(c)
Evidence of completion of requirements under PA 2.05 (2) (b) if the licensee has not held an active Wisconsin license in the last five years.(d)
Evidence of completion of disciplinary requirements, if applicable.(e)
Evidence of rehabilitation or a change in circumstances, warranting reinstatement of the license.
PA 2.06 Reciprocal Credentials for Service Members, Former Service Members, and their Spouses. A reciprocal license shall be granted to a service member, former service member, or the spouse of a service member or former service member who the board determines meets all of the requirements under s. 440.09 (2), Stats. subject to s. 9.9
(2m), Stats. The board may request verification necessary to make a determination under this section.PA 2.07 Title Protection. No person may designate himself or herself as a “physician assistant” or “physician associate” or use or assume the title “physician assistant” or “physician associate” or append to the person’s name the words or letters “physician assistant”, “physician associate” or “P.A.” or any other titles, letters, or designation which represents or may tend to represent that person as a physician assistant or physician associate unless that person is a physician assistant licensed by the board or a federally credentialed physician assistant or physician associate.
CHAPTER PA 3 COLLABORATION AND PRACTICE
PA 3.01 Practice Standards. (1) Regardless of employment status, a physician assistant shall practice pursuant to one of the following:
(a)
In accordance with s. 448.975 (2) (a) 1. a., Stats. the physician assistant practices pursuant to an employment arrangement. Under this option, a physician assistant is not required under this rule to enter into a written collaborative agreement with a physician. This provision shall not prevent an employer from requiring a written collaborative or practice agreement; or(b)
The physician assistant enters into a written collaborative agreement with a physician pursuant to s. 448.975 (2) (a) 1. b., Stats.:1.
If a physician assistant practices pursuant to a written collaborative agreement under sub. (1) (b) of this section, the agreement must be kept on file at the practice site. The agreement must include, at a minimum:a.
A statement that the collaborating physician shall remain reasonably available to the physician assistant for consultation via telecommunications or other electronic means and that consultation shall occur within a medically appropriate time;b.
A statement that the collaborating physician may designate an alternate collaborator to be consulted when the collaborating physician is temporarily unavailable.c.
A statement that if the patient requests a physician consultation, arrangements must be made for such a consult within a medically appropriate time;d.
A clause specifying that either party may terminate the collaborative agreement by providing written notice at least 30 days prior to the date of termination, or in a manner otherwise specified by the collaborating physician and the physician assistant; ande.
The signature of both the collaborating physician and the physician assistant.
(2)
A physician is not required under this rule to be physically present at the location where the physician assistant practices or renders care.PA 3.02 Practice of Podiatry. A physician assistant may practice with the supervision and direction of a podiatrist pursuant to s. 448.975 (1) (b) 2., stats. and the rules promulgated under s. 448.695 (4) (b), Stats. PA 3.03 Emergency, Disaster, and Volunteer Practice. (1) A physician assistant licensed under s. PA 2 may perform any of the following:
(a)
Render such emergency medical care that they are able to provide at the scene of an accident or emergency situation, not to be defined as an emergency situation that occurs in the place of one’s employment, in the absence of an employment or collaborative agreement entered into under PA 3.01 (1).(b)
Render such medical care that they are able to provide during a declared state of emergency or other disaster, notwithstanding an employment or collaborative agreement entered into under PA 3.01 (1).(c)
Provide volunteer medical care at camps or sporting events, notwithstanding an employment or collaborative agreement entered into under PA 3.01 (1).(2) Pursuant to ss. 448.975 (5) (a) b 1. and 257.03 (3) Physician assistants who voluntarily and gratuitously render emergency, disaster, or volunteer care pursuant to sub. (1) of this section shall not be liable for civil damages for any personal injuries that result from acts or omissions which may constitute ordinary negligence. The immunity granted by this section shall not apply to acts or omissions constituting reckless, wanton, or intentional misconduct.
PA 3.04 Practice During Interruption in Collaboration. If a physician assistant’s collaborating physician under PA 3.01 (1) (b) is unable to collaborate as specified in that section due to an interruption in licensed practice, a leave of absence of 30 days or longer such that the physician is unreachable, change in employment, change in license or privileges, or death:
(1)
When the interruption is temporary, and an alternate has not been identified in the current agreement, or is otherwise not available, a new alternate physician may provide temporary collaboration to the physician assistant. An interim collaborative agreement shall be documented within and maintained at the site of practice in accordance with s. PA 3.01 (1) (b).(2)
If the collaborating physician will be unavailable for more than 90 business days due to an interruption in licensure or privileges, employment, extended leave of absence or death, the physician assistant shall secure a new collaborating physician and document the agreement in accordance with s. PA 3.01 (1) (b).(3)
If no physician is available to collaborate with the physician assistant, either:(a)
A Physician Assistant possessing at least 2,080 hours of practice experience in the same specialty or concentration shall notify the board within 3 business days of the collaborating physician’s absence and attestation to active search for replacement. The physician assistant may continue to practice under the current terms of the physician assistant’s collaboration agreement without physician collaboration for up to 90 business days, at which time the physician assistant may petition the board to extend practice under the same terms. The board shall consider the practice setting, experience, and qualifications of the physician assistant, and potential availability of collaborating physicians when reviewing requests to extend practice under this subsection; or(b)
A Physician Assistant possessing less than 2,080 hours of practice experience in the same specialty or concentration shall enter into a written interim collaborative agreement with a physician assistant possessing at least 10,000 hours of practice experience in the same specialty or concentration; and shall notify the board within 3 business days of the collaborating physician’s absence, provide a copy of the interim written collaborative agreement and, an attestation to active search for replacement of the collaborating physician. The physician assistant may continue to practice under the current terms of the physician assistant’s interim collaboration agreement with physician assistant collaboration for up to 30 business days, at which time the physician assistant may petition the board to extend practice under the same terms. The board shall consider the practice setting, experience, and qualifications of the physician assistant, the collaborating physician assistant and potential availability of collaborating physicians when reviewing requests to extend practice under this subsection. This interim collaborative agreement may not exceed 180 consecutive days or 180 days in any calendar year.(4)
The board may audit and review the practice of a physician assistant temporarily practicing without a collaborating physician under sub. (3) of this section at any time during or after the collaborating physician’s absence.(5)
Physician assistants temporarily practicing without a collaborating physician under sub. (3) of this section shall not practice outside of their education, training, and experience and shall refer patients to another provider when appropriate to the patient’s condition and the standard of care.PA 3.05 Minimum Standards for Patient Health Care Records. (1) When patient healthcare records are not maintained by a separate entity, a physician assistant shall ensure patient health care records are maintained on every patient for a period of not less than 5 years after the date of the last entry, or for a longer period as may be otherwise required by law.
