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1998 SESSION

981184753
SENATE BILL NO. 690
AMENDMENT IN THE NATURE OF A SUBSTITUTE
(Proposed by the Senate Committee on Education and Health
on February 12, 1998)
(Patron Prior to Substitute--Senator Walker)
A BILL to amend and reenact §§ 54.1-2900 and 54.1-2951 of the Code of Virginia and to amend the Code of Virginia by adding sections numbered 54.1-2950.1 and 54.1-2951.1, relating to the practice of physician assistants.

Be it enacted by the General Assembly of Virginia:

1. That §§ 54.1-2900 and 54.1-2951 of the Code of Virginia are amended and reenacted and that the Code of Virginia is amended by adding sections numbered 54.1-2950.1 and 54.1-2951.1 as follows:

§ 54.1-2900. Definitions.

As used in this chapter, unless the context requires a different meaning:

"Acupuncturist" means individuals approved by the Board to practice acupuncture. This is limited to "licensed acupuncturist" which means an individual other than a doctor of medicine, osteopathy or podiatry, who has successfully completed the requirements for licensure established by the Board (approved titles are limited to: Licensed Acupuncturist, Lic.Ac., L.Ac.) and "physician acupuncturist" which means doctors of medicine, osteopathy, chiropractic and podiatry who have fulfilled the physician requirements for licensure to practice acupuncture established by the Board.

"Auricular acupuncture" means the subcutaneous insertion of sterile, disposable acupuncture needles in predetermined, bilateral locations in the outer ear when used exclusively and specifically in the context of an approved chemical dependency treatment program, under the appropriate supervision of a licensed physician acupuncturist or licensed acupuncturist.

"Board" means the Board of Medicine.

"Healing arts" means the arts and sciences dealing with the prevention, diagnosis, treatment and cure or alleviation of human physical or mental ailments, conditions, diseases, pain or infirmities.

"Physician assistant" means an individual licensed by the Board who has graduated from a physician assistant program accredited by the American Medical Association or a committee of the American Medical Association established to approve or accredit allied health education programs, or who has passed the certifying examination for physician assistants administered by the National Commission on Certification of Physician Assistants and is practicing under the supervision of a doctor of medicine, osteopathy, or podiatry licensed by the Board. "Physician assistant program" shall also include a surgeon assistant program.

"Practice of acupuncture" means the stimulation of certain points on or near the surface of the body by the insertion of needles to prevent or modify the perception of pain or to normalize physiological functions, including pain control, for the treatment of certain ailments or conditions of the body and includes the techniques of electroacupuncture, cupping and moxibustion. The practice of acupuncture does not include the use of physical therapy, chiropractic, osteopathic manipulative techniques, the use or prescribing of any drugs, medications, herbal preparations, nutritional supplements, serums or vaccines, nor the procedure of auricular acupuncture as exempted in § 54.1-2901 when used specifically and exclusively in the context of a publicly supported comprehensive drug treatment program by an employee of the program who is trained and approved by the National Acupuncture Detoxification Association.

"Practice of chiropractic" means the adjustment of the twenty-four movable vertebrae of the spinal column, and assisting nature for the purpose of normalizing the transmission of nerve energy, but does not include the use of surgery, obstetrics, osteopathy or the administration or prescribing of any drugs, medicines, serums or vaccines.

"Practice of medicine or osteopathic medicine" means the prevention, diagnosis and treatment of human physical or mental ailments, conditions, diseases, pain or infirmities by any means or method.

"Practice of physical therapy" means, upon medical referral and direction, the evaluation, testing, treatment, reeducation and rehabilitation by physical, mechanical or electronic measures and procedures of individuals who, because of trauma, disease or birth defect, present physical and emotional disorders, but does not include the use of Roentgen rays and radium for diagnostic or therapeutic purposes or the use of electricity for shock therapy and surgical purposes including cauterization.

"Practice of podiatry" means the medical, mechanical and surgical treatment of the ailments of the human foot and ankle, but does not include amputation proximal to the metatarsal-phalangeal joints. The Board of Medicine shall determine whether a specific type of treatment of the foot and ankle is within the scope of practice of podiatry.

"Practice of radiologic technology" means the application of x-rays to human beings for diagnostic or therapeutic purposes.

