Amendment SSA1-SB477

SB477-SSA1,11 Section 11 . 448.21 (3) of the statutes is amended to read:

SB477-SSA1,4,12 448.21 (3) Prescriptive authority. A physician assistant may issue a prescription order for a drug or device in accordance with guidelines established by a supervising physician or podiatrist and the physician assistant and with rules promulgated by the board. If any conflict exists between the guidelines and the rules, the rules shall control.

SB477-SSA1,12 Section 12 . 448.21 (4) of the statutes is created to read:

SB477-SSA1,4,16 448.21 (4) Practice of podiatry. A physician assistant who is acting under the supervision and direction of a podiatrist shall be limited to providing nonsurgical patient services.

SB477-SSA1,13 Section 13. 448.62 (2m) of the statutes is created to read:

SB477-SSA1,4,21 448.62 (2m) An advanced practice nurse who is certified to issue prescription orders under s. 441.16 and who is providing nonsurgical patient services as directed, supervised, and inspected by a podiatrist who has the power to direct, decide, and oversee the implementation of the patient services rendered.

SB477-SSA1,14 Section 14 . 448.62 (7) of the statutes is created to read:

SB477-SSA1,4,24 448.62 (7) A physician assistant who is acting under the supervision and direction of a podiatrist, subject to s. 448.21 (4).

SB477-SSA1,15 Section 15 . 448.695 (4) of the statutes is created to read:

SB477-SSA1,5,2 448.695 (4) The affiliated credentialing board shall promulgate rules establishing all of the following:

SB477-SSA1,5,4 (a) Practice standards for a physician assistant practicing podiatry as provided in s. 448.21 (4).

SB477-SSA1,5,6 (b) Requirements for a podiatrist who is supervising a physician assistant as provided in s. 448.21 (4).

SB477-SSA1,16 Section 16 . Med 8.01 (2) of the statutes is amended to read:

SB477-SSA1,5,17 Med 8.01 (2) Physician assistants provide health care services as part of physician-led or podiatrist-led teams, the objectives of which include safe, efficient, and economical health care. The realities of the modern practice of medicine and surgery require supervising physicians and podiatrists and physician assistants to use discretion in delivering health care services, typically at the level of general supervision. The constant physical presence of a supervising physician or podiatrist is often unnecessary. The supervising physician or podiatrist and the physician assistant are jointly responsible for employing more intensive supervision when circumstances require direct observation or hands-on assistance from the supervising physician.

SB477-SSA1,17 Section 17 . Med 8.02 (5x) of the administrative code is created to read:

SB477-SSA1,5,19 Med 8.02 (5x) “Podiatrist” has the meaning given in s. 448.60 (3), Stats.

SB477-SSA1,18 Section 18 . Med 8.05 (4) of the administrative code is amended to read:

SB477-SSA1,5,24 Med 8.05 (4) Licensure; renewal. At the time of licensure and each biennial registration of licensure thereafter, a physician assistant shall list with the board the name and address of the supervising physician or podiatrist and shall notify the board within 20 days of any change of a supervising physician or podiatrist.

SB477-SSA1,19 Section 19. Med 8.07 (1), (2) (i) and (3) of the administrative code are amended to read:

SB477-SSA1,6,11 Med 8.07 (1) Scope and limitations. In providing medical care, the entire practice of any physician assistant shall be under the supervision of one or more licensed physicians or, physicians exempt from licensure requirements pursuant to s. 448.03 (2) (b), Stats., or licensed podiatrists. The scope of practice is limited to providing medical care as specified in sub. (2). A physician assistant's practice may not exceed his or her educational training or experience and may not exceed the scope of practice of the physician or podiatrist providing supervision. A medical care task assigned by the supervising physician or podiatrist to a physician assistant may not be delegated by the physician assistant to another person.

SB477-SSA1,6,17 (2) (i) Issuing written prescription orders for drugs provided the physician assistant has had an initial and at least annual thereafter, review of the physician assistant's prescriptive practices by a physician or podiatrist providing supervision. Such reviews shall be documented in writing, signed by the reviewing physician or podiatrist and by the physician assistant, and made available to the Board for inspection upon reasonable request.

SB477-SSA1,6,21 (3) Identifying supervising physician or podiatrist. The physician or podiatrist providing supervision must be readily identifiable by the physician assistant through procedures commonly employed in the physician assistant's practice.

SB477-SSA1,20 Section 20 . Med 8.09 of the administrative code is amended to read:

SB477-SSA1,7,2 Med 8.09 Employee status. No physician assistant may be self-employed. If the employer of a physician assistant is other than a licensed physician or podiatrist, the employer shall provide for, and may not interfere with, the supervisory responsibilities of the physician or podiatrist, as defined in s. Med 8.02 (6) and required in ss. Med 8.07 (1) and 8.10.

SB477-SSA1,21 Section 21 . Med 8.10 of the administrative code is amended to read:

SB477-SSA1,7,9 Med 8.10 Physician or podiatrist to physician assistant ratio. (1) No physician or podiatrist may supervise more than 4 on-duty physician assistants at any time unless a written plan to do so has been submitted to and approved by the board. Nothing herein shall limit the number of physician assistants for whom a physician or podiatrist may provide supervision over time. A physician assistant may be supervised by more than one physician or podiatrist while on duty.

SB477-SSA1,7,12 (2) A supervising physician or podiatrist shall be available to the physician assistant at all times for consultation either in person or within 15 minutes of contact by telecommunication or other means.

SB477-SSA1,22 Section 22 . Nonstatutory provisions.

SB477-SSA1,7,20 (1) Emergency rules. Using the procedure under section 227.24 of the statutes, the podiatry affiliated credentialing board may promulgate emergency rules under section 448.695 (4). Notwithstanding section 227.24 (1) (a), (2) (b), and (3) of the statutes, the board is not required to provide evidence that promulgating rules under this subsection as emergency rules is necessary for the preservation of the public peace, health, safety, or welfare and is not required to provide a finding of emergency for rules promulgated under this subsection.

SB477-SSA1,23 Section 23 . Effective dates. This act takes effect on the day after publication, except as follows:

SB477-SSA1,7,24 (1) The modifications of administrative rules take effect as provided in section 227.265 of the statutes.

SB477-SSA1,7,25 (End)