HB 1028 revise certain provisions regarding the...
State of South Dakota
|
EIGHTY-SECOND SESSION
LEGISLATIVE ASSEMBLY,
2007
|
400N0234
|
HOUSE HEALTH AND HUMAN SERVICES
COMMITTEE ENGROSSED
NO.
HB 1028
-
01/19/2007
|
Introduced by:
The Committee on Health and Human Services at the request of the Board of
Medical and Osteopathic Examiners
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FOR AN ACT ENTITLED, An Act to
revise certain provisions regarding the regulation of
physician assistants.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF SOUTH DAKOTA:
Section
1.
That
§
36-4A-1
be amended to read as follows:
36-4A-1.
Terms as used in this chapter mean:
(1)
"Assistant to the primary care physician," a person who is a graduate of an approved
program of instruction in primary health care, who has passed a licensure
examination administered by the board, and is approved by the board to perform
direct patient care services under the supervision of a primary care physician or
physicians approved by the board to supervise such an assistant;
(2)
"Assistant to the specialist physician," a person who is a graduate of an approved
program for instruction in a recognized clinical specialty, who has passed a licensure
examination administered by the board and is approved by the board to perform
direct patient care services in said specialty under the supervision of a specialist
physician or physicians approved by the board to supervise such assistant;
(3)
"Board," the State Board of Medical and Osteopathic Examiners;
(4)
(2) "Physician assistant," a health professional who meets the qualifications defined in
this chapter and is licensed by the board;
(3)
"Supervising physician,"
the physician, either primary care or specialist, with whom
a physician assistant has a practice agreement;
(5)
"Physician assistant," a person who is either an assistant to the primary care physician
or an assistant to the specialist physician;
(6)
"Primary care physician," a physician, approved by the board, who supervises a
particular assistant to the primary care physician;
(7)
"Specialist physician," a physician in a given specialty of medicine, approved by the
board, who supervises a particular assistant to a specialist physician
a doctor of
medicine or doctor of osteopathy licensed by the board who supervises a physician
assistant;
(4) "Supervision," the act of overseeing the activities of, and accepting responsibility for,
the medical services rendered by a physician assistant
.
Section
2.
That
§
36-4A-3.1
be amended to read as follows:
36-4A-3.1.
The board shall appoint a physician assistant advisory committee composed of
three physician assistants. Each committee member shall serve a term of three years. However,
the terms of initial appointees shall be staggered so that no more than one member's term
expires in
any
one year. No committee member may be appointed to more than three
consecutive full terms. If a vacancy occurs, the board shall appoint a person to fill the unexpired
term. The appointment of a member to an unexpired term is not considered a full term. The
committee shall meet at least annually or as deemed necessary to conduct business. The advisory
committee shall assist the board in
evaluating standards of physician assistant care and
the
regulation of physician assistants pursuant to this chapter. The committee shall also make
recommendations to the board regarding rules promulgated pursuant to this chapter.
Section
3.
That
§
36-4A-4
be amended to read as follows:
36-4A-4.
Except as provided in §§ 36-4A-5
to 36-4A-7, inclusive, it is a Class 2
misdemeanor for any person not certified under this chapter to practice as a physician assistant
or to hold himself out to be a physician assistant in this state
and 36-4A-6, any person who
practices as a physician assistant in this state without a license issued by the board and a practice
agreement approved by the board is guilty of a Class 1 misdemeanor
. Each violation shall be
considered a separate offense.
Section
4.
That
§
36-4A-5
be amended to read as follows:
36-4A-5.
Nothing in this chapter
shall be construed to limit
limits
the activities and services
of a physician assistant in pursuing an approved course of study
or a trainee serving in an
approved physician assistant traineeship
at an accredited physician assistant program
.
Section
5.
That
§
36-4A-6
be amended to read as follows:
36-4A-6.
Nothing in this chapter
shall be construed to limit
limits
the activities of
employees
of the United States Army, Air Force, Navy, or Marine Hospitals or of the United States
Veterans' Administration, or the United States Public Health Service
a physician assistant
employed by the federal government
in the performance of their duties, nor to the Christian
Scientists as such who do not practice medicine, surgery, or obstetrics by the use of any material
remedies or agencies.
Any physician assistant who is employed by the federal government and
practices outside of the federal system shall be licensed and abide by the terms of this chapter.
Section
6.
That
§
36-4A-8
be amended to read as follows:
36-4A-8.
