06 (1c) or 441.10 (1c), an.

SB400,,44 e. An applicant for a compact license under s. 448.05 (2) (f), an.

SB400,,45 f. An applicant for a physical therapist license under s. 448.53 or physical therapist assistant license under s. 448.535, an.

SB400,,46 g. An applicant for an occupational therapist or occupational therapy assistant compact privilege under s. 448.987 (4), and an applicant for an occupational therapist or occupational therapy assistant license described in s. 448.987 (5) (b) 2. a., an

SB400,,47 h. An applicant for a psychologist license under s. 455.04, and a.

SB400,,48 z. A person for whom the department conducts an investigation under par. (b), to be photographed and fingerprinted on 2 fingerprint cards, each bearing a complete set of the person’s fingerprints.

SB400,,49 2. The department of justice may submit the fingerprint cards, and the department of justice shall submit the fingerprint cards of all applicants for a real estate appraiser certification under s. 458.06 or license under s. 458.08, of all applicants for a multistate license under s. 441.06 (1c) or 441.10 (1c), of all applicants for a compact license under s. 448.05 (2) (f), of all applicants for a physical therapist license under s. 448.53 or a physical therapist assistant license under s. 448.535, and of all applicants for a psychologist license under s. 455.04 identified in subd. 1. c. to i., to the federal bureau of investigation for the purpose of verifying the identity of the persons fingerprinted and obtaining records of their criminal arrests and convictions.

SB400,,50 3. Information obtained from the federal bureau of investigation may be shared with the department or the appropriate credentialing board, but shall otherwise be kept confidential and is not subject to disclosure under s. 19.35.

SB400,19 Section 19. 440.03 (13) (c) 1. i. of the statutes is created to read:

SB400,,52 440.03 (13) (c) 1. i. An applicant for a physician assistant license or compact privilege under s. 448.974 when required pursuant to the PA licensure compact under s. 448.988.

SB400,20 Section 20. 440.094 (1) (c) 4. of the statutes is amended to read:

SB400,,54 440.094 (1) (c) 4. A physician, physician assistant, perfusionist, or respiratory care practitioner licensed or certified under subch. II of ch. 448.

SB400,21 Section 21. 440.094 (1) (c) 9m. of the statutes is created to read:

SB400,,56 440.094 (1) (c) 9m. A physician assistant licensed under subch. IX of ch. 448.

SB400,22 Section 22. 440.15 of the statutes is amended to read:

SB400,,58 440.15 No fingerprinting. Except as provided under ss. 440.03 (13) (c), 441.51 (5) (a) 5., 448.980 (5) (b) 3., 448.985 (3) (a) 4., 448.987 (3) (a) 5. a. and (5) (b) 2. a., 448.988 (3) (a) 5., 450.071 (3) (c) 9., 450.075 (3) (c) 9., and 455.50 (3) (e) 4. and (f) 4., the department or a credentialing board may not require that an applicant for a credential or a credential holder be fingerprinted or submit fingerprints in connection with the department’s or the credentialing board’s credentialing.

SB400,23 Section 23. 448.015 (4) (am) 2m. of the statutes is renumbered 448.978 (1g) (a) and amended to read:

SB400,,60 448.978 (1g) (a) A “Unprofessional conduct” includes a determination made by a physician assistant under ch. 154 or 155 if the physician assistant does not have sufficient education, training, and experience to make the determination.

SB400,24 Section 24. 448.971 (1L) of the statutes is created to read:

SB400,,62 448.971 (1L) “Compact” means the PA licensure compact under s. 448.988.

SB400,25 Section 25. 448.971 (1m) of the statutes is created to read:

SB400,,64 448.971 (1m) “Compact privilege” means a compact privilege, as defined in s. 448.988 (2) (b), that is granted under the compact to an individual to practice in this state.

SB400,26 Section 26. 448.971 (2) of the statutes is amended to read:

SB400,,66 448.971 (2) “Physician assistant” means a person who is licensed under this subchapter or who holds a compact privilege.

SB400,27 Section 27. 448.972 (1) of the statutes is amended to read:

SB400,,68 448.972 (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 or holds a compact privilege.