32-2531. Health care tasks; scope of practice; restrictions; civil penalty

(L00, Ch. 193, sec. 312. Eff. until 1/1/11)

A. After a supervising physician receives board approval of a notice of supervision, that physician may delegate health care tasks to the physician assistant. The physician assistant may perform these tasks in any setting authorized by the approved supervising physician and the board, pursuant to subsections E and F of this section, including clinics, hospitals, ambulatory surgical centers, patient homes, nursing homes and other health care institutions. These tasks may include:

1. Obtaining patient histories.

2. Performing physical examinations.

3. Ordering and performing diagnostic and therapeutic procedures.

4. Formulating a diagnostic impression.

5. Developing and implementing a treatment plan.

6. Monitoring the effectiveness of therapeutic interventions.

7. Assisting in surgery.

8. Offering counseling and education to meet patient needs.

9. Making appropriate referrals.

10. Prescribing schedule IV or V controlled substances as defined in the federal controlled substances act of 1970 (P.L. 91-513; 84 Stat. 1242; 21 United States Code section 802) and prescription-only medications.

11. Prescribing schedule II and III controlled substances as defined in the federal controlled substances act of 1970.

12. Performing minor surgery as defined in section 32-2501.

13. Performing other nonsurgical health care tasks that are normally taught in courses of training approved by the board, that are consistent with the training and experience of the physician assistant and that have been properly delegated by the approved supervising physician.

B. The approved supervising physician shall:

1. Meet the requirements established by the board for supervising a physician assistant and receive written board notification of this compliance.

2. Accept responsibility for all tasks and duties the physician delegates to a physician assistant.

3. Notify the board and the physician assistant in writing if the physician assistant exceeds the scope of the delegated health care tasks.

4. Notify the board if the physician has delegated authority to the physician assistant to prescribe medication. The physician shall also notify the board if the physician makes any changes to this authority.

C. Supervision does not require the personal presence of the physician at the place where health care tasks are performed. The board by order may require the personal presence of a physician when designated health care tasks are performed.

D. A physician assistant shall meet in person with the supervising physician at least once each week to discuss patient management. If the supervising physician is unavailable due to vacation, illness or continuing education programs, a physician assistant may meet with the supervising physician's agent. If the supervising physician is unavailable for any other reason, the fulfillment of this responsibility by the supervising physician's agent is subject to board approval.

E. A physician assistant shall not perform health care tasks in a place which is geographically separated from the supervising physician's primary place for meeting patients without the authorization of the supervising physician and the board.

F. The board may approve the performance of health care tasks by a physician assistant in a place which is geographically separated from the supervising physician's primary place for meeting patients if:

1. Adequate provision for immediate communication between the supervising physician or supervising physician's agent and the physician assistant exists.

2. The physician assistant's performance of health care tasks is adequately supervised and reviewed.

3. A printed announcement which contains the names of the physician assistant and supervising physician and states that the facility employs a physician assistant who is performing health care tasks under the supervision of a licensed physician is posted in the waiting room of the geographically separated site.

G. At all times while a physician assistant is on duty, he shall wear a name tag with the designation "physician assistant" on it.

H. The board by rule may prescribe a civil penalty for a violation of this article relating to charting, wearing tags, identifying prescriptions and posting signs in geographically separated locations. The penalty shall not exceed fifty dollars for each violation. The board shall deposit, pursuant to sections 35-146 and 35-147, all monies it receives from this penalty in the state general fund. A physician assistant and the supervising physician may contest the imposition of this penalty pursuant to board rule. The imposition of a civil penalty is public information, and the board may use this information in any future disciplinary actions.

32-2531. Health care tasks; scope of practice; restrictions; civil penalty

(L00, Ch. 193, sec. 312. Eff. until 1/1/11)

A. After a supervising physician receives board approval of a notice of supervision, that physician may delegate health care tasks to the physician assistant. The physician assistant may