The board
shall license as a physician assistant and issue an appropriate license
to any person who files a verified application with the board signed by both the proposed
supervising physician and the physician assistant to be licensed, upon a form prescribed by the
board, renders payment of the required fee, and furnishes evidence to the board that the
physician assistant applying for licensure
may grant a license to an applicant who
:
(1)
Is at least eighteen years of age;
(2)
Is of good moral character;
(3)
Is a resident of South Dakota;
(4)
Has completed a course of study approved by the board at an accredited university,
college, or school which includes the subjects of anatomy, physiology, biochemistry,
pathology, pharmacology, microbiology, medicine, surgery, pediatrics, psychiatry,
and obstetrics, and possesses a license of completion of the physician assistant
courses of study from the institution;
(5)
Has had at least two years' experience with patients in a clinical setting in an
associated field such as military medicine, nursing, dentistry, pharmacy, etc. The
board shall decide in each individual case as to what experience would be recognized
as fulfillment of the requirement;
(6)
Has passed an impartially administered examination given and graded by the board
or one of equivalency authorized by the board. Such examination may be in writing
or oral, or both, and shall fairly test the applicant's knowledge in theoretical and
applied primary medical care as it applies to the practice of the physician assistant in
at least the subjects of physical diagnosis, laboratory procedures, common childhood
diseases and common medical diseases, emergency care and treatment, minor
surgery, emergency obstetrics, and common psychiatric disorders. The applicant's
professional skill and judgment in the utilization of medical and surgical techniques
may also be examined; and
(7)
Deleted by SL 1999, ch 192, § 2.
(8)
(2) Has successfully completed an educational program for physician assistants
accredited by the Accreditation Review Commission on Education for the Physician
Assistant or its successor agency, or, prior to 2001, either by the Committee on Allied
Health Education and Accreditation or the Commission on Accreditation of Allied
Health Education Program;
(3) Has passed the Physician Assistant National Certification Examination administered
by the National Committee on Education for Physician Assistants; and
(4)
Has submitted verification that
neither
the physician assistant applicant
nor the
supervising physician named in the practice agreement are
is not
subject to any
disciplinary proceeding or pending complaint before any medical or other licensing
board unless
such pending complaint is waived by the licensing board
the board
considers such proceedings or complaint and agrees to licensure
.
Section
7.
That
§
36-4A-8.1
be amended to read as follows:
36-4A-8.1.
Upon application and payment of a fifty dollar fee, the
The
board may issue a
temporary
permit to practice as a physician assistant
license
to an applicant who has successfully
completed an approved program and
the curriculum requirements pursuant to §§ 36-4A-12 and
36-4A-13 and
has submitted evidence to the board that
he
the applicant
is a candidate accepted
to write the examination required by § 36-4A-8 or is awaiting the results of the first examination
for which the applicant is eligible after graduation from an approved physician assistant
program. A temporary
permit
license
may be issued only once and is effective for a term of not
more than
eight months
one hundred twenty days
. A temporary
permit
license
expires on the
occurrence of the following:
(1)
Issuance of a regular license;
(2)
Failure to pass the licensing examination; or
(3)
Expiration of the term for which the temporary
permit
license
was issued.
Section
8.
That
§
36-4A-10
be amended to read as follows:
36-4A-10.
The board may
certify
license
, as a physician assistant in this state,
without
examination,
those physician assistants practicing in this state on July 1, 1973
, except that
.
However,
such physician assistants
, shall be
are
subject to the provisions of this chapter in so
far as
said
the
chapter provides for a revocation of licenses and the causes
therefor
thereof
.
Section
9.
That chapter
36-4A
be amended by adding thereto a NEW SECTION to read as
follows:
The term, practice agreement, as used in this chapter, means a written agreement authored
and signed by the physician assistant and the supervising physician. The practice agreement
shall prescribe the delegated activities which the physician assistant may perform, consistent
with section 10 of this Act and contain such other information as required by the board to
describe the physician assistant's level of competence and the supervision provided by the
physician. A signed copy of the practice agreement shall be kept on file at the physician
assistant's primary practice site and be filed with and approved by the board prior to beginning
practice. No physician assistant may practice without an approved practice agreement.
Section
10.
That chapter
36-4A
be amended by adding thereto a NEW SECTION to read
as follows:
A physician assistant shall be considered an agent of the supervising physician in the
performance of all practice-related activities. A physician assistant may provide those medical
services that are delegated by the supervising physician pursuant to section 9 of this Act if the
service is within the physician assistant's skills, forms a component of the physician's scope of
practice, and is provided with supervision including:
(1) Initial medical diagnosis and institution of a plan of therapy or referral;
(2) Prescribing and provision of drug samples or a limited supply of labeled medications,
including controlled substances listed on Schedule II in chapter 34-20B for one
period of not more than thirty days, for treatment of causative factors and symptoms.
