Pennsylvania Act 1993-59 — OSTEOPATHIC MEDICAL PRACTICE ACT - AMEND

Act text

OSTEOPATHIC MEDICAL PRACTICE ACT - AMEND
                  Act of Jul. 2, 1993, P.L. 418, No. 59               Cl. 63
                             Session of 1993

                               No. 1993-59

                                  AN ACT

     HB 1009

     Amending the act of October 5, 1978 (P.L.1109, No.261), entitled
        "An act requiring the licensing of practitioners of
        osteopathic medicine and surgery; regulating their practice;
        providing for certain funds and penalties for violations and
        repeals," further providing for the State Board of
        Osteopathic Medicine and for penalties; and regulating the
        practice of respiratory care practitioners.

        The General Assembly finds and declares that the practice of
     respiratory care in this Commonwealth affects the public health,
     safety and welfare and is to be subject to regulation and
     control in the public interest to protect the public from the
     unauthorized and unqualified practice of respiratory care and
     from unprofessional conduct by persons certified to practice
     respiratory care.

        The General Assembly of the Commonwealth of Pennsylvania
     hereby enacts as follows:

        Section 1.  Section 2 of the act of October 5, 1978
     (P.L.1109, No.261), known as the Osteopathic Medical Practice
     Act, is amended by adding definitions to read:
      Section 2.  Definitions.
        The following words and phrases when used in this act shall
     have, unless the context clearly indicates otherwise, the
     meanings given to them in this section:
        * * *
        "Board-regulated practitioner."  An osteopathic physician,
     physician assistant or respiratory care practitioner or an
     applicant for a license or certificate issued by the board.
        * * *
        "Respiratory care."  A health care specialty employing
     evaluation, analysis, care and treatment of patients with
     cardiopulmonary disorders and related diseases.
        "Respiratory care practitioner."  An individual who is
     certified to practice respiratory care by the State Board of
     Osteopathic Medicine.
        * * *
        Section 2.  Sections 2.1(a) and 6.1 of the act, added
     December 20, 1985 (P.L.398, No.108), are amended to read:
      Section 2.1.  State Board of Osteopathic Medicine.
        (a)  The State Board of Osteopathic Medicine shall consist of
     the Commissioner of Professional and Occupational Affairs[,] or
     his designee; the Secretary of Health[,] or his designee[,]; two
     members appointed by the Governor[, with the advice and consent
     of a majority of the members elected to the Senate,] who shall
     be persons representing the public at large[,]; one member
     appointed by the Governor who shall be either a respiratory care
     practitioner or a physician assistant; and [five] six members
     appointed by the Governor[, with the advice and consent of a
     majority of the members elected to the Senate,] who shall be
     graduates of a legally incorporated and reputable college of
     osteopathy and shall have been licensed to practice [osteopathy]
     osteopathic medicine under the laws of this Commonwealth and
     shall have been engaged in the practice of osteopathy in this
     Commonwealth for a period of at least five years. All
     professional and public members of the board shall be appointed
     by the Governor with the advice and consent of a majority of the
     members elected to the Senate. The Governor shall assure that
     respiratory care practitioners and physician assistants are
     appointed to four-year terms on a rotating basis so that of
     every two appointments to a four-year term one is a physician
     assistant and one is a respiratory care practitioner.
        * * *
      Section 6.1.  Reporting of multiple licensure or certificates.
        Any licensed osteopathic physician of this Commonwealth who
     is also licensed to practice osteopathic medicine or surgery in
     any other state, territory or country or any other board-
     regulated practitioner licensed or certified to practice in any
     other state, territory or country shall report this information
     to the board on the biennial registration application. Any
     disciplinary action taken in other states shall be reported to
     the board on the biennial registration application or within 90
     days of final disposition, whichever is sooner. Multiple
     licensure shall be noted by the board on the osteopathic
     physician's or other board-regulated practitioner's record, and
     such state, territory or country shall be notified by the board
     of any disciplinary actions taken against said osteopathic
     physician or other board-regulated practitioner in this
     Commonwealth.
        Section 3.  The act is amended by adding sections to read:
      Section 10.1.  Respiratory care practitioners.
        (a)  Eighteen months after the effective date of this
     section, it shall be unlawful for any person to hold himself out
     to the public as a respiratory care practitioner and to practice
     or offer to practice respiratory care unless he holds a valid,
     current temporary permit or certificate issued by the board.
        (b)  A respiratory care practitioner who holds a valid,
     current temporary permit or certificate issued by the board may
     use the title respiratory care practitioner or respiratory care
