2020 -- H 7530 | |
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LC004520 | |
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STATE OF RHODE ISLAND | |
IN GENERAL ASSEMBLY | |
JANUARY SESSION, A.D. 2020 | |
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A N A C T | |
RELATING TO BUSINESSES AND PROFESSIONS -- PHYSICIAN ASSISTANTS | |
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Introduced By: Representatives Bennett, Canario, Edwards, McNamara, and Shekarchi | |
Date Introduced: February 12, 2020 | |
Referred To: House Health, Education & Welfare | |
It is enacted by the General Assembly as follows: | |
1 | SECTION 1. Sections 5-54-2 and 5-54-28 of the General Laws in Chapter 5-54 entitled |
2 | "Physician Assistants" are hereby amended to read as follows: |
3 | 5-54-2. Definitions. |
4 | As used in this chapter, the following words have the following meanings: |
5 | (1) "Administrator" means the administrator, division of professional regulation. |
6 | (2) "Approved program" means a program for the education and training of physician |
7 | assistants formally approved by the American Medical Association's (A.M.A.'s) Committee on |
8 | Allied Health, Education and Accreditation, its successor, the Commission on Accreditation of |
9 | Allied Health Education Programs (CAAHEP) or its successor. |
10 | (3) "Approved program for continuing medical education" means a program for |
11 | continuing education approved by the American Academy of Physician Assistants (AAPA) or the |
12 | Accreditation Council for Continuing Medical Education of the American Medical Association |
13 | (AMA), or the American Academy of Family Physicians (AAPFP) or the American Osteopathic |
14 | Association Committee on Continuing Medical Education (AOACCME) or any other board- |
15 | approved program. |
16 | (4) "Board" means the board of licensure of physician assistants. |
17 | (5) "Collaboration" means the physician assistant shall, as indicated by the patient's |
18 | condition, the education, competencies, and experience of the physician assistant, and the |
19 | standards of care, consult with or refer to an appropriate physician or other healthcare |
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1 | professional. The degree of collaboration shall be determined by the practice and includes |
2 | decisions made by a physician in solo practice or employer, physician group practice as defined |
3 | in § 5-37-1, and the credentialing and privileging systems of a licensed hospital, health center, or |
4 | ambulatory care center health care facility licensed pursuant to the provisions of chapter 17 of |
5 | title 23, or health-maintenance organization licensed pursuant to the provisions of chapter 17 of |
6 | title 23 or chapter 41 of title 27. A physician must be accessible at all times for consultation by |
7 | the physician assistant. |
8 | (6) "Director" means the director of the department of health. |
9 | (7) "Division" means the division of professional regulation, department of health. |
10 | (8) [Deleted by P.L. 2013, ch. 320, § 1 and P.L. 2013, ch. 420, § 1]. |
11 | (9) "Physician" means a person licensed under the provisions of chapter 29 or 37 of this |
12 | title. |
13 | (10) "Physician assistant" or "PA" means a person who is qualified by academic and |
14 | practical training to provide medical and surgical services in collaboration with physicians. |
15 | (11) "Unprofessional conduct" includes, but is not limited to, the following items or any |
16 | combination and may be defined by regulations established by the board with prior approval of |
17 | the director: |
18 | (i) Fraudulent or deceptive procuring or use of a license; |
19 | (ii) Representation of himself or herself as a physician; |
20 | (iii) Conviction of a crime involving moral turpitude; conviction of a felony; conviction |
21 | of a crime arising out of the practice of medicine. All advertising of medical business that is |
22 | intended or has a tendency to deceive the public; |
23 | (iv) Abandonment of a patient; |
24 | (v) Dependence upon a controlled substance, habitual drunkenness, or rendering |
25 | professional services to a patient while intoxicated or incapacitated by the use of drugs; |
26 | (vi) Promotion of the sale of drugs, devices, appliances, or goods or services provided for |
27 | a patient in a manner that exploits the patient for the financial gain of the physician assistant; |
28 | (vii) Immoral conduct of a physician assistant in the practice of medicine; |
29 | (viii) Willfully making and filing false reports or records; |
30 | (ix) Willful omission to file or record or willfully impeding or obstructing a filing or |