(2)
A patient health care record shall contain all of the following clinical health care information which applies to the patient’s medical condition:(a)
Pertinent patient history.(b)
Pertinent objective findings related to examination and test results.(c)
Assessment or diagnosis.(d)
Plan of treatment for the patient.(3)
Each patient health care record entry shall be dated, shall identify the physician assistant, and shall be sufficiently legible to allow interpretation by other health care practitioners.PA 3.06 Standards for Dispensing and Prescribing Drugs. (1) PRESCRIPTIVE AUTHORITY.
(e)
A physician assistant may order, prescribe, procure, dispense, and administer prescription drugs, medical devices, services, and supplies.(f)
A physician assistant practicing under the supervision and direction of a podiatrist may issue a prescription order for a drug or device in accordance with guidelines established by the supervising podiatrist and the physician assistant.(2)
PACKAGING. A prescription drug dispensed by a physician assistant shall be dispensed in a child-resistant container if it is a substance requiring special packaging under 16 CFR 1700.14 (1982) of the federal regulations for the federal poison packaging act of 1970.(3)
LABELING. A prescription drug dispensed by a physician assistant shall contain a legible label affixed to the immediate container disclosing all of the following:(a)
The name and address of the facility from which the prescribed drug is dispensed.(b)
The date on which the prescription is dispensed.(c)
The name of the physician assistant who prescribed the drug.(d)
The full name of the patient.(e)
The generic name and strength of the prescription drug dispensed unless the prescribing physician assistant requests omission of the name and strength of the drug dispensed.(f)
Directions for the use of the prescribed drug and cautionary statements, if any, contained in the prescription or required by law.(4)
RECORDKEEPING. A physician assistant shall maintain complete and accurate records of each prescription drug received, dispensed, or disposed of in any other manner.(g)
Records required by the federal controlled substances act and ch. 961, Stats., shall be maintained at the location where the drug is received, distributed, or dispensed and be available for inspection by authorized persons for at least 5 years from the date of the record.(h)
Controlled substances dispensed by a physician assistant shall be recorded on a separate log, in a separate bound logbook in which each schedule of controlled substances dispensed is recorded separately and in chronological order with the following information:1.
The name of the substance.2.
Dosage form and strength of the substance.3.
Name and address of the person for whom dispensed.6.
Name or initials of physician assistant who dispensed the substance.PA 3.07 Informed Consent. (1) Pursuant to s. 448.9785, Stats., a physician assistant shall communicate alternate modes of treatment to a patient. (2)
Any physician assistant who treats a patient shall inform the patient about the availability of reasonable alternative 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.(3)
The physician assistant’s duty to inform the patient under this section does not require disclosure of any of the following:(a)
Detailed technical information that in all probability a patient would not understand.(b)
Risks apparent or known to the patient.(c)
Extremely remote possibilities that might falsely or detrimentally alarm the patient.(d)
Information in emergencies where failure to provide treatment would be more harmful to the patient than treatment.(e)
Information in cases where the patient is incapable of consenting.(f)
Information about alternate modes of treatment for any condition the physician assistant has not included in the physician assistant’s diagnosis at the time the physician assistant informs the patient.(4)
A physician assistant’s record shall include documentation that alternate modes of treatment have been communicated to the patient and informed consent has been obtained from the patient.CHAPTER PA 4 UNPROFESSIONAL CONDUCT
PA 4.01 Unprofessional Conduct. “Unprofessional conduct” includes, but is not limited to the following, or aiding or abetting the same:
(1)
DISHONESTY AND CHARACTER. (a) Violating or attempting to violate any provision or term of subch. VIII of ch. 448, Stats., or of any valid rule of the board.(b)
Violating or attempting to violate any term, provision, or condition of any order of the board.(c)
Knowingly engaging in fraud or misrepresentation or dishonesty in applying, for or procuring a physician assistant license, or in connection with applying for or procuring periodic renewal of a physician assistant license, or in otherwise maintaining such licensure.(d)
Knowingly giving false, fraudulent, or deceptive testimony while serving as an expert witness.