     practitioner-certified or an appropriate abbreviation of that
     title, such as "R.C.P." or "R.C.P.-C."
        (c)  The board is authorized to promulgate regulations to
     implement this section.
        (d)  A respiratory care practitioner certified by the board
     may implement direct respiratory care to an individual being
     treated by either a licensed medical doctor or a licensed doctor
     of osteopathic medicine upon physician prescription or referral
     or under medical direction and approval consistent with standing
     orders or protocols of an institution or health care facility.
     This care may constitute indirect services, such as consultation
     or evaluation of an individual, and also includes, but is not
     limited to, the following services:
            (1)  Administration of medical gases.
            (2)  Humidity and aerosol therapy.
            (3)  Administration of aerosolized medications.
            (4)  Intermittent positive pressure breathing.
            (5)  Incentive spirometry.
            (6)  Bronchopulmonary hygiene.
            (7)  Management and maintenance of natural airways.
            (8)  Maintenance and insertion of artificial airways.
            (9)  Cardiopulmonary rehabilitation.
            (10)  Management and maintenance of mechanical
        ventilation.
            (11)  Measurement of ventilatory flows, volumes and
        pressures.
            (12)  Analysis of ventilatory gases and blood gases.
        (e)  This section shall not prevent or restrict the
     practices, services or activities of:
            (1)  A person licensed or certified in this Commonwealth
        to provide another health care service, including, but not
        limited to, physicians, physical therapists, chiropractors,
        nurses, dentists, physician assistants and podiatrists.
            (2)  A person rendering respiratory care services
        pursuant to employment by a Federal agency.
            (3)  A person pursuing a course of study leading to a
        degree or certificate in respiratory care in an accredited
        educational program if he is clearly designated as a student
        and provides care under supervision implemented through that
        program.
            (4)  A person executing or conveying medical orders
        pursuant to lawful delegation by a physician.
            (5)  A person who, pursuant to lawful delegation by a
        physician, delivers, installs, monitors or maintains a device
        which enables an individual to self-administer respiratory
        care.
            (6)  A person qualified by academic and clinical
        education to operate extracorporeal circulation equipment in
        a medical or surgical setting which requires support to or
        the temporary replacement of a patient's circulatory or
        respiratory functions.
        (f)  Information or allegations filed with the board against
     a respiratory care practitioner certified by the State Board of
     Medicine shall be referred to that board for appropriate action.
      Section 10.2.  Respiratory care practitioner certificates and
                    permits.
        (a)  A respiratory care practitioner certificate issued by
     the board empowers the holder to practice respiratory care under
     the supervision of a licensed medical doctor or a licensed
     doctor of osteopathic medicine. In a health care facility, that
     supervision may consist of standing orders or protocols approved
     by the institution consistent with acceptable and prevailing
     medical standards which may include services rendered directly
     to the patient in his home or other residence.
        (b)  Twelve months after the effective date of this section,
     the board shall issue temporary permits for the practice of
     respiratory care to individuals who have applied for
     certification from the board and who meet any of the following
     requirements:
            (1)  Graduation from an accredited respiratory care
        training program recognized by the board.
            (2)  Enrollment in an accredited respiratory care
        training program recognized by the board if the individual is
        expected to graduate within 30 days from the date of
        application.
            (3)  Designation as a "Certified Respiratory Therapy
        Technician" or a "Registered Respiratory Therapist" by a
        nationally recognized credentialing agency approved by the
        board.
            (4)  Continuous provision of respiratory care services
        for a minimum of 12 months immediately preceding the
        effective date of this section.
            (5)  Holding certification, licensure or registration as
        a respiratory care practitioner issued by another state, the
        District of Columbia or a territory of the United States
        where the requirements for licensure, registration or
        certification are substantially similar to those required by
        the board.
        (c)  Temporary permits shall be valid for 12 months and for
     such additional period as the board may, in each case, specially
     determine, except that a temporary permit shall expire if the
     holder fails the examination. An appropriate fee for a temporary
     permit shall be established by the board by regulation. If he is
     not in violation of any other provision of this act, a holder of
     a temporary permit qualifies for admission to the examination