Medications or sample drugs provided to patients shall be accompanied with written
administration instructions and appropriate documentation shall be entered in the
patient's record. Physician assistants may request, receive, and sign for professional
samples of drugs provided by the manufacturer;
(3) Responding to emergencies and the institution of emergency treatment measures
including the writing of a chemical or physical restraint order when the patient may
do personal harm or harm others;
(4) Completing and signing of official documents such as birth and death certificates and
similar documents required by law;
(5) Taking X rays and performing radiologic procedures; and
(6) Performing physical examinations for participation in athletics and certifying that the
patient is healthy and able to participate in athletics.
Section
11.
That chapter
36-4A
be amended by adding thereto a NEW SECTION to read
as follows:
A physician assistant licensed in this state or licensed or authorized to practice in any other
United States jurisdiction or who is credentialed as a physician assistant by a federal employer
who is responding to a need for medical care created by an emergency or a state or local disaster
(not to be defined as an emergency situation which occurs in the place of one's employment)
may render such care that he or she is able to provide without supervision as it is defined in this
chapter, or with such supervision as is available.
No physician who supervises a physician assistant providing medical care in response to
such an emergency or state or local disaster is required to meet the requirements set forth in this
chapter for a supervising physician.
Section
12.
That chapter
36-4A
be amended by adding thereto a NEW SECTION to read
as follows:
No physician assistant licensed in this state or licensed or authorized to practice in other
states of the United States who voluntarily and gratuitously, and other than in the ordinary
course of employment or practice, renders emergency medical assistance is liable for civil
damages for any personal injuries which result from acts or omissions by those persons in
rendering emergency care which constitute ordinary negligence. The immunity granted by this
section does not apply to acts or omissions constituting willful, or wanton negligence or if the
medical assistance is rendered at any hospital, physician's office, or other health care delivery
entity where those services are normally rendered. No physician who supervises a physician
assistant voluntarily and gratuitously providing emergency care as described in this section is
liable for civil damages for any personal injuries which result from acts or omissions by the
physician assistant rendering emergency care.
Section
13.
That
§
36-4A-27
be amended to read as follows:
36-4A-27.
Nothing in this chapter
shall be construed to authorize physician's assistants
authorizes any physician assistant
to perform those specific functions and duties delegated by
law to those persons licensed as chiropractors under chapter 36-5, dentists and dental hygienists
under chapter 36-6A, optometrists under chapter 36-7, podiatrists under chapter 36-8 or
pharmacists under chapter 36-11.
Section
14.
That
§
36-4A-28
be amended to read as follows:
36-4A-28.
In the event
If
any physician assistant
shall render
renders
services in a hospital
and related institutions as licensed pursuant to the provisions of chapter 34-12, the
physician
assistant
shall be
is
subject to the rules and regulations of that hospital and related institutions.
Section
15.
That
§
36-4A-29
be amended to read as follows:
36-4A-29.
The physician, by
direct and indirect
supervision, continuous monitoring, and
evaluation accepts initial and continuing responsibility for the physician assistant or assistants
responsible to the physician until such relationship is terminated.
This supervision may be by
personal contact or indirect contact by telecommunication.
Supervision may be by direct
personal contact, or by a combination of direct personal contact and contact via
telecommunication, as may be required by the board.
If the office of a physician assistant is
separate from the main office of the supervising physician, the supervision shall include
at least
one-half business day per week of
on-site personal supervision by a supervising physician
as
required by the board
. A physician assistant who is issued a temporary
permit
license
pursuant
to § 36-4A-8.1 shall initially receive thirty days of on-site, direct supervision by a supervising
physician. Thereafter, and until expiration of the temporary
permit
license
, the supervision shall
include at least two one-half business days per week of on-site personal supervision by a
supervising physician.
Section
16.
That
§
36-4A-29.1
be amended to read as follows:
36-4A-29.1.
In consideration of the health care needs of urban and rural residents, a
supervising physician may apply to the board for authority to modify the method and frequency
of supervision of a physician assistant as required by § 36-4A-29.
The board may
grant the
authorize
modifications
in the method and frequency of supervision of a physician assistant
required by
§
36-4A-29 that
it considers appropriate based upon its finding of adequate
supervision, training, and proficiency.