31 | recording, or inducing another person to omit to file or record medical or other reports as required |
32 | by law; |
33 | (x) Agreeing with clinical or bioanalytical laboratories to accept payments from these |
34 | laboratories for individual tests or test series for patients; |
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1 | (xi) Practicing with an unlicensed physician or physician assistant or aiding or abetting |
2 | these unlicensed persons in the practice of medicine; |
3 | (xii) Offering, undertaking, or agreeing to cure or treat a disease by a secret method, |
4 | procedure, treatment, or medicine; |
5 | (xiii) Professional or mental incompetence; |
6 | (xiv) Surrender, revocation, suspension, limitation of privilege based on quality of care |
7 | provided, or any other disciplinary action against a license or authorization to practice in another |
8 | state or jurisdiction; or surrender, revocation, suspension, or any other disciplinary action relating |
9 | to membership on any medical staff or in any medical professional association, or society while |
10 | under disciplinary investigation by any of those authorities or bodies for acts or conduct similar to |
11 | acts or conduct that would constitute grounds for action as stated in this chapter; |
12 | (xv) Any adverse judgment, settlement, or award arising from a medical liability claim |
13 | related to acts or conduct that would constitute grounds for action as stated in this chapter; |
14 | (xvi) Failure to furnish the board, the administrator, investigator, or representatives, |
15 | information legally requested by the board; |
16 | (xvii) Violation of any provisions of this chapter or the rules and regulations promulgated |
17 | by the director or an action, stipulation, or agreement of the board; |
18 | (xviii) Cheating or attempting to subvert the certifying examination; |
19 | (xix) Violating any state or federal law or regulation relating to controlled substances; |
20 | (xx) Medical malpractice; |
21 | (xxi) Sexual contact between a physician assistant and patient during the existence of the |
22 | physician assistant/patient relationship; |
23 | (xxii) Providing services to a person who is making a claim as a result of a personal |
24 | injury, who charges or collects from the person any amount in excess of the reimbursement to the |
25 | physician assistant by the insurer as a condition of providing or continuing to provide services or |
26 | treatment. |
27 | 5-54-28. Participation in charitable and voluntary care. |
28 | A physician assistant licensed in this state, or licensed or authorized to practice in any |
29 | other U.S. jurisdiction, or who is credentialed by a federal employer or meets the licensure |
30 | requirements of his or her requisite federal agency as a physician assistant may volunteer to |
31 | render such care that he or she is able to provide at a children's summer camp or for a public or |
32 | community event or in a licensed ambulatory health center providing free care without a |
33 | collaborating physician as it is defined in this section of law or with such collaborating physicians |
34 | as may be available. Such care must be rendered without compensation or remuneration. It is the |
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1 | obligation of the physician assistant to assure adequate and appropriate professional liability |
2 | coverage. |
3 | SECTION 2. Chapter 5-54 of the General Laws entitled "Physician Assistants" is hereby |
4 | amended by adding thereto the following section: |
5 | 5-54-29. Restrictive covenants. |
6 | (a) Any contract or agreement that creates or establishes the terms of a partnership, |
7 | employment, or any other form of professional relationship with a physician assistant licensed to |
8 | practice pursuant to this section that includes any restriction of the right of such physician |
9 | assistant to practice shall be void and unenforceable with respect to said restriction; provided, |
10 | however, that nothing herein shall render void or unenforceable the remaining provisions of any |
11 | such contract or agreement. |
12 | (b) Restrictions rendered void under subsection (a) of this section shall include, but shall |
13 | not be limited to the following: |
14 | (1) The right to practice in any geographic area for any period of time after the |
15 | termination of such partnership, employment, or professional relationship; and |
16 | (2) The right of such physician assistant to provide treatment, advise, consult with or |
17 | establish a professional relationship with any current patient of the employer; and |
