HF 2105 (LSB 5100HH (7) 86)

HOUSE FILE 2105

BY  PETTENGILL and VANDER LINDEN

A BILL FOR

An Act eliminating the board of physician assistants, transferring regulatory responsibilities regarding physician assistants to the board of medicine, making penalties applicable, and including effective date provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  Section 135.24, subsection 2, paragraph a, Code 2016, is amended to read as follows:
   a.  Procedures for registration of health care providers deemed qualified by the board of medicine, the board of physician assistants, the dental board, the board of nursing, the board of chiropractic, the board of psychology, the board of social work, the board of behavioral science, the board of pharmacy, the board of optometry, the board of podiatry, the board of physical and occupational therapy, the board of respiratory care and polysomnography, and the Iowa department of public health, as applicable.
    Sec. 2.  Section 139A.8, subsection 4, paragraph a, subparagraph (1), Code 2016, is amended to read as follows:
   (1)  The applicant, or if the applicant is a minor, the applicant’s parent or legal guardian, submits to the admitting official a statement signed by a physician, advanced registered nurse practitioner, or physician assistant who is licensed by the board of medicine, or board of nursing, or board of physician assistants that the immunizations required would be injurious to the health and well-being of the applicant or any member of the applicant’s family.
    Sec. 3.  Section 139A.22, subsection 6, Code 2016, is amended to read as follows:
   6.  The board of medicine, the board of physician assistants, the board of podiatry, the board of nursing, the dental board, and the board of optometry shall require that licensees comply with the recommendations issued by the centers for disease control and prevention of the United States department of health and human services for preventing transmission of human immunodeficiency virus and hepatitis B virus to patients during exposure-prone invasive procedures, with the recommendations of the expert review panel established pursuant to subsection 3, with hospital protocols established pursuant to subsection 1, and with health care facility procedures established pursuant to subsection 2, as applicable.
    Sec. 4.  Section 147.13, subsection 1, Code 2016, is amended to read as follows:
   1.  For medicine and surgery, osteopathic medicine and surgery, physician assistants, and acupuncture, the board of medicine.
    Sec. 5.  Section 147.13, subsection 2, Code 2016, is amended by striking the subsection.
    Sec. 6.  Section 147.14, subsection 1, paragraph l, Code 2016, is amended by striking the paragraph.
    Sec. 7.  Section 147.16, subsection 2, Code 2016, is amended by striking the subsection.
    Sec. 8.  Section 147.107, subsections 4 and 5, Code 2016, are amended to read as follows:
   4.  Notwithstanding subsection 3, a physician assistant shall not dispense prescription drugs as an incident to the practice of the supervising physician or the physician assistant, but may supply, when pharmacist services are not reasonably available, or when it is in the best interests of the patient, a quantity of properly packaged and labeled prescription drugs, controlled substances, or medical devices necessary to complete a course of therapy. However, a remote clinic, staffed by a physician assistant, where pharmacy services are not reasonably available, shall secure the regular advice and consultation of a pharmacist regarding the distribution, storage, and appropriate use of such drugs, substances, and devices. Prescription drugs supplied under the provisions of this subsection shall be supplied for the purpose of accommodating the patient and shall not be sold for more than the cost of the drug and reasonable overhead costs, as they relate to supplying prescription drugs to the patient, and not at a profit to the physician or the physician assistant. If prescription drug supplying authority is delegated by a supervising physician to a physician assistant, a nurse or staff assistant may assist the physician assistant in providing that service. Rules shall be adopted by the board of physician assistants medicine, after consultation with the board of pharmacy, to implement this subsection.
   5.  Notwithstanding subsection 1 and any other provision of this section to the contrary, a physician may delegate the function of prescribing drugs, controlled substances, and medical devices to a physician assistant licensed pursuant to chapter 148C. When delegated prescribing occurs, the supervising physician’s name shall be used, recorded, or otherwise indicated in connection with each individual prescription so that the individual who dispenses or administers the prescription knows under whose delegated authority the physician assistant is prescribing. Rules relating to the authority of physician assistants to prescribe drugs, controlled substances, and medical devices pursuant to this subsection shall be adopted by the board of physician assistants medicine, after consultation with the board of medicine and the board of pharmacy. However, the rules shall prohibit the prescribing of schedule II controlled substances which are listed as depressants pursuant to chapter 124.