A supervising physician may apply to the board for permission to supervise more than one
physician assistant. The board shall establish the number of
physician
assistants, up to four FTE,
to be supervised by a supervising physician based upon its finding that adequate supervision will
exist under the arrangement proposed by the supervising physician.
The board may consider a joint application for both modification of supervision and the
number of
physician
assistants supervised as provided in this section.
Nothing in this section is intended to diminish the professional and legal responsibility of
a supervising physician toward the physician's patients as provided in § 36-4A-30.
Section
17.
That chapter
36-4A
be amended by adding thereto a NEW SECTION to read
as follows:
In order to supervise a physician assistant, a physician shall:
(1) Be licensed as a physician by the board pursuant to chapter 36-4;
(2) Be free from any restriction on his or her ability to supervise a physician assistant that
has been imposed by board disciplinary action; and
(3) Maintain a written practice agreement with the physician assistant as described in
section 8 of this Act.
Section
18.
That
§
36-4A-30
be amended to read as follows:
36-4A-30.
Nothing in this chapter
shall be construed to relieve
relieves
the physician of the
professional or legal responsibility for the care and treatment of
his
patients
cared for by the
physician assistant
.
Section
19.
That chapter
36-4A
be amended by adding thereto a NEW SECTION to read
as follows:
Nothing in this chapter limits the employment arrangement of a physician and a physician
assistant licensed under this Act.
Section
20.
That
§
36-4A-31
be amended to read as follows:
36-4A-31.
Every person holding a license as a physician assistant under the provisions of
this chapter shall renew his license annually on or before the fifteenth day of July. Renewal of
a license shall be requested by every person licensed as a physician assistant upon a form which
shall be furnished to him by the Board of Medical and Osteopathic Examiners.
The license of
every person licensed under the provisions of this chapter shall be renewed annually on a date
set by the board.
The request for renewal
shall be made on a form furnished by the board and
shall include such proof, as may be required by the board, of continuance of the qualifications
for original licensure including the information set forth in subdivision
36-4A-8(8)
36-4A-8(2)
and payment of the
annual
renewal fee.
Section
21.
That
§
36-4A-32
be amended to read as follows:
36-4A-32.
A renewal request shall be accompanied by the prescribed fee together with
evidence satisfactory to the board of the completion during the preceding twelve months of at
least thirty hours of post-graduate studies
in family medicine
approved by the board.
Such
request shall be further accompanied by a letter from both physician and physician assistant
indicating the location and scope of practice of the physician assistant. The board shall be
further notified in writing, by both the physician and physician assistant within seventy-two
hours of termination of any such working contract and the reasons for such terminations.
Any
physician assistant who maintains current certification by the National Commission on
Certification of Physician Assistants (NCCPA) may document compliance with this requirement
by providing proof of current certification by the NCCPA.
Section
22.
That
§
36-4A-33
be amended to read as follows:
36-4A-33.
Any license not renewed pursuant to § 36-4A-31
shall be
is
suspended. A license
so suspended may be reinstated during the following twelve months by
application to the board
and
payment of the renewal fee and a reinstatement fee as fixed by the board
pursuant to
§
36-
4A-34
. Thereafter, a license so suspended may be reinstated only upon payment of all
delinquent renewal fees and a reinstatement fee fixed by the board pursuant to § 36-4A-34,
following specific approval by the board.
Section
23.
That
§
36-4A-34
be amended to read as follows:
36-4A-34.
The
fees in connection with a license as a physician assistant shall be as follows
board shall collect in advance the following nonrefundable fees from applicants
:
(1)
For
license by examination, not less than twenty-five dollars nor
an initial license, not
more than seventy-five dollars;
(2)
For reexamination within one year, not less than fifteen dollars nor more than
forty-five dollars;
(3)
For license by reciprocity, not less than twenty-five dollars nor more than
seventy-five dollars;
(4)
For renewal of a license, not more than one hundred dollars;
(5)
(3)
For reinstatement of a
lapsed
license,
not less than five dollars nor
the current
renewal fee plus not
more than twenty-five dollars;
(6)
For reissuance of a lost or destroyed license, following approval of the board, ten
dollars
(4) For a temporary license, not more than fifty dollars
.
Section
24.
That
§
36-4A-36
be amended to read as follows:
36-4A-36.
All fees received by the board and
all fines
moneys
collected under the provisions
of this chapter shall be
paid to the Board of Medical and Osteopathic Examiners who shall
credit the same to the State Board of Medical Examiner's fund
deposited in a bank as authorized
by the board
. No fee
shall
may
be refunded.