"Radiologic technologist" means an individual, other than a licensed doctor of medicine, osteopathy, podiatry, or chiropractic, or a dentist licensed pursuant to Chapter 27 (§ 54.1-2700 et seq.) of this title, who (i) performs, may be called upon to perform, or who is licensed to perform a comprehensive scope of diagnostic radiologic procedures employing equipment which emits ionizing radiation and (ii) is delegated or exercises responsibility for the operation of radiation-generating equipment, the shielding of patient and staff from unnecessary radiation, the appropriate exposure of radiographs or other procedures which contribute to any significant extent to the site or dosage of ionizing radiation to which a patient is exposed.

"Radiologic technologist, limited" means an individual, other than a licensed radiologic technologist, dental hygienist or who is otherwise authorized by the Board of Dentistry under Chapter 27 of this title and the regulations pursuant thereto, who performs diagnostic radiographic procedures employing equipment which emits ionizing radiation which is limited to specific areas of the human body.

§ 54.1-2950.1. Advisory Committee on Physician Assistants; membership; qualifications.

The Advisory Committee on Physician Assistants is hereby established. The Advisory Committee shall assist the Board of Medicine in carrying out the provisions of this chapter regarding the qualifications, examination, licensure and regulation of physician assistants.

The Advisory Committee shall be appointed by the Governor and shall be composed of nine members, of whom three shall be licensed physicians of the Board of Medicine, one physician who supervises one or more physician assistants, four licensed physician assistants who have practiced their professions for not less than three years prior to their appointment, and one citizen at-large. Members shall be appointed for terms of four years. Vacancies occurring other than by expiration of term shall be filled for the unexpired term. No person shall be eligible to serve on the Advisory Committee for more than two successive terms.

§ 54.1-2951. Application for licensure as physician assistant; notice of intent to practice as physician assistant.

The A. Upon receipt of an application to practice as a physician assistant, the Board shall formulate guidelines for the consideration of applications to supervise and employ assistants. Each application shall be submitted on forms as may be required by the Board, and shall include the following:

1. The qualifications, including related experience, possessed by the assistant; applicant.

2. The professional background and specialty of the licensee who will supervise the assistant;

3. A description of the practice and the way in which the assistant is to be utilized.

2. Documentation that the applicant has completed a physician assistant program accredited by the American Medical Association or a committee of the American Medical Association established to approve or accredit allied health education programs, or that the applicant has passed the certifying examination administered by the National Commission on Certification of Physician Assistants.

3. Certification that the applicant is mentally and physically able to practice as a physician assistant.

4. Evidence verified by affidavits that the applicant is of good moral character.

5. Documentation that any applicant for licensure has not had his license or certification as a physician assistant suspended or revoked and is not the subject of any disciplinary proceedings in another state, any possession or territory of the United States or a foreign country.

6. Submission of such other information regarding his qualifications for licensure as the Board may require.

B. A physician assistant licensed by the Board of Medicine shall notify the Board of his intent to initiate practice on such forms as the Board may require. Such notification shall include, but not be limited to:

1. The name, address, telephone number and any changes thereto, of the physician assistant;

2. The name, address, telephone number and any changes thereto, of the physician who will supervise the assistant; and

3. A description of the practice and the way in which the physician assistant will be utilized.

No physician assistant shall practice in this Commonwealth unless and until all required forms and information have been submitted to the Board and the Board has granted the applicant approval to practice as a physician assistant.

§ 54.1-2951.1. Restricted volunteer license for certain physician assistants.

A. The Board may issue a restricted volunteer license to a physician assistant who meets the qualifications for licensure for physician assistants. The Board may refuse issuance of licensure pursuant to § 54.1-2915 and § 54.1-2916.

B. A person holding a restricted volunteer license under this section shall:

1. Only practice in public health or community free clinics approved by the Board;

2. Only treat patients who have no insurance or who are not eligible for financial assistance for medical care; and

3. Not receive remuneration directly or indirectly for practicing as a physician assistant.

C. A physician assistant with a restricted volunteer license issued under this section shall only practice as a physician assistant and perform certain delegated acts which constitute the practice of medicine to the extent and in the manner authorized by the Board if:

1. A physician who supervises physician assistants is available; or

2. The physician supervising any physician assistant periodically reviews the relevant patient records.

D. A restricted volunteer license granted pursuant to this section shall be issued to the physician assistant without charge, shall expire twelve months from the date of issuance and may be renewed annually in accordance with regulations promulgated by the Board.

E. A physician assistant holding a restricted volunteer license issued pursuant to this section is subject to the provisions of this chapter and the regulations promulgated under this chapter unless otherwise provided for in this section.