     and shall apply for the next regularly scheduled certification
     examination administered by the board. The board is authorized
     to promulgate regulations to establish procedures for
     application, credentials verification, examination and
     certification, together with appropriate fees.
        (d)  Pursuant to section 812.1 of the act of April 9, 1929
     (P.L.177, No.175), known as The Administrative Code of 1929, the
     board shall contract for the development and administration of
     an examination for the certification of respiratory care
     practitioners. At least one administration of this examination
     shall be given within 12 months of the effective date of this
     section, and the examination shall thereafter be given at least
     twice per year. An individual qualifying for a temporary permit
     under subsection (b)(5) shall be issued a certificate by the
     board without examination. An individual qualifying for a
     temporary permit under subsection (b)(3) shall be issued a
     certificate by the board without examination if the individual
     passed an examination in order to obtain designation as a
     "Certified Respiratory Therapy Technician" or a "Registered
     Respiratory Therapist" and that examination was comparable to
     the examination developed and administered pursuant to this
     subsection.
        (e)  A respiratory care practitioner certificate shall be
     renewed biennially upon application on a form prescribed by the
     board and upon payment of a renewal fee adopted by the board by
     regulation.
        Section 4.  Section 11(c) of the act, amended December 20,
     1985 (P.L.398, No.108), is amended to read:
      Section 11.  Penalty provisions.
        * * *
        (c)  Board-imposed civil penalty.--In addition to any other
     civil remedy or criminal penalty provided for in this act, the
     board, by a vote of the majority of the maximum number of the
     authorized membership of the board as provided by law, or by a
     vote of the majority of the duly qualified and confirmed
     membership or a minimum of [four] five members, whichever is
     greater, may levy a civil penalty of up to $1,000 on any current
     licensee who violates any provision of this act or on any person
     who practices osteopathic medicine without being properly
     licensed to do so under this act. The board shall levy this
     penalty only after affording the accused party the opportunity
     for a hearing, as provided in Title 2 of the Pennsylvania
     Consolidated Statutes (relating to administrative law and
     procedure).
        Section 5.  Section 14 of the act, amended December 20, 1985,
     (P.L.398, No.108), is amended to read:
      Section 14.  Temporary and automatic suspension.
        (a)  A license or certificate issued under this act may be
     temporarily suspended under circumstances as determined by the
     board to be an immediate and clear danger to the public health
     and safety. The board shall issue an order to that effect
     without a hearing, but upon due notice, to the licensee
     concerned at his or her last known address, which shall include
     a written statement of all allegations against the licensee. The
     provisions of section 15(d) shall not apply to temporary
     suspension. The board shall thereupon commence formal action to
     suspend, revoke or restrict the license or certificate of the
     person concerned as otherwise provided for in this act. All
     actions shall be taken promptly and without delay. Within 30
     days following the issuance of an order temporarily suspending a
     license or certificate, the board shall conduct or cause to be
     conducted, a preliminary hearing to determine that there is a
     prima facie case supporting the suspension. The licensee whose
     license or certificate has been temporarily suspended may be
     present at the preliminary hearing and may be represented by
     counsel, cross-examine witnesses, inspect physical evidence,
     call witnesses, offer evidence and testimony and make a record
     of the proceedings. If it is determined that there is not a
     prima facie case, the suspended license or certificate shall be
     immediately restored. The temporary suspension shall remain in
     effect until vacated by the board, but in no event longer than
     180 days.
        (b)  A license or certificate issued under this act shall
     automatically be suspended upon the commitment to an institution
     of a licensee because of mental incompetency from any cause upon
     filing with the board a certified copy of such commitment,
     conviction of a felony under the act of April 14, 1972 (P.L.233,
     No.64), known as "The Controlled Substance, Drug, Device and
     Cosmetic Act," or conviction of an offense under the laws of
     another jurisdiction, which, if committed in Pennsylvania, would
     be a felony under "The Controlled Substance, Drug, Device and
     Cosmetic Act." As used in this section the term "conviction"
     shall include a judgment, an admission of guilt or a plea of
     nolo contendere. Automatic suspension under this section shall
     not be stayed pending any appeal of a conviction. Restoration of
     such license or certificate shall be made as in the case of
     revocation or suspension of license or certificate.
        Section 6.  This act shall take effect in 180 days.

     APPROVED--The 2nd day of July, A. D. 1993.

     MARK L. SINGEL
     ACTING GOVERNOR