ARIZONA STATE SENATE
Phoenix, Arizona
physician
assistants
Purpose
Makes numerous changes to the statutes governing the Joint Board on the Regulation of Physician Assistants (Board) and increases the scope of practice of physician assistants (PAs).
Background
Currently, PAs are authorized to perform health care tasks under the direction of a supervising physician after the supervising physician receives approval by the Board. The supervising physician must obtain permission from the Board to delegate to a PA the authority to prescribe schedule II and III controlled substances for up to 72 hours and schedule IV and V controlled substances for up to 34 days.
Last year, the Board submitted a sunrise application to increase the prescribing authority of PAs. On December 4, 2001, the Senate Health and House of Representatives Health Committees of Reference held a sunrise hearing to consider the application. The Committee of Reference recommended expanding a PA’s prescribing authority, which is included in H.B. 2542. Specifically, this legislation allows a PA to prescribe schedule II and III controlled substances up to 14 days if the PA has completed 45 hours of pharmacology, clinical management of drug therapy or is certified by the National Commission on the Certification of Physician Assistants within last 3 years. Further, H.B. 2542 increases a PA’s authority to prescribe schedule IV and V controlled substances to a maximum of 5 refills in 6 months.
According to statute, PAs may perform invasive procedures that were approved by the Board as within a PAs scope of practice prior to June 30, 1993. However, the Board does not have on record a list either in statue or administrative rule prescribing the pre-1993 invasive procedures that a PA may perform. H.B. 2542 allows the Board to determine approved minor surgery procedures by eliminating the pre-1993 reference.
The Board utilizes the administrative infrastructure of the Board of Medical Examiners (BOMEX) by sharing an Executive Director, staff and fund. H.B. 2542 codifies some BOMEX governing statutes under the Board’s statutes. In addition, H.B. 2542 increases Board member compensation from $100 to $200 for each day of service, which is estimated to cost $8,000.
1. Authorizes the Board to update approved invasive procedures that a supervising physicians may delegate to a PA.
2. Prohibits a PA from performing a surgical abortion.
3. Increases the authority of PAs to prescribe schedule II drugs from 3 days to 14 days with no refills if: (a) within the last 3 years the PA has completed 45 hours of pharmacology, clinical management of drug therapy or is certified by the National Commission on the Certification of Physician Assistants; and (b) meets other Board rules.
4. Allows a PA to prescribe schedule III drugs up to 14 days with no refills if: (a) within the last 3 years the PA has completed 45 hours of pharmacology, clinical management of drug therapy or is certified by the National Commission on the Certification of Physician Assistants; and (b) meets other Board rules.
5. Increased the authority of a PA to prescribe schedule IV and V drugs from a period of 34 days to a maximum of 5 refills in a 6-month period.
6. Expands the PA prescription recording requirements schedule III drug prescriptions.
7. Requires a supervising physician to develop a system for recording and reviewing a PA’s 14-day prescriptions of schedule II and III drugs. Requires the Board to approve this system.
8. Shifts the responsibility of appointing the allopathic and osteopathic physician Board members from their respective regulatory boards to the Governor.
9. Allows the Governor to appoint a Board member to two additional full terms if the member first filled the unexpired portion of a term vacancy.
10. Changes the automatic termination of a physician Board member’s term from the date of retirement to five years after retirement from active practice.
11. Increases Board member compensation from $100 to $200 for each day of service.
12. Re-codifies the responsibilities of the Executive Director.
13. Re-codifies internet licensee profile requirements for PAs.
14. Prohibits from licensure an applicant who has had a license to practice revoked, surrendered or given up in lieu of disciplinary action in another jurisdiction for an act that constitutes unprofessional conduct in this State.
15. Prohibits from licensure an applicant who is under investigation, suspension or restriction in another jurisdiction for an act that constitutes unprofessional conduct in this State.
16. Requires the Board to suspend the application process if an applicant is under investigation in another jurisdiction. Prohibits the Board from issuing or denying a license until the investigation is resolved.
