S-0101

AN ACT Relating to podiatric physicians and surgeons; amending RCW 18.71A.010, 18.71A.020, 18.71A.060, 18.57A.010, 18.57A.020, 18.57A.060, and 18.22.035; adding a new section to chapter 18.71A RCW; adding a new section to chapter 18.57A RCW; and creating a new section.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION. Sec. 1. Podiatric physicians and surgeons are well-trained, well-educated, and required to take postgraduate training to be licensed in Washington. They are well-suited to become physician assistants. The growing older population of citizens is particularly well-served by having access to these well-trained providers. The legislature finds that by providing for the licensure and supervision of podiatric physicians and surgeons by physicians as physician assistants, the health and welfare of our citizens will be improved and access to preventative health care will be increased.

Sec. 2. RCW 18.71A.010 and 1994 sp.s. c 9 s 318 are each amended to read as follows:

The definitions set forth in this section apply throughout this chapter.

(1) "Physician assistant" means: (a) A person who is licensed by the commission to practice medicine to a limited extent only under the supervision of a physician as defined in chapter 18.71 RCW and who is academically and clinically prepared to provide health care services and perform diagnostic, therapeutic, preventative, and health maintenance services; and (b) a person who is currently licensed as a podiatric physician and surgeon as defined in chapter 18.22 RCW and who is licensed by the commission to practice medicine to a limited extent only under the supervision of a physician licensed under chapter 18.71 RCW.

(2) "Commission" means the medical quality assurance commission.

(3) "Practice medicine" has the meaning defined in RCW 18.71.011.

(4) "Secretary" means the secretary of health or the secretary's designee.

(5) "Department" means the department of health.

Sec. 3. RCW 18.71A.020 and 1998 c 132 s 14 are each amended to read as follows:

(1) The commission shall adopt rules fixing the qualifications and the educational and training requirements for licensure as a physician assistant or for those enrolled in any physician assistant training program. The requirements shall include completion of an accredited physician assistant training program approved by the commission and eligibility to take an examination approved by the commission, if the examination tests subjects substantially equivalent to the curriculum of an accredited physician assistant training program. Physician assistants licensed by the board of medical examiners as of June 7, 1990, shall continue to be licensed. No additional training either academically or clinically shall be required of a person currently licensed as a podiatric physician and surgeon under chapter 18.22 RCW to become a physician assistant under this chapter.

(2)(a) The commission shall adopt rules governing the extent to which:

(i) Physician assistant students may practice medicine during training; and

(ii) Physician assistants may practice after successful completion of a physician assistant training course.

(b) Such rules shall provide:

(i) That the practice of a physician assistant shall be limited to the performance of those services for which he or she is trained; and

(ii) That each physician assistant shall practice medicine only under the supervision and control of a physician licensed in this state, but such supervision and control shall not be construed to necessarily require the personal presence of the supervising physician or physicians at the place where services are rendered.

(3) Applicants for licensure shall file an application with the commission on a form prepared by the secretary with the approval of the commission, detailing the education, training, and experience of the physician assistant and such other information as the commission may require. The application shall be accompanied by a fee determined by the secretary as provided in RCW 43.70.250 and 43.70.280. A surcharge of twenty-five dollars per year shall be charged on each license renewal or issuance of a new license to be collected by the department and deposited into the impaired physician account for physician assistant participation in the impaired physician program. Each applicant shall furnish proof satisfactory to the commission of the following:

(a) That the applicant has completed an accredited physician assistant program approved by the commission, or that the applicant is licensed as a podiatric physician and surgeon under chapter 18.22 RCW, and the applicant is eligible to take the examination approved by the commission;

(b) That the applicant is of good moral character; and

(c) That the applicant is physically and mentally capable of practicing medicine as a physician assistant with reasonable skill and safety. The commission may require an applicant to submit to such examination or examinations as it deems necessary to determine an applicant's physical or mental capability, or both, to safely practice as a physician assistant.

(4) The commission may approve, deny, or take other disciplinary action upon the application for license as provided in the Uniform Disciplinary Act, chapter 18.130 RCW. The license shall be renewed as determined under RCW 43.70.250 and 43.70.280. The commission may authorize the use of alternative supervisors who are licensed either under chapter 18.57 or 18.71 RCW.

Sec. 4. RCW 18.71A.060 and 1994 sp.s. c 9 s 324 are each amended to read as follows:

No health care services may be performed under this chapter in any of the following areas:

(1) The measurement of the powers or range of human vision, or the determination of the accommodation and refractive state of the human eye or the scope of its functions in general, or the fitting or adaptation of lenses or frames for the aid thereof.

(2) The prescribing or directing the use of, or using, any optical device in connection with ocular exercises, visual training, vision training, or orthoptics.

(3) The prescribing of contact lenses for, or the fitting or adaptation of contact lenses to, the human eye.

(4) Nothing in this section shall preclude the performance of routine visual screening.

(5) The practice of dentistry or dental hygiene as defined in chapters 18.32 and 18.29 RCW respectively. The exemptions set forth in RCW 18.32.030 (1) and (8), shall not apply to a physician assistant.

(6) The practice of chiropractic as defined in chapter 18.25 RCW including the adjustment or manipulation of the articulations of the spine.

(7) The practice of podiatric medicine and surgery as defined in chapter 18.22 RCW unless the physician assistant is licensed as a podiatric physician and surgeon under chapter 18.22 RCW.

