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S.B. 46





Sponsor: Robert C. Steiner

5    Robert F. Montgomery
Millie M. Peterson

11    This act affects sections of Utah Code Annotated 1953 as follows:
12    ENACTS:
13         58-70a-101, Utah Code Annotated 1953
14         58-70a-102, Utah Code Annotated 1953
15         58-70a-201, Utah Code Annotated 1953
16         58-70a-301, Utah Code Annotated 1953
17         58-70a-302, Utah Code Annotated 1953
18         58-70a-303, Utah Code Annotated 1953
19         58-70a-304, Utah Code Annotated 1953
20         58-70a-305, Utah Code Annotated 1953
21         58-70a-306, Utah Code Annotated 1953
22         58-70a-401, Utah Code Annotated 1953
23         58-70a-501, Utah Code Annotated 1953
24         58-70a-502, Utah Code Annotated 1953
25         58-70a-503, Utah Code Annotated 1953
26         58-70a-504, Utah Code Annotated 1953
27    REPEALS:

1         58-70-101, as renumbered and amended by Chapter 253, Laws of Utah 1996
2         58-70-102, as renumbered and amended by Chapter 253, Laws of Utah 1996
3         58-70-201, as renumbered and amended by Chapter 253, Laws of Utah 1996
4         58-70-301, as last amended by Chapter 247 and renumbered and amended by Chapter 253,
5    Laws of Utah 1996
6         58-70-302, as renumbered and amended by Chapter 253, Laws of Utah 1996
7         58-70-303, as renumbered and amended by Chapter 253, Laws of Utah 1996
8         58-70-304, as renumbered and amended by Chapter 253, Laws of Utah 1996
9         58-70-401, as renumbered and amended by Chapter 253, Laws of Utah 1996
10         58-70-501, as renumbered and amended by Chapter 253, Laws of Utah 1996
11         58-70-502, as renumbered and amended by Chapter 253, Laws of Utah 1996
12    Be it enacted by the Legislature of the state of Utah:
13        Section 1. Section 58-70a-101 is enacted to read:

Part 1. General Provisions

16         58-70a-101. Title.
17        This chapter is known as the "Physician Assistant Act."
18        Section 2. Section 58-70a-102 is enacted to read:
19         58-70a-102. Definitions.
20        In addition to the definitions in Section 58-1-102, as used in this chapter:
21        (1) "Board" means the Physician Assistant Licensing Board created in Section 58-70a-201.
22        (2) (a) "Delegation of services agreement" means written criteria jointly developed by a
23    physician assistant's supervising physician and any substitute supervising physicians and the
24    physician assistant, that permits a physician assistant, working under the direction or review of the
25    supervising physician, to assist in the management of common illnesses and injuries.
26        (b) The agreement defines the working relationship and delegation of duties between the
27    supervising physician and the physician assistant as specified by division rule and shall include:
28        (i) the prescribing of controlled substances;
29        (ii) the degree and means of supervision;
30        (iii) the frequency and mechanism of chart review;
31        (iv) procedures addressing situations outside the scope of practice of the physician