18 | (3) The right of such physician assistant to solicit or seek to establish a professional |
19 | relationship with any current patient of the employer. |
20 | (c) Notwithstanding the foregoing, the prohibition on physician assistant covenants shall |
21 | not apply in connection with the purchase and sale of a practice, provided the restrictive covenant |
22 | and non-compete covenant is for a period of a time of not more than five (5) years. |
23 | SECTION 3. Section 16-91-3 of the General Laws in Chapter 16-91 entitled "School and |
24 | Youth Programs Concussion Act" is hereby amended to read as follows: |
25 | 16-91-3. School district's guidelines to be developed and implemented. |
26 | (a) The department of education and the department of health shall work in concert with |
27 | the Rhode Island Interscholastic League to develop and promulgate guidelines to inform and |
28 | educate coaches, teachers, school nurses, youth athletes, and their parents and/or guardians of the |
29 | nature and risk of concussion and head injury, including continuing to play after concussion or |
30 | head injury. A concussion and head injury information sheet shall be signed and returned by the |
31 | youth athlete and the athlete's parent and/or guardian prior to the youth athlete's return to practice |
32 | or competition. |
33 | (b) School districts are required to use training materials made available by the United |
34 | States Center for Disease Control and Prevention entitled "Heads Up: Concussion in the High |
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1 | School Sports/Concussion in Youth Sports" and any updates or amendments thereto, or training |
2 | materials substantively and substantially similar thereto. The department of education shall post |
3 | training materials made available by the Center for Disease Control and Prevention and the |
4 | Rhode Island Interscholastic League on its website. All coaches and volunteers involved in a |
5 | youth sport or activity covered by this chapter must complete a training course and a refresher |
6 | course annually thereafter in concussions and traumatic brain injuries. All school nurses must |
7 | complete a training course and an annual refresher course in concussions and traumatic brain |
8 | injuries. Teachers and teachers' aides are strongly encouraged to complete the training course in |
9 | concussions and traumatic brain injuries. Training may consist of videos, classes, and any other |
10 | generally accepted mode and medium of providing information. |
11 | (c) School districts are encouraged to have all student athletes perform baseline |
12 | neuropsychological testing, computerized or otherwise. Parents and/or guardians shall be |
13 | provided with information as to the risk of concussion and/or traumatic brain injuries prior to the |
14 | start of every sport season and they shall sign an acknowledgement as to their receipt of such |
15 | information. |
16 | (d) A youth athlete, who is suspected of sustaining a concussion or head injury in a |
17 | practice or game, shall be removed from competition at that time. |
18 | (e) A youth athlete, who has been removed from play, may not return to play until the |
19 | athlete is evaluated by a licensed physician, physician assistant or certified nurse practitioner who |
20 | may consult with an athletic trainer, all of whom shall be trained in the evaluation and |
21 | management of concussions. The athlete must receive written clearance to return to play from |
22 | that licensed physician, physician assistant or certified nurse practitioner. |
23 | (f) All school districts are encouraged to have an athletic trainer, or similarly trained |
24 | person, at all recreational and athletic events addressed by this statute. |
25 | SECTION 4. Section 16-91.1-3 of the General Laws in Chapter 16-91.1 entitled "The |
26 | Sudden Cardiac Arrest Prevention Act" is hereby amended to read as follows: |
27 | 16-91.1-3. School districts' guidelines to be developed and implemented. |
28 | (a) The department of education and the department of health shall promulgate guidelines |
29 | to inform and educate coaches, teachers, school nurses, youth athletes, and their parents and/or |
30 | guardians about the nature and warning signs of sudden cardiac arrest, including the risks |
31 | associated with continuing to play or practice after experiencing the following symptoms: fainting |
32 | or seizures during exercise, unexplained shortness of breath, chest pains, dizziness, racing heart |
33 | rate and extreme fatigue. |
34 | (b) School districts may use training materials made available at no cost to the school |
