2014 -- H 7754

========

LC004351

========

     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2014

____________

A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS - NURSES

     Introduced By: Representative Scott Slater

     Date Introduced: February 27, 2014

     Referred To: House Health, Education & Welfare

     It is enacted by the General Assembly as follows:

     SECTION 1. Section 5-34-42 of the General Laws in Chapter 5-34 entitled "Nurses" is

hereby amended to read as follows:

     5-34-42. Global signature authority of certified registered nurse practitioners. --

Whenever any provision of the general or public law, or regulation requires a signature, a

certification of any kind, stamp, verification, affidavit or endorsement by a physician however

defined, it shall be deemed to include a signature, certification, stamp, verification, affidavit or

endorsement by a certified registered nurse practitioner; provided, however, that nothing in this

section shall be construed to expand the scope of practice of nurse practitioners. No statute,

general law, special law, or public law, whether enacted prior to or after enactment of this act,

shall be deemed to supersede the authority provided by this section unless the statute cites this

section of the general laws to that effect.

     SECTION 2. Section 5-54-8 of the General Laws in Chapter 5-54 entitled "Physician

Assistants" is hereby amended to read as follows:

     5-54-8. Permitted health care practices by physician assistants. -- (a) Physician

assistants shall practice with physician supervision and shall be considered the agents of their

supervising physicians in the performance of all practice-related activities. Whenever any

provision of general or public law, or regulation, requires a signature, a certification of any kind,

stamp, verification, affidavit or endorsement by a physician however defined, it shall be deemed

to include a signature, certification, stamp, verification, affidavit or endorsement by a physician

assistant; provided, however, that nothing in this section shall be construed to expand the scope of

practice of physician assistants. No statute, general law, special law, or public law, whether

enacted prior to or after enactment of this act, shall be deemed to supersede the authority

provided by this section unless the statute cites this section of the general laws to that effect.

     (b) Physician assistants may perform those duties and responsibilities consistent with the

limitations of this section, including prescribing of drugs and medical devices, which are

delegated by their supervising physician(s). Physician assistants may request, receive, sign for

and distribute professional samples of drugs and medical devices to patients only within the

limitations of this section. Notwithstanding any other provisions of law, a physician assistant may

perform health care services when those services are rendered under the supervision of a licensed

physician.

      (b) (c) Physician assistants, depending upon their level of professional training and

experience, as determined by a supervising physician, may perform health care services

consistent with their expertise and that of the supervising physician, who is a licensed physician

in solo practice, in group practice, or in health care facilities.

      (c) (d) Physician assistants may write prescriptions and medical orders to the extent

provided in this paragraph. When employed by or extended medical staff privileges by a licensed

hospital or other licensed health care facility a physician assistant may write medical orders for

inpatients as delineated by the medical staff bylaws of the facility as well as its credentialing

process and applicable governing authority. Physician assistants employed directly by physicians,

health maintenance organizations or other health care delivery organizations may prescribe

legend medications including schedule II, III, IV and V medications under chapter 28 of title 21

of the Rhode Island Uniform Controlled Substances Act, medical therapies, medical devices and

medical diagnostics according to guidelines established by the employing physician, health

maintenance organization or other health care delivery organization.

      (d) (e) When supervised by a physician licensed under chapter 29 of this title, the service

rendered by the physician assistant shall be limited to the foot. The "foot" is defined as the pedal

extremity of the human body and its articulations, and includes the tendons and muscles of the

lower leg only as they are involved in conditions of the foot.

      (e) (f) Hospitals and other licensed health care facilities have discretion to grant

privileges to a physician assistant and to define the scope of privileges or services which a

physician assistant may deliver in a facility. In no event shall those privileges, if granted, exceed

the privileges granted to the supervising physician.

     SECTION 3. Section 21-28.6-13 of the General Laws in Chapter 21-28.6 entitled "The

LC004351 - Page 2 of 4

Edward O. Hawkins and Thomas C. Slater Medical Marijuana Act" is hereby amended to read as

follows:

     21-28.6-13. Construction. -- This chapter shall be liberally construed so as to effectuate

the purposes thereof. Provided further, nothing in this chapter shall be construed to limit the

authority of physicians to delegate any activities, including written certifications, to physician

assistants as provided for in § 5-54-8 or to certified registered nurse practitioners under the

provision of § 5-34-42.

     SECTION 4. This act shall take effect upon passage.

========

LC004351

========

LC004351 - Page 3 of 4

EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS - NURSES

***

     This act would amend the requirements necessary for a registered nurse practitioner or

physician assistant to be considered the agent of their supervising physician and would specify

that the Edward O. Hawkins and Thomas C. Slater Medical Marijuana Act has no impact on these

requirements.

     This act would take effect upon passage.

========

LC004351

========

LC004351 - Page 4 of 4