Effective Date of Rule: Thirty-one days after filing.

     Purpose: The rule establishes and clarifies the types of drugs that can be prescribed, ordered, and dispensed by an osteopathic physician assistant. The rule also indicates that prescriptions must be written in accordance with state and federal drug laws. The rule removes the requirement that the supervisor must approve or sign for all drugs prior to administration, dispensing or releasing the medication to the patient.

     Citation of Existing Rules Affected by this Order: Amending WAC 246-854-030 Osteopathic physician assistant prescriptions.

     Statutory Authority for Adoption: RCW 18.57A.020.

      Adopted under notice filed as WSR 06-22-097 on November 1, 2006.

     A final cost-benefit analysis is available 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.

     Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 1, Repealed 0.

     Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0;      Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.

     Date Adopted: January 26, 2007.

Daniel Dugaw, DO

Board Chair

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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