Original Notice.

     Preproposal statement of inquiry was filed as WSR 98-22-084.

     Title of Rule and Other Identifying Information: WAC 246-854-030 Osteopathic physician assistant prescriptions, establishes standards to allow osteopathic physician assistants to prescribe, order and dispense legend drugs and schedule II-V controlled substances.

     Hearing Location(s): St. Francis Hospital, 34515 9th Avenue South, Federal Way, WA 98003, on January 26, 2007, at 9:30 a.m.

     Date of Intended Adoption: January 26, 2007.

     Submit Written Comments to: Arlene Robertson, P.O. Box 47866, Olympia, WA 98504-7866, web site http://www3.doh.wa.gov/policyreview/, fax (360) 236-2406, by January 19, 2007.

     Assistance for Persons with Disabilities: Contact Arlene Robertson by January 19, 2007, TTY (800) 833-6388 or 711.

     Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The proposal establishes and clarifies the types of drugs that can be prescribed, ordered, and dispensed by an osteopathic physician assistant. The proposal also indicates that prescriptions must be written in accordance with state and federal drug laws. In addition, the proposal removes the requirement that the osteopathic physician supervisor must approve or sign for all drugs prior to administration, dispensing, or releasing the medication to the patient.

     Reasons Supporting Proposal: The proposed changes will establish parity and consistent practice standards for prescribing legend drugs and schedule II-V controlled substances between osteopathic and allopathic physician assistants. The rules will result in greater access to care. The osteopathic physician supervisor remains responsible for patient oversight.

     Statutory Authority for Adoption: RCW 18.57A.020.

     Statute Being Implemented: Chapter 18.57A RCW.

     Rule is not necessitated by federal law, federal or state court decision.

     Name of Proponent: Department of health, board of osteopathic medicine and surgery, governmental.

     Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Arlene Robertson, 310 Israel Road S.E., Tumwater, WA 98501, (360) 236-4945.

     No small business economic impact statement has been prepared under chapter 19.85 RCW. Per RCW 19.85.030, a small business economic impact statement was not prepared because the proposed rule language does not impose more than minor costs to businesses within an industry. In fact, they do not impose additional costs at all.

     A copy of the statement may be obtained by contacting Arlene Robertson, P.O. Box 47866, Olympia, WA 98504-7866, phone (360) 236-4945, fax (360) 236-2406, e-mail arlene.robertson@doh.wa.gov.

     A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Arlene Robertson, P.O. Box 47866, Olympia, WA 98504-7866, phone (360) 236-4945, fax (360) 236-2406, e-mail arlene.robertson@doh.wa.gov.

October 31, 2006

Blake T. Maresh

Executive Director

OTS-7295.5

AMENDATORY SECTION(Amending WSR 93-24-028, filed 11/22/93, effective 12/23/93)

WAC 246-854-030   Osteopathic physician assistant prescriptions.   (1) An osteopathic physician assistant may issue written or oral prescriptions as provided ((herein)) in this section when designated by the supervising physician on the practice plan and approved by the board ((and assigned by the supervising physician)).

     (((1) Except for schedule two controlled substances as listed under federal and state controlled substances acts, a physician assistant may issue prescriptions for a patient who is under the care of the physician responsible for the supervision of the physician assistant.

     (a) Written prescriptions shall be written on the blank of the supervising physician and shall include the name, address and telephone number of the physician and physician assistant. The prescription shall also bear the name and address of the patient and the date on which the prescription was written.

     (b) The physician assistant shall sign such a prescription by signing his or her own name followed by the letters "P.A." and the physician assistant license number or)) (a) An osteopathic physician assistant certified by the National Commission on Certification of Physician Assistants (P.A.-C.) may issue prescriptions for legend drugs and Schedule II through V controlled substances.

     (b) A noncertified osteopathic physician assistant (P.A.) may issue prescriptions for legend drugs and Schedule III through V controlled substances.

     (2) Written prescriptions shall comply with state and federal prescription writing laws. The osteopathic physician assistant shall sign a prescription by using his or her own name followed by the letters "P.A." to designate a noncertified osteopathic physician assistant, or "P.A.-C." to designate a certified osteopathic physician assistant and the physician assistant's license number.

     (3) Prescriptions for Schedule II through V controlled substances must include the osteopathic physician assistant drug enforcement administration registration number or, if none, the supervising physician's drug enforcement administration registration number((, followed by the initials "P.A." and the physician assistant license number issued by the board.

     (c) Prescriptions for legend drugs and schedule three through five controlled substances must each be approved or signed by the supervising physician prior to administration, dispensing or release of the medication to the patient, except as provided in subsection (5) of this section)).

     (((2) A)) (4) An osteopathic physician assistant may issue prescriptions for a patient who is under his or her care, or the care of the supervising osteopathic physician.

     (5) An osteopathic physician assistant employed or having been extended privileges by a hospital, nursing home or other health care institution may, if permissible under the bylaws((,)) and rules ((and regulations)) of the institution, ((write medical orders, except those for schedule two controlled substances,)) order pharmaceutical agents for inpatients under his or her care or the care of the supervising osteopathic physician ((responsible for his or her supervision)).

     (((3) The license of a physician assistant who issues a prescription in violation of these provisions shall be subject to revocation or suspension.

     (4))) (6) An osteopathic physician assistant may dispense legend drugs and controlled substances from office supplies. An osteopathic physician assistant((s)) may ((not)) dispense prescription drugs ((to exceed)) for treatment ((for)) up to forty-eight hours((, except as provided in subsection (6) of this section)). The medication so dispensed must comply with the state law prescription labeling requirements.

     (((5) Authority to issue prescriptions for legend drugs and schedule three through five controlled substances without the prior approval or signature of the supervising physician may be granted by the board to an osteopathic physician assistant who has:

     (a) Provided a statement signed by)) (7) The supervising physician ((that he or she)) shall assume((s)) full responsibility ((and that he or she will)) for review of the osteopathic physician assistant's prescription writing practice on an ongoing basis((;

     (b) A certificate from the National Commission on Certification of Physician Assistants';

     (c) Demonstrated the necessity in the practice for authority to be granted permitting a physician assistant to issue prescriptions without prior approval or signature of the supervising physician.

     (6) A physician assistant authorized to issue prescriptions under subsection (5) of this section may dispense medications the physician assistant has prescribed from office supplies. The physician assistant shall comply with the state laws concerning prescription labeling requirements)).

[Statutory Authority: RCW 18.57.005. 93-24-028, § 246-854-030, filed 11/22/93, effective 12/23/93; 91-20-120 (Order 199B), § 246-854-030, filed 9/30/91, effective 10/31/91; 90-24-055 (Order 100B), recodified as § 246-854-030, filed 12/3/90, effective 1/31/91. Statutory Authority: RCW 18.57A.020, 18.57.005 and 18.130.050. 89-23-067 (Order 018), § 308-138A-025, filed 11/15/89, effective 12/16/89; 88-09-030 (Order PM 723), § 308-138A-025, filed 4/15/88. Statutory Authority: RCW 18.57A.020. 87-20-099 (Order PM 671), § 308-138A-025, filed 10/7/87. Statutory Authority: RCW 18.57.005, 18.57A.020 and 18.57A.070. 84-05-011 (Order PL 457), § 308-138A-025, filed 2/7/84. Statutory Authority: RCW 18.57A.020. 83-16-024 (Order PL 440), § 308-138A-025, filed 7/27/83. Statutory Authority: RCW 18.57.005 and 18.57A.020. 82-17-005 (Order PL 402), § 308-138A-025, filed 8/5/82. Formerly WAC 308-138-025.]

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