Sec. 5. RCW 18.57A.010 and 1979 c 117 s 17 are each amended to read as follows:

(1) "Osteopathic physician's assistant" means: (a) A person who has satisfactorily completed a board-approved training program designed to prepare persons to practice osteopathic medicine to a limited extent; and (b) a person who is currently licensed as a podiatric physician and surgeon as defined in chapter 18.22 RCW and who is licensed by the commission to practice medicine to a limited extent only under the supervision of an osteopathic physician licensed under chapter 18.57 RCW;

(2) "Board" means the board of osteopathic medicine and surgery; and

(3) "Practice medicine" shall have the meaning defined in RCW 18.57.001.

Sec. 6. RCW 18.57A.020 and 1998 c 132 s 13 are each amended to read as follows:

(1) The board shall adopt rules fixing the qualifications and the educational and training requirements for licensure as an osteopathic physician assistant or for those enrolled in any physician assistant training program. The requirements shall include completion of an accredited physician assistant training program approved by the board and eligibility to take an examination approved by the board, providing such examination tests subjects substantially equivalent to the curriculum of an accredited physician assistant training program. No additional training either academically or clinically shall be required of a person currently licensed as a podiatric physician and surgeon under chapter 18.22 RCW to become an osteopathic physician's assistant under this chapter.

(2)(a) The board shall adopt rules governing the extent to which:

(i) Physician assistant students may practice medicine during training; and

(ii) Physician assistants may practice after successful completion of a training course.

(b) Such rules shall provide:

(i) That the practice of an osteopathic physician assistant shall be limited to the performance of those services for which he or she is trained; and

(ii) That each osteopathic physician assistant shall practice osteopathic medicine only under the supervision and control of an osteopathic physician licensed in this state, but such supervision and control shall not be construed to necessarily require the personal presence of the supervising physicians at the place where services are rendered. The board may authorize the use of alternative supervisors who are licensed either under chapter 18.57 or 18.71 RCW.

(3) Applicants for licensure shall file an application with the board on a form prepared by the secretary with the approval of the board, detailing the education, training, and experience of the physician assistant and such other information as the board may require. The application shall be accompanied by a fee determined by the secretary as provided in RCW 43.70.250 and 43.70.280. A surcharge of twenty-five dollars per year may be charged on each license renewal or issuance of a new license to be collected by the department of health for physician assistant participation in an impaired practitioner program. Each applicant shall furnish proof satisfactory to the board of the following:

(a) That the applicant has completed an accredited physician assistant program approved by the board, or that the applicant is licensed as a podiatric physician and surgeon under chapter 18.22 RCW, and the applicant is eligible to take the examination approved by the board;

(b) That the applicant is of good moral character; and

(c) That the applicant is physically and mentally capable of practicing osteopathic medicine as an osteopathic physician assistant with reasonable skill and safety. The board may require any applicant to submit to such examination or examinations as it deems necessary to determine an applicant's physical and/or mental capability to safely practice as an osteopathic physician assistant.

(4) The board may approve, deny, or take other disciplinary action upon the application for a license as provided in the uniform disciplinary act, chapter 18.130 RCW. The license shall be renewed as determined under RCW 43.70.250 and 43.70.280.

Sec. 7. RCW 18.57A.060 and 1973 c 77 s 20 are each amended to read as follows:

No health care services may be performed under this chapter in any of the following areas:

(2) The prescribing or directing the use of, or using, any optical device in connection with ocular exercises, visual training, vision training or orthoptics.

(3) The prescribing of contact lenses for, or the fitting or adaptation of contact lenses to, the human eye.

(4) Nothing in this section shall preclude the performance of routine visual screening.

(5) The practice of dentistry or dental hygiene as defined in chapter 18.32 and 18.29 RCW respectively. The exemptions set forth in RCW 18.32.030, paragraphs (1) and (8), shall not apply to a physician's assistant.

(6) The practice of chiropractic as defined in chapter 18.25 RCW including the adjustment or manipulation of the articulations of the spine.

(7) The practice of ((~~podiatry~~)) podiatric medicine and surgery as defined in chapter 18.22 RCW unless the osteopathic physician's assistant is licensed as a podiatric physician and surgeon under chapter 18.22 RCW.

Sec. 8. RCW 18.22.035 and 1990 c 147 s 6 are each amended to read as follows:

(1) A podiatric physician and surgeon is responsible for the quality of podiatric care.

(2) The practice of podiatric medicine and surgery is the diagnosis and the medical, surgical, mechanical, manipulative, and electrical treatments of ailments of the human foot.

(3) Podiatric physicians and surgeons may issue prescriptions valid at any pharmacy for any drug, including narcotics, necessary in the practice of podiatry.

(4) Podiatrists shall not:

(a) Amputate the foot;

(b) Administer spinal anesthetic or any anesthetic that renders the patient unconscious; or

NEW SECTION. Sec. 9. A new section is added to chapter 18.71A RCW to read as follows:

From 2000 through 2004, the commission shall report to the legislature each December on the number of podiatric physicians and surgeons who apply and the number who are licensed as physician assistants.

NEW SECTION. Sec. 10. A new section is added to chapter 18.57A RCW to read as follows:

From 2000 through 2004, the board shall report to the legislature each December on the number of podiatric physicians and surgeons who apply and the number who are licensed as osteopathic physicians' assistants.