The funds are subject to withdrawal as authorized
by the board. A report of all receipts and expenditures shall be made at the close of each fiscal
year and filed with the state auditor.
Section
25.
That
§
36-4A-37
be amended to read as follows:
36-4A-37.
The
South Dakota State Board of Medical and Osteopathic Examiners
board
may
deny the issuance or renewal of a license
or suspend or revoke
. The board may suspend, revoke,
or impose other disciplinary actions upon
the license of any physician assistant issued under this
chapter upon satisfactory proof, in compliance with chapter 1-26, of
such person's
the licensee's
:
(1)
Incompetence
Professional incompetence
or unprofessional or dishonorable conduct
as defined in §
§
36-4-29 and
36-4-30;
(2)
Violation of this chapter in any respect;
(3)
Failure to
notify the board, in writing, of the termination of the contract with the
person's supervising physician within seven days after the termination
maintain on
file with the board a copy of each practice agreement containing the current
information regarding the licensee's practice status as required by the board
;
(4)
Rendering medical services beyond
the specific tasks allowed
those delegated
to the
physician assistant
in the practice agreement
; or
(5)
Rendering medical services without supervision of a physician as required by law and
the rules of the board.
Section
26.
That
§
36-4A-41
be amended to read as follows:
36-4A-41.
Upon application, the board may reissue a license to practice to any person whose
licensure
which
has been canceled, suspended, or revoked.
A reissuance of a license which has
been canceled or revoked shall not be made prior to one year after said cancellation or
revocation and the reissuance of any license may be made in such manner and form and under
conditions as the board may require.
Section
27.
That
§
36-4A-42
be amended to read as follows:
36-4A-42.
The board shall promulgate rules pursuant to chapter 1-26 pertaining to
:
fees,
licensure of physician assistants,
placement of physician assistants
supervision requirements,
and disciplinary proceedings.
Section
28.
That
§
36-4A-2
be repealed.
36-4A-2.
Supervision of physician assistant refers to the responsibility of the physician to
observe, direct and review the work, records, and practice permitted by §§ 36-4A-21 to 36-4A-
26, inclusive, to ensure the patient, the physician, and the physician assistant that good and safe
treatment is rendered.
Section
29.
That
§
36-4A-3
be repealed.
36-4A-3.
There is hereby created a state physician assistant program under the direction and
control of the State Board of Medical and Osteopathic Examiners.
Section
30.
That
§
36-4A-7
be repealed.
36-4A-7.
Nothing in this chapter shall be construed to limit the employment of a physician
assistant by any federal agency, but the physician assistant so employed must be individually
supervised by a designated and approved physician. Such employment shall be subject to all the
provisions of this chapter.
Section
31.
That
§
36-4A-9
be repealed.
36-4A-9.
The board may license as a physician assistant in this state, without examination,
a person who has been so certified or licensed by examination in another state of the United
States which has requirements substantially equivalent to those in this chapter and who meets
all requirements of this chapter other than examination.
Section
32.
That
§
36-4A-11
be repealed.
36-4A-11.
Nothing in this chapter shall be construed to limit the practice in this state for a
period of not more than six months by a person licensed as a physician assistant in another state
with requirements for such licensure substantially equivalent to those in this chapter, if such
person first secures a permit from the board in a manner prescribed by the board, but the board
may reduce such period to not less than thirty days.
Section
33.
That
§
36-4A-12
be repealed.
36-4A-12.
An educational program for instruction of a physician assistant shall be approved
by the board.
Section
34.
That
§
36-4A-13
be repealed.
36-4A-13.
The curriculum of an educational program for instruction of a physician assistant
shall be approved by the board.
Section
35.
That
§
36-4A-14
be repealed.
36-4A-14.
