House File 2105 - Introduced HOUSE FILE 2105 BY PETTENGILL and VANDER LINDEN A BILL FOR An Act eliminating the board of physician assistants, 1 transferring regulatory responsibilities regarding physician 2 assistants to the board of medicine, making penalties 3 applicable, and including effective date provisions. 4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 5 TLSB 5100HH (7) 86 tr/nh

H.F. 2105 Section 1. Section 135.24, subsection 2, paragraph a, Code 1 2016, is amended to read as follows: 2 a. Procedures for registration of health care providers 3 deemed qualified by the board of medicine, the board of 4 physician assistants, the dental board, the board of nursing, 5 the board of chiropractic, the board of psychology, the board 6 of social work, the board of behavioral science, the board 7 of pharmacy, the board of optometry, the board of podiatry, 8 the board of physical and occupational therapy, the board of 9 respiratory care and polysomnography, and the Iowa department 10 of public health, as applicable. 11 Sec. 2. Section 139A.8, subsection 4, paragraph a, 12 subparagraph (1), Code 2016, is amended to read as follows: 13 (1) The applicant, or if the applicant is a minor, the 14 applicant’s parent or legal guardian, submits to the admitting 15 official a statement signed by a physician, advanced registered 16 nurse practitioner, or physician assistant who is licensed 17 by the board of medicine , or board of nursing , or board of 18 physician assistants that the immunizations required would be 19 injurious to the health and well-being of the applicant or any 20 member of the applicant’s family. 21 Sec. 3. Section 139A.22, subsection 6, Code 2016, is amended 22 to read as follows: 23 6. The board of medicine, the board of physician assistants, 24 the board of podiatry, the board of nursing, the dental board, 25 and the board of optometry shall require that licensees comply 26 with the recommendations issued by the centers for disease 27 control and prevention of the United States department of 28 health and human services for preventing transmission of human 29 immunodeficiency virus and hepatitis B virus to patients during 30 exposure-prone invasive procedures, with the recommendations of 31 the expert review panel established pursuant to subsection 3 , 32 with hospital protocols established pursuant to subsection 1 , 33 and with health care facility procedures established pursuant 34 to subsection 2 , as applicable. 35 -1- LSB 5100HH (7) 86 tr/nh 1/ 6

H.F. 2105 Sec. 4. Section 147.13, subsection 1, Code 2016, is amended 1 to read as follows: 2 1. For medicine and surgery, osteopathic medicine and 3 surgery, physician assistants, and acupuncture, the board of 4 medicine. 5 Sec. 5. Section 147.13, subsection 2, Code 2016, is amended 6 by striking the subsection. 7 Sec. 6. Section 147.14, subsection 1, paragraph l, Code 8 2016, is amended by striking the paragraph. 9 Sec. 7. Section 147.16, subsection 2, Code 2016, is amended 10 by striking the subsection. 11 Sec. 8. Section 147.107, subsections 4 and 5, Code 2016, are 12 amended to read as follows: 13 4. Notwithstanding subsection 3 , a physician assistant 14 shall not dispense prescription drugs as an incident to 15 the practice of the supervising physician or the physician 16 assistant, but may supply, when pharmacist services are not 17 reasonably available, or when it is in the best interests 18 of the patient, a quantity of properly packaged and labeled 19 prescription drugs, controlled substances, or medical devices 20 necessary to complete a course of therapy. However, a remote 21 clinic, staffed by a physician assistant, where pharmacy 22 services are not reasonably available, shall secure the 23 regular advice and consultation of a pharmacist regarding the 24 distribution, storage, and appropriate use of such drugs, 25 substances, and devices. Prescription drugs supplied under the 26 provisions of this subsection shall be supplied for the purpose 27 of accommodating the patient and shall not be sold for more 28 than the cost of the drug and reasonable overhead costs, as 29 they relate to supplying prescription drugs to the patient, and 30 not at a profit to the physician or the physician assistant. 31 If prescription drug supplying authority is delegated by a 32 supervising physician to a physician assistant, a nurse or 33 staff assistant may assist the physician assistant in providing 34 that service. Rules shall be adopted by the board of physician 35 -2- LSB 5100HH (7) 86 tr/nh 2/ 6

H.F. 2105 assistants medicine , after consultation with the board of 1 pharmacy, to implement this subsection . 2 5. Notwithstanding subsection 1 and any other provision 3 of this section to the contrary, a physician may delegate 4 the function of prescribing drugs, controlled substances, 5 and medical devices to a physician assistant licensed 6 pursuant to chapter 148C . When delegated prescribing 7 occurs, the supervising physician’s name shall be used, 8 recorded, or otherwise indicated in connection with each 9 individual prescription so that the individual who dispenses 10 or administers the prescription knows under whose delegated 11 authority the physician assistant is prescribing. Rules 12 relating to the authority of physician assistants to prescribe 13 drugs, controlled substances, and medical devices pursuant to 14 this subsection shall be adopted by the board of physician 15 assistants medicine , after consultation with the board of 16 medicine and the board of pharmacy. However, the rules shall 17 prohibit the prescribing of schedule II controlled substances 18 which are listed as depressants pursuant to chapter 124 . 19 Sec. 9. Section 147A.13, subsection 1, Code 2016, is amended 20 to read as follows: 21 1. Documentation has been reviewed and approved at the 22 local level by the medical director of the service program in 23 accordance with the rules of the board of physician assistants 24 medicine developed after consultation with the department. 25 Sec. 10. Section 148.13, Code 2016, is amended to read as 26 follows: 27 148.13 Authority of board as to supervising physicians 28 and review of contested cases under chapter 148C relating to 29 physician assistants —— rules. 30 1. The board of medicine shall adopt rules setting 31 forth in detail its criteria and procedures for determining 32 the ineligibility of a physician to serve as a supervising 33 physician under chapter 148C . The rules shall provide that a 34 physician may serve as a supervising physician under chapter 35 -3- LSB 5100HH (7) 86 tr/nh 3/ 6

H.F. 2105 148C until such time as the board of medicine determines, 1 following normal disciplinary procedures, that the physician is 2 ineligible to serve in that capacity. 3 2. The board of medicine shall establish by rule specific 4 procedures for consulting with and considering the advice of 5 the board of physician assistants in determining whether to 6 initiate a disciplinary proceeding under chapter 17A against 7 a licensed physician in a matter involving the supervision of 8 a physician assistant. 9 3. 2. In exercising their respective authorities its 10 authority , the board of medicine and the board of physician 11 assistants shall cooperate with the goal of encouraging 12 encourage the utilization of physician assistants in a manner 13 that is consistent with the provision of quality health care 14 and medical services for the citizens of Iowa. 15 4. 3. The board of medicine shall adopt rules requiring 16 a physician serving as a supervising physician to notify the 17 board of medicine of the identity of a physician assistant the 18 physician is supervising, and of any change in the status of 19 the supervisory relationship. 20 Sec. 11. Section 148C.1, subsection 2, Code 2016, is amended 21 to read as follows: 22 2. “Board” means the board of physician assistants medicine 23 created under chapter 147 . 24 Sec. 12. Section 148C.3, subsection 6, Code 2016, is amended 25 by striking the subsection. 26 Sec. 13. Section 272C.1, subsection 6, paragraph m, Code 27 2016, is amended by striking the paragraph. 28 Sec. 14. REPEAL. Section 148C.12, Code 2016, is repealed. 29 Sec. 15. TRANSITION PROVISIONS. 30 1. The board of medicine and the department of public health 31 shall coordinate any transitional procedures required for 32 allocation of moneys held by the department on behalf of the 33 board of physician assistants to the board of medicine. 34 2. a. Any rule, regulation, form, order, or directive 35 -4- LSB 5100HH (7) 86 tr/nh 4/ 6

H.F. 2105 promulgated by the board of physician assistants as required 1 to administer and enforce the provisions of chapter 148C shall 2 continue in full force and effect until amended, repealed, or 3 supplemented by affirmative action of the board of medicine. 4 b. Any license issued by the board of physician assistants 5 under chapter 148C, and in effect on the effective date of this 6 Act, shall continue in full force and effect until expiration 7 or renewal. 8 3. An administrative hearing or court proceeding arising 9 out of an enforcement action under chapter 148C pending on the 10 effective date of this Act shall not be affected due to this 11 Act. Any cause of action or statute of limitation relating to 12 an action taken by the board of physician assistants shall not 13 be affected as a result of this Act and such cause or statute of 14 limitation shall apply to the board of medicine. 15 Sec. 16. EFFECTIVE DATE. This Act shall take effect January 16 1, 2017, except that the board of medicine and department 17 of public health may begin implementation prior to January 18 1, 2017, to the extent necessary to transition to full 19 implementation of the provisions relating to the licensure and 20 supervision of physician assistants. 21 EXPLANATION 22 The inclusion of this explanation does not constitute agreement with 23 the explanation’s substance by the members of the general assembly. 24 This bill eliminates the board of physician assistants and 25 gives the board of medicine authority over Code chapter 148C, 26 relating to physician assistant licensure and practice. 27 The bill provides transition provisions to assist the boards 28 and the department of public health in accomplishing the 29 transfer. The provisions relate to the reallocation of moneys 30 held by the department of public health on behalf of the board 31 of physician assistants to the board of medicine, the validity 32 of existing rules, regulations, forms, orders, and directives 33 promulgated by the board of physician assistants, licenses 34 issued by the board of physician assistants, and pending 35 -5- LSB 5100HH (7) 86 tr/nh 5/ 6

H.F. 2105 enforcement or civil actions involving the board of physician 1 assistants. 2 The bill takes effect January 1, 2017, except that the board 3 of medicine and the department of public health may begin 4 implementation prior to that date to the extent necessary to 5 transition to full implementation. 6 -6- LSB 5100HH (7) 86 tr/nh 6/ 6