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1 | district by organizations such as Simon's Fund, Parent Heart Watch, Sudden Arrhythmia Death |
2 | Syndromes Foundation, or training materials substantively and substantially similar thereto. The |
3 | department of education shall post links to training materials on its website. All coaches and |
4 | volunteers involved in a youth sport program or activity covered by this chapter must complete a |
5 | training course that may be completed online about the nature and warning signs of sudden |
6 | cardiac arrest, including the risks associated with continuing to play or practice after experiencing |
7 | symptoms including: fainting or seizures during exercise, unexplained shortness of breath, chest |
8 | pains, dizziness, racing heart rate and extreme fatigue. Training may consist of videos, classes, |
9 | and any other generally accepted mode and medium of providing information. |
10 | (c) Parents and/or guardians shall be provided with information as to the nature and |
11 | warning signs of sudden cardiac arrest prior to the start of every sport season. |
12 | (d)(1) A student who, as determined by a game official, coach from the student's team, |
13 | certified athletic trainer, licensed physician, or other official designated by the student's school |
14 | entity, exhibits signs or symptoms of sudden cardiac arrest while participating in an athletic |
15 | activity shall be removed by the coach from participation at that time, subject to subsection (d)(3) |
16 | of this section. |
17 | (2) If a student is known to have exhibited signs or symptoms of sudden cardiac arrest at |
18 | any time prior to or following an athletic activity, the student shall be prevented from |
19 | participating in an athletic activity, subject to subsection (d)(3) of this section. |
20 | (3) A student removed or prevented from participating in an athletic activity under |
21 | subsections (d)(1) or (d)(2) of this section shall not return to participation until the student is |
22 | evaluated and cleared for return to participation in writing by a licensed physician, physician |
23 | assistant, certified registered nurse practitioner, or cardiologist. |
24 | (e) All school districts are encouraged to have an athletic trainer, or similarly trained |
25 | person, at all recreational and athletic events addressed by this statute. |
26 | SECTION 5. Section 23-1.7-5 of the General Laws in Chapter 23-1.7 entitled "Rhode |
27 | Island Program to Address Alzheimer's Disease" is hereby amended to read as follows: |
28 | 23-1.7-5. Medical professional training. |
29 | (a) All physicians licensed pursuant to chapter 37 of title 5, physician assistants licensed |
30 | pursuant to chapter 54 of title 5, and nurses licensed pursuant to chapter 34 of title 5, shall, no |
31 | later than October 1, 2021, complete a one-time course of training consisting of a minimum of |
32 | one hour of instruction on the diagnosis, treatment, and care of patients with cognitive |
33 | impairments including, but not limited to, Alzheimer's disease and dementia. |
34 | (b) The department of health shall promulgate rules to implement the training |
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1 | requirement of subsection (a). |
2 | SECTION 6. This act shall take effect upon passage. |
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EXPLANATION | |
BY THE LEGISLATIVE COUNCIL | |
OF | |
A N A C T | |
RELATING TO BUSINESSES AND PROFESSIONS -- PHYSICIAN ASSISTANTS | |
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1 | This act would expand participation in charitable and voluntary care to allow a physician |
2 | assistant licensed in this state to provide free care without a collaborating physician; prohibit any |
3 | agreement whereby a physician assistant is restricted in his or her right to practice in a certain |
4 | geographic area, assist or provide treatment or establish a professional relationship with any other |
5 | employer; establish the right of the physician assistant to solicit or seek to establish a professional |
6 | relationship with any current patient of the employer. This restriction does not apply with the |
7 | purchase and sale of a practice which includes a restriction or non-compete clause within five (5) |
8 | years; and would allow physician assistants to clear students to participate in athletic activities at |
9 | school and evaluate and clear a young student athlete who has been removed from play due to |
10 | injury. |
11 | This act would take effect upon passage. |
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