An educational program for instruction as an assistant to the specialist physician
in any recognized clinical specialty shall meet the following general requirements, as well as
specific curriculum requirements for the particular specialty more specifically set forth in § 36-
4A-15, for approval:
(1)
The program shall establish that its theoretical and clinical training program produces
an assistant to the specialist physician necessary to the effective delivery of medical
services within that specialty;
(2)
Candidates for admission shall have successfully completed an approved high school
course of study or have passed a standard equivalency test;
(3)
Prior clinical experience in direct patient contact is required for each candidate;
(4)
The educational program shall be established in educational institutions approved by
the board which meet the standards of any accrediting agency recognized by the
National Commission on Accrediting and which are affiliated with board approved
clinical facilities;
(5)
The educational program shall develop an evaluation mechanism satisfactory to the
board to determine the effectiveness of its theoretical and clinical program
compatible with state-wide standards, the results of which must be made available
to the board annually;
(6)
Course work may carry academic credit. Upon successful completion of the
theoretical and clinical program the student may receive an associate of arts or
science degree;
(7)
The educational program shall establish equivalency and proficiency testing and
other mechanisms whereby full academic credit is given for past education and
experience in the courses of the curriculum required for the particular specialty, more
specifically set forth herein;
(8)
The director of the educational program must be a licensed physician who is certified
as or eligible to be a member of the appropriate official national specialty board for
the particular specialty and who holds a faculty appointment at the educational
institution;
(9)
Instructors in the theoretical program and clinical training program shall be
competent in their respective fields of instruction and clinical training and be
properly qualified;
(10)
The educational program shall establish a definitive candidate selection procedure
satisfactory to the board;
(11)
The number of students enrolled in the theoretical program should not exceed the
number that can be clinically supervised and trained;
(12)
The educational program shall have an elective period, preferably near the end of the
program, to permit the student to gain knowledge of subjects which pertain to the
clinical specialty and the student's particular intended employment therein;
(13)
The educational program shall establish a continuing clinical educational program
for physician assistants in the particular specialty.
Section
36.
That
§
36-4A-15
be repealed.
36-4A-15.
An approved educational program for instruction of an assistant to the specialist
physician shall include the curriculum provided in § 36-4A-13 and, in addition, adequate
instruction in the special subjects approved by the given specialty advisory committee to the
Board of Medical and Osteopathic Examiners.
Section
37.
That
§
36-4A-16
be repealed.
36-4A-16.
Educational programs for instruction of an assistant to the primary care physician
and assistant to the specialist physician must be approved by the Board of Medical and
Osteopathic Examiners and schools offering such programs shall submit applications for
approval on forms provided by said board.
Section
38.
That
§
36-4A-16.1
be repealed.
36-4A-16.1.
All state funds appropriated for the support and development of physician's
assistants programs shall be administered under the direction and supervision of the University
of South Dakota School of Medicine.
Section
39.
That
§
36-4A-17
be repealed.
36-4A-17.
An educational program approved by the board as meeting the general
educational requirements of § 36-4A-12 or § 36-4A-14 and specific curriculum requirements
established in this chapter for educational programs for an assistant to the primary care
physician or for a particular curriculum specialty shall notify the board whenever a change
occurs in the directorship of the educational program or when major modifications in the
curriculum are anticipated.
Section
40.
That
§
36-4A-18
be repealed.
36-4A-18.
Failure of an educational program to continue compliance with the general
requirements of § 36-4A-14 and the specific curriculum requirements for the particular specialty
set forth in § 36-4A-15 subsequent to approval by the board may result in the board withdrawing
said approval.
Section
41.
That
§
36-4A-19
be repealed.
36-4A-19.
The South Dakota State Board of Medical and Osteopathic Examiners shall
provide for the placement of physician assistants. The board shall notify the physician who has
made application to place a physician assistant of the board's affirmative or negative decision
regarding the placement. In placing physician assistants the board may consider:
(1)
The distance between the supervising physician and the physician assistant;
(2)
The ability of the supervising physician to adequately provide supervision as required
by law and good medical practice; and
(3)
The consistency between the type and scope of medical practice of the supervising
physician and the proposed medical practice of the physician assistant.
In addition, if the proposed office of the physician assistant is separate from the main office
of the supervising physician, the board may also consider the availability or nonavailability of
medical services in the proposed location of the physician assistant and such specific
requirements as the board may provide as a condition precedent to approving a particular
placement.
Section
42.
That
§
36-4A-20
be repealed.
36-4A-20.
A certified true copy of the proposed practice agreement between the supervising
physician and the physician assistant outlining those activities in §§ 36-4A-21 to 36-4A-26,
inclusive, which the physician assistant may perform, shall be filed with and approved by the
board.
Section
43.
That
§
36-4A-21
be repealed.
36-4A-21.
An assistant to the primary care physician may perform, under the responsibility
and supervision of the primary care physician, selected diagnostic and therapeutic tasks in each
of five major clinical disciplines (medicine, surgery, pediatrics, psychiatry, and obstetrics).
Section
44.
That
§
36-4A-22
be repealed.
36-4A-22.
Specifically, and by way of limitations, an assistant to the primary care physician
may:
(1)
Take a complete, detailed, and accurate history; do a complete physical examination,
when appropriate, to include pelvic and breast examinations specifically excluding
endoscopic examinations; record pertinent data in acceptable medical form; and, if
the physical examination is for participation in athletics, certify that the patient is
healthy and able to participate;
(2)
Perform or assist in the performance of the following routine laboratory and
governing techniques:
(a)
The drawing of venous or peripheral blood and the routine examination of the
blood;
(b)
Urinary bladder catheterization and routine urinalysis;
(c)
Nasogastric intubation and gastric lavage;
(d)
The collection of and the examination of the stool;
(e)
The taking of cultures;
(f)
The performance and reading of skin tests;
(g)
The performance of pulmonary function tests excluding endoscopic
procedures;
(h)
The performance of tonometry;
(i)
The performance of hearing screenings;
(j)
The taking of EKG tracings;
(3)
Make a tentative medical diagnosis and institute therapy or referral; prescribe
medications and provide drug samples or a limited supply of labeled medications,
including controlled drugs or substances listed on Schedule II in chapter 34-20B for
one period of not more than thirty days, for symptoms and temporary pain relief; treat
common childhood diseases; to assist in the follow-up treatment of geriatric and
psychiatric disorders referred by the physicians. Medications or sample drugs
provided to patients shall be accompanied with written administration instructions
and appropriate documentation shall be entered in the patient's medical record;
(4)
Perform the following routine therapeutic procedures:
(a)
Injections;
(b)
Immunizations;
(c)
Debridement, suture, and care of superficial wounds;
(d)
Debridement of minor superficial burns;
(e)
Removal of foreign bodies from the external surface of the skin (specifically
excluding foreign bodies of the cornea);
(f)
Removal of sutures;
(g)
Removal of impacted cerumen;
(h)
Subcutaneous local anesthesia, excluding any nerve blocks;
(i)
Strapping, casting, and splinting of sprains;
(j)
Anterior nasal packing for epistaxis;
(k)
Removal of cast;
(l)
Application of traction;
(m)
Application of physical therapy modalities;
(n)
Incision and drainage of superficial skin infections;
(5)
Assist the primary care physician in health maintenance of patients by:
(a)
Well-baby and well-child clinics to include initial and current booster
immunization for communicable disease;
(b)
Pre- and post-natal surveillance to include clinics and home visits;
(c)
Family planning, counseling, and management;
(6)
Institute emergency measures and emergency treatment or appropriate measures in
situations such as cardiac arrest, shock, hemorrhage, convulsions, poisonings, and
emergency obstetric delivery. Emergency measures includes writing a chemical or
physical restraint order when the patient may do personal harm or harm others;
(7)
Assist the primary care physician in the management of long-term care to include:
(a)
Ordering indicated laboratory procedures;
(b)
Managing a medical care regimen for acute and chronically ill patients within
established standing orders. (Prescription of modifications needed by patients
coping with illness or maintaining health, such as in diet, exercise, relief from
pain, medication, and adaptation to handicaps or impairments);
(c)
Making referrals to appropriate agencies;
(8)
Assist the primary care physician in the hospital setting by arranging hospital
admissions under the direction of the physician, by accompanying the primary care
physician on rounds, and recording the physician's patient progress notes; by
accurately and appropriately transcribing and executing specific orders at the
direction of the physician; by assistance at surgery; by compiling detailed narrative
and case summaries; by completion of the forms pertinent to the patient's medical
record;
(9)
Assist the primary care physician in the office in the ordering of drugs and supplies,
in the keeping of records, and in the upkeep of equipment;
(10)
Assist the primary care physician in providing services to patients requiring
continuing care (nursing home, extended care, and home care) including follow-up
visits after the initial treatment by the physician;
(11)
Assist the primary care physician in the completion of official documents such as
death certificates, birth certificates, and similar documents required by law, including
signing the documents;
(12)
Take X-rays to be read by a physician. A physician's assistant may not administer
injections in conjunction with the taking of any X-rays.
Section
45.
That
§
36-4A-23
be repealed.
36-4A-23.
In addition to the tasks performable listed in § 36-4A-22 an assistant to the
primary care physician may be permitted to perform, under the supervision of the primary care
physician, such other tasks, except those expressly excluded herein, for which adequate training
and proficiency can be demonstrated in a manner satisfactory to the board.
Section
46.
That
§
36-4A-24
be repealed.
36-4A-24.
An assistant to the specialist physician may perform, under the responsibility and
supervision of the specialist physician, selected diagnostic and therapeutic tasks in the major
clinical disciplines.