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1    assistant; and
2        (v) procedures for providing backup for the physician assistant in emergency situations.
3        (3) "Direct supervision" means the supervising physician is:
4        (a) physically present at the point of patient treatment on site where the physician assistant
5    he is supervising is practicing; and
6        (b) immediately available for consultation with the physician assistant.
7        (4) "Practice as a physician assistant" means:
8        (a) the professional activities and conduct of a physician assistant in diagnosing, treating,
9    advising, or prescribing for any human disease, ailment, injury, infirmity, deformity, pain, or other
10    condition, dependent upon and under the supervision of a supervising physician or substitute
11    supervising physician in accordance with a delegation of services agreement; and
12        (b) the physician assistant acts as the agent of the supervising physician or substitute
13    supervising physician when acting in accordance with a delegation of services agreement.
14        (5) "Substitute supervising physician" means an individual who meets the requirements
15    of a supervising physician under this chapter and acts as the supervising physician in the absence
16    of the supervising physician.
17        (6) "Supervising physician" means an individual who:
18        (a) is currently licensed to practice under Title 58, Chapter 67, Utah Medical Practice Act
19    or Title 58, Chapter 68, Utah Osteopathic Medical Practice Act;
20        (b) acts as the primary supervisor of a physician assistant and takes responsibility for the
21    professional practice and conduct of a physician assistant in accordance with this chapter; and
22        (c) is not an employee of the physician assistant he supervises.
23        (7) "Supervision" means the supervising physician is available for consultation with the
24    physician assistant, either personally or by other means permitting direct verbal communication
25    between the physician and physician assistant.
26        (8) "Unlawful conduct" is as defined in Sections 58-1-501 and 58-70a-502.
27        (9) "Unprofessional conduct" is as defined in Sections 58-1-501 and 58-70a-503 and as
28    may be further defined by rule.
29        Section 3. Section 58-70a-201 is enacted to read:
Part 2. Board

31         58-70a-201. Board.

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1        (1) There is created the Physician Assistant Licensing Board, which consists of seven
2    members:
3        (a) four licensed physicians, at least two of whom are individuals who are supervising or
4    who have supervised a physician assistant, and one of whom may be a member of a physician
5    licensing board under Section 58-67-201or 58-68-201;
6        (b) one physician assistant;
7        (c) one person who is involved in the administration of an approved physician assistant
8    education program within the state; and
9        (d) one person from the general public.
10        (2) The board shall be appointed and serve in accordance with Section 58-1-201.
11        (3) The duties and responsibilities of the board are in accordance with Sections 58-1-202
12    and 58-1-203. In addition, the board shall designate one of its members on a permanent or rotating
13    basis to:
14        (a) assist the division in reviewing complaints concerning the unlawful or unprofessional
15    conduct of a licensee; and
16        (b) advise the division in its investigation of these complaints.
17        (4) A board member who has, under Subsection (3), reviewed a complaint or advised in
18    its investigation may be disqualified from participating with the board when the board serves as
19    a presiding officer in an adjudicative proceeding concerning the complaint. The board member
20    may be disqualified:
21        (a) on his own motion, due to actual or perceived bias or lack of objectivity; or
22        (b) upon challenge for cause raised on the record by any party to the adjudicative
23    proceeding.
24        Section 4. Section 58-70a-301 is enacted to read:
Part 3. Licensing

26         58-70a-301. Licensure required -- License classifications.
27        (1) A license is required to engage in practice as a physician assistant, except as
28    specifically provided in Section 58-70a-305 or 58-1-307.
29        (2) The division shall issue to a person who qualifies under this chapter a license in the
30    classification of physician assistant.
31        Section 5. Section 58-70a-302 is enacted to read:

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1         58-70a-302. Qualifications for licensure.
2        Each applicant for licensure as a physician assistant shall:
3        (1) submit an application in a form prescribed by the division;
4        (2) pay a fee determined by the department under Section 63-38-3.2;
5        (3) be of good moral character;
6        (4) have successfully completed a physician assistant program accredited by the
7    Commission on Accreditation of Allied Health Education Programs;
8        (5) have passed the licensing examinations required by division rule made in collaboration
9    with the board;
10        (6) meet with the board and representatives of the division, if requested, for the purpose
11    of evaluating the applicant's qualifications for licensure; and
12        (7) (a) if the applicant desires to practice in Utah, complete a form provided by the division
13    indicating:
14        (i) the applicant has completed delegation of services agreement signed by the physician
15    assistant, supervising physician, and substitute supervising physicians; and
16        (ii) the agreement is on file at the Utah practice sites; or
17        (b) complete a form provided by the division indicating the applicant is not practicing in
18    Utah and, prior to practicing in Utah, the applicant will meet the requirements of Subsection (7)(a).
19        Section 6. Section 58-70a-303 is enacted to read:
20         58-70a-303. Term of license -- Expiration -- Renewal.
21        (1) (a) The division shall issue each license under this chapter in accordance with a
22    two-year renewal cycle established by division rule.
23        (b) The division may by rule extend or shorten a renewal period by as much as one year
24    to stagger the renewal cycles it administers.
25        (2) At the time of renewal, the licensee shall show compliance with renewal requirements
26    of:
27        (a) continuing education; and
28        (b) quality review program participation.
29        (3) Each license issued under this chapter expires on the expiration date shown on the
30    license unless renewed in accordance with Section 58-1-308.
31        Section 7. Section 58-70a-304 is enacted to read:

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1         58-70a-304. License renewal requirements.
2        (1) (a) Prior to license renewal, each licensee shall, during each two-year licensure cycle
3    or other cycle defined by division rule, complete qualified continuing professional education
4    requirements as defined by division rule made in collaboration with the board.
5        (b) If a renewal period is extended or shortened under Section 58-70a-303, the continuing
6    education hours required for license renewal under this section are increased or decreased
7    proportionally.
8        (2) As a condition precedent for license renewal on and after July 1, 2000, each licensee
9    shall participate in the quality review program in which his or her supervising physician is
10    participating under Section 58-67-304 or 58-68-304.
11        Section 8. Section 58-70a-305 is enacted to read:
12         58-70a-305. Exemptions from licensure.
13        In addition to the exemptions from licensure in Section 58-1-307, the following persons
14    may engage in acts included within the definition of practice as a physician assistant, subject to
15    the stated circumstances and limitations, without being licensed under this chapter:
16        (1) a student enrolled in an accredited physician assistant education program while
17    engaged in activities as a physician assistant:
18        (a) that are a part of the education program;
19        (b) that are conducted under the direct supervision of a physician associated with the
20    program; and
21        (c) for which the program accepts in writing the responsibility for the student; and
22        (2) a person acting as a "medical assistant," as defined in Sections 58-67-102 and
23    58-68-102, and who:
24        (a) is working under the direct supervision of a physician;
25        (b) does not diagnose, advise, independently treat, or prescribe to or on behalf of any
26    person; and
27        (c) for whom the supervising physician accepts responsibility.
28        Section 9. Section 58-70a-306 is enacted to read:
29         58-70a-306. Temporary license.
30        (1) An applicant for licensure as a physician assistant who has met all qualifications for
31    licensure except passing an examination component as required in Section 58-70a-302, may apply

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1    for and be granted a temporary license to practice under Subsection (2).
2        (2) (a) The applicant shall submit to the division evidence of completion of a physician
3    assistant program as defined in Subsection 58-70a-302(4).
4        (b) The temporary license shall be issued for a period ending on the earlier of the date of
5    the next succeeding physician assistant examination, if the applicant does not take that
6    examination, or ten days after the date examination results of the next succeeding physician
7    assistant examination are available to those taking the examination.
8        (c) A physician assistant holding a temporary license may work only under the direct
9    supervision of an approved supervising or substitute supervising physician in accordance with a
10    delegation of services agreement, and all patient charts shall be reviewed and countersigned by the
11    supervising or substitute supervising physician.
12        Section 10. Section 58-70a-401 is enacted to read:
Part 4. License Denial and Discipline

14         58-70a-401. Grounds for denial of license -- Disciplinary proceedings.
15        Grounds for the following division actions regarding a licensee are under Section 58-1-401:
16        (1) refusing to issue a license to an applicant;
17        (2) refusing to renew the license of a licensee;
18        (3) revoking, suspending, restricting, or placing on probation the license of a licensee;
19        (4) issuing a public or private reprimand to a licensee; and
20        (5) issuing a cease and desist order.
21        Section 11. Section 58-70a-501 is enacted to read:
Part 5. Scope of Practice - Unlawful and Unprofessional Conduct - Penalties