17. Requires the Board to determine before issuing a license, if in another jurisdiction an applicant has been disciplined or has committed an act that is grounds for disciplinary action, if the act has been corrected or if mitigating circumstances prevent its resolution.
18. Authorizes the Board to delegate to the Executive Director the authority to deny a license to an applicant who do not meet the licensing requirements.
19. Re-codifies the application deficiency hearing and probationary licensure statute.
20. Prohibits inactive license status for a licensee who is under investigation or for whom a disciplinary proceeding has commenced.
21. Changes to permissive the requirement of the Board to grant inactive licenses.
22. Allows the Executive Director to notify a PA and the PA’s supervising physician of the content of a complaint.
23. Allows the Board to delegate to the Executive Director the ability to require a mental, physical or medical competency examination for investigational purposes and to make investigations.
24. Allows the Board or the Executive Director to require a PA, at the PA’s expense, to undergo assessment by a rehabilitative, retraining or assessment program.
25. Expands the Board’s disciplinary options to include restrictions and limitations when emergency action is warranted and proceedings for other action are pending.
26. Allows a licensee to file a written response with the Board within 30 days after receiving an advisory letter.
27. Allows the Board to enter into an agreement with a PA to limit the PA’s practice if the PA is mentally or physically unable to safely practice.
28. Allows, if the Board finds it can take rehabilitative or disciplinary action without a PA’s presence at a formal interview, the Board to enter into a consent agreement with the PA to limit or restrict the PA’s practice or to rehabilitate the PA.
29. Allows the Board to require a PA to successfully complete a Board-approved rehabilitative retraining or assessment program.
30. Prohibits the Board from disclosing the name of a person who provides information regarding a licensee’s drug or alcohol impairment or who files a complaint and requests anonymity.
31. Renames the informal interview as the formal interview.
32. Allows a PA to request a copy of specific investigational information at least ten business days before a formal interview.
33. Prohibits a person who obtains investigational information from releasing the information to any other person or entity or use it in any proceeding or action except the formal interview, administrative proceeding and appeals related to the formal interview. Allows the Board to charge the PA or the PA’s attorney for the information.
34. Allows the Board to issue a letter of reprimand after a formal interview.
35. Expands probationary terms to include restitution of patient fees and education or rehabilitation at the licensee’s expense.
36. Allows, in addition to other actions, the Board to impose a civil penalty from $300 to $10,000 for each violation.
37. Prescribes the conditions under which the Board may accept the surrender of an active license.
38. Requires, when determining disciplinary action, the Board to consider a licensee’s previous nondisciplinary and disciplinary record.
39. Requires the Board to initiate an investigation if a regulatory board in another jurisdiction has taken disciplinary action against a licensee for an act the occurred in that jurisdiction and constitutes unprofessional conduct in this State.
40. Requires the Board to order the summary suspension of a license pending proceedings for further action if a regulatory board in another jurisdiction has taken the same emergency action.
41. Allows the Board to issue a license to an applicant whose license was previously revoked by the Board if the applicant demonstrates rehabilitation for the conduct that caused the revocation.
42. Requires the Board to consider specific criteria when determining to reinstate a revoked license.
43. Prohibits a person from applying for reinstatement within two years following the date of revocation.
44. Requires the Board to vacate its previous order to revoke a license if a conviction of a felony or an offense involving moral turpitude was reversed on appeal.
45. Allows a person to submit an application for reinstatement when the court enters the reversal.
46. Requires an applicant for reinstatement to comply with all initial licensing requirements.
47. Renames the Board as the Arizona Regulatory Board of Physician Assistants.
48. Expands the definition of self-supporting regulatory board to include the Board and the Board of Athletic Trainers.
49. Defines and updates terms.
50. Makes numerous conforming and technical changes.
51. Provides for a general effective date.
Health 2/4/02 DP 7-0-1-2
3rd Read 2/12/02 50-9-1
Prepared by Senate Staff
March 22, 2002