Section
47.
That
§
36-4A-25
be repealed.
36-4A-25.
Specifically, and by way of limitations, an assistant to the specialist physician
may perform those tasks authorized for the assistant to the primary care physician under
subdivisions 36-4A-22(1), (2), (4), and (6), provided, however, that the assistant to the specialist
physician may remove superficial foreign bodies of the cornea. An assistant to the specialist
physician may also assist at major surgery.
Section
48.
That
§
36-4A-26
be repealed.
36-4A-26.
In addition to the tasks performable listed in § 36-4A-25 an assistant to the
specialist physician may be permitted to perform, under the supervision of the specialist
physician, such other tasks, except those expressly excluded herein, for which adequate training
and proficiency can be demonstrated in a manner satisfactory to the board.
Section
49.
That
§
36-4A-35
be repealed.
36-4A-35.
Not later than the first day of April of each fiscal year, the board shall promulgate
rules pursuant to chapter 1-26 to set fees in each of the above categories within the stated limits
in an amount which will produce sufficient revenue for the ensuing fiscal year not to exceed one
hundred twenty percent of the anticipated expenses of the board for the operation of the
physician assistant program by the board for that year.
Section
50.
That
§
36-4A-43
be repealed.
36-4A-43.
A locum tenens license allows the holder thereof to practice as a physician
assistant in this state for a limited period of time and is subject to the requirements and
conditions set forth in the license.
Section
51.
That
§
36-4A-44
be repealed.
36-4A-44.
Each new applicant for a locum tenens license shall submit a licensure fee of fifty
dollars made payable to the secretary of the board and appear personally at the office of the
board or at the office of a member of the board.
Section
52.
That
§
36-4A-45
be repealed.
36-4A-45.
The board may issue a license for locum tenens to an applicant who holds a valid
physician assistant license in any state or territory of the United States, the District of Columbia,
or province of Canada or who has successfully completed an approved program and the
curriculum requirements pursuant to §§ 36-4A-12 and 36-4A-13. To obtain a locum tenens
license, the applicant shall present a petition to the board signed under oath by a licensed
physician practicing in this state and by the applicant requesting a locum tenens license. The
petition shall set forth the reasons why the applicant should be issued a locum tenens license.
In addition to the petition, the locum tenens applicant shall complete and submit to the board
the application required by § 36-4A-8. A new petition shall be submitted to the board for each
locum tenens practice location.
Section
53.
That
§
36-4A-46
be repealed.
36-4A-46.
Any person holding a locum tenens license under the provisions of this chapter
shall renew the license annually on or before the fifteenth day of July upon a form which shall
be furnished to the person by the board. The request for renewal shall include proof, as may be
required by the board, of continuance of the qualifications for original licensure and payment
of an annual renewal fee of fifty dollars.
Section
54.
That
§
36-4A-47
be repealed.
36-4A-47.
A renewal request pursuant to § 36-4A-46 shall be accompanied by evidence
satisfactory to the board of the completion during the preceding twelve months of at least thirty
hours of post-graduate studies in family medicine which has been approved by the board.
Section
55.
That
§
36-4A-48
be repealed.
36-4A-48.
Any physician assistant applying for a locum tenens license shall have practiced
a minimum of three hundred hours in the preceding twenty-four months and shall meet locum
tenens licensure requirements as set forth in §§ 36-4A-43 to 36-4A-47, inclusive.
Section
56.
That
§
36-4A-49
be repealed.
36-4A-49.
The term, employer physician, wherever it is used in chapter 36-4A means
supervising physician. The Code Commission in future supplements and revisions of the South
Dakota Codified Laws shall substitute the term, supervising physician, and its derivatives for
the term, employer physician, and its derivatives.
The term, employment contract, wherever it is used in chapter 36-4A means practice
agreement. The Code Commission in future supplements and revisions of the South Dakota
Codified Laws shall substitute the term, practice agreement, and its derivatives for the term,
employment contract, and its derivatives.
The term, physician's assistant, wherever it is used in chapter 36-4A means physician
assistant. The Code Commission in future supplements and revisions of the South Dakota
Codified Laws shall substitute the term, physician assistant, and its derivatives for the term,
physician's assistant, and its derivatives.
The term, certification, wherever it is used in chapter 36-4A means licensure. The Code
Commission in future supplements and revisions of the South Dakota Codified Laws shall
substitute the term, licensure, and its derivatives for the term, certification, and its derivatives.