23         58-70a-501. Scope of practice.
24        (1) A physician assistant may provide any medical services that are not specifically
25    prohibited under this chapter or rules adopted under this chapter, and that are:
26        (a) within the physician assistant's skills and scope of competence;
27        (b) within the usual scope of practice of the physician assistant's supervising physician;
28    and
29        (c) provided under the supervision of a supervising physician and in accordance with a
30    delegation of services agreement.
31        (2) A physician assistant, in accordance with a delegation of services agreement, may

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1    prescribe or administer an appropriate controlled substance if:
2        (a) the physician assistant holds a Utah controlled substance license and a DEA
3    registration; and
4        (b) the prescription or administration of the controlled substance is within the prescriptive
5    practice of the supervising physician and also within the delegated prescribing stated in the
6    delegation of services agreement.
7        (3) A physician assistant shall, while practicing as a physician assistant, wear an
8    identification badge showing his license classification as a practicing physician assistant.
9        (4) A physician assistant may not:
10        (a) independently charge or bill a patient, or others on behalf of the patient, for services
11    rendered;
12        (b) identify himself to any person in connection with activities allowed under this chapter
13    other than as a physician assistant; or
14        (c) use the title "doctor" or "physician," or by any knowing act or omission lead or permit
15    anyone to believe he is a physician.
16        (5) During the initial six months of a physician assistant's licensed practice:
17        (a) the physician assistant shall work only under the direct supervision of a supervising
18    or substitute supervising physician in accordance with a delegation of services agreement; and
19        (b) all patient charts in which the physician assistant enters information shall be reviewed
20    and countersigned by the supervising or substitute supervising physician.
21        Section 12. Section 58-70a-502 is enacted to read:
22         58-70a-502. Unlawful Conduct.
23        "Unlawful conduct" includes engaging in practice as a licensed physician assistant while
24    not under the supervision of a supervising physician or substitute supervising physician.
25        Section 13. Section 58-70a-503 is enacted to read:
26         58-70a-503. Unprofessional Conduct.
27        "Unprofessional conduct" includes:
28        (1) violation of a patient confidence to any person who does not have a legal right and a
29    professional need to know the information concerning the patient;
30        (2) knowingly prescribing, selling, giving away, or directly or indirectly administering,
31    or offering to prescribe, sell, furnish, give away, or administer any prescription drug except for a

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1    legitimate medical purpose upon a proper diagnosis indicating use of that drug in the amounts
2    prescribed or provided;
3        (3) prescribing prescription drugs for himself or administering prescription drugs to
4    himself, except those that have been legally prescribed for him by a licensed practitioner and that
5    are used in accordance with the prescription order for the condition diagnosed;
6        (4) failure to maintain at the practice site a delegation of services agreement that accurately
7    reflects current practices; and
8        (5) failure to make the delegation of services agreement available to the division for
9    review upon request.
10        Section 14. Section 58-70a-504 is enacted to read:
11         58-70a-504. Penalty for unlawful conduct.
12        (1) Any person who violates the unlawful conduct provision defined in Subsection
13    58-1-501(1)(a) is guilty of a third degree felony.
14        (2) Any person who violates any of the unlawful conduct provisions defined in
15    Subsections 58-1-501(1)(b) through (1)(e) or Section 58-70a-502 is guilty of a class A
16    misdemeanor.
17        Section 15. Repealer.
18        This act repeals:
19        Section 58-70-101, Title.
20        Section 58-70-102, Definitions.
21        Section 58-70-201, Physician Assistant Licensing Board.
22        Section 58-70-301, License -- Exceptions from licensure.
23        Section 58-70-302, Qualifications for licensure.
24        Section 58-70-303, Temporary license.
25        Section 58-70-304, Term of license -- Expiration -- Renewal.
26        Section 58-70-401, Grounds for denial of license -- Disciplinary proceedings.
27        Section 58-70-501, Scope of practice -- Prohibited activities.
28        Section 58-70-502, Penalty for unlawful conduct.

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Legislative Review Note
    as of 1-15-97 7:28 AM

A limited legal review of this bill raises no obvious constitutional or statutory concerns.

Office of Legislative Research and General Counsel

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