    Sec. 9.  Section 147A.13, subsection 1, Code 2016, is amended to read as follows:
   1.  Documentation has been reviewed and approved at the local level by the medical director of the service program in accordance with the rules of the board of physician assistants medicine developed after consultation with the department.
    Sec. 10.  Section 148.13, Code 2016, is amended to read as follows:
   148.13  Authority of board as to supervising physicians and review of contested cases under chapter 148C relating to physician assistants —— rules.
   1.  The board of medicine shall adopt rules setting forth in detail its criteria and procedures for determining the ineligibility of a physician to serve as a supervising physician under chapter 148C. The rules shall provide that a physician may serve as a supervising physician under chapter 148C until such time as the board of medicine determines, following normal disciplinary procedures, that the physician is ineligible to serve in that capacity.
   2.  The board of medicine shall establish by rule specific procedures for consulting with and considering the advice of the board of physician assistants in determining whether to initiate a disciplinary proceeding under chapter 17A against a licensed physician in a matter involving the supervision of a physician assistant.
   3.  2.  In exercising their respective authorities its authority, the board of medicine and the board of physician assistants shall cooperate with the goal of encouraging encourage the utilization of physician assistants in a manner that is consistent with the provision of quality health care and medical services for the citizens of Iowa.
   4.  3.  The board of medicine shall adopt rules requiring a physician serving as a supervising physician to notify the board of medicine of the identity of a physician assistant the physician is supervising, and of any change in the status of the supervisory relationship.
    Sec. 11.  Section 148C.1, subsection 2, Code 2016, is amended to read as follows:
   2.  “Board” means the board of physician assistants medicine created under chapter 147.
    Sec. 12.  Section 148C.3, subsection 6, Code 2016, is amended by striking the subsection.
    Sec. 13.  Section 272C.1, subsection 6, paragraph m, Code 2016, is amended by striking the paragraph.
    Sec. 14.  REPEAL.  Section 148C.12, Code 2016, is repealed.
    Sec. 15.  TRANSITION PROVISIONS. 
   1.  The board of medicine and the department of public health shall coordinate any transitional procedures required for allocation of moneys held by the department on behalf of the board of physician assistants to the board of medicine.
   2.  a.  Any rule, regulation, form, order, or directive promulgated by the board of physician assistants as required to administer and enforce the provisions of chapter 148C shall continue in full force and effect until amended, repealed, or supplemented by affirmative action of the board of medicine.
   b.  Any license issued by the board of physician assistants under chapter 148C, and in effect on the effective date of this Act, shall continue in full force and effect until expiration or renewal.
   3.  An administrative hearing or court proceeding arising out of an enforcement action under chapter 148C pending on the effective date of this Act shall not be affected due to this Act. Any cause of action or statute of limitation relating to an action taken by the board of physician assistants shall not be affected as a result of this Act and such cause or statute of limitation shall apply to the board of medicine. 
    Sec. 16.  EFFECTIVE DATE.  This Act shall take effect January 1, 2017, except that the board of medicine and department of public health may begin implementation prior to January 1, 2017, to the extent necessary to transition to full implementation of the provisions relating to the licensure and supervision of physician assistants.
EXPLANATION
The inclusion of this explanation does not constitute agreement with

the explanation’s substance by the members of the general assembly.
   This bill eliminates the board of physician assistants and gives the board of medicine authority over Code chapter 148C, relating to physician assistant licensure and practice.
   The bill provides transition provisions to assist the boards and the department of public health in accomplishing the transfer. The provisions relate to the reallocation of moneys held by the department of public health on behalf of the board of physician assistants to the board of medicine, the validity of existing rules, regulations, forms, orders, and directives promulgated by the board of physician assistants, licenses issued by the board of physician assistants, and pending enforcement or civil actions involving the board of physician assistants.
   The bill takes effect January 1, 2017, except that the board of medicine and the department of public health may begin implementation prior to that date to the extent necessary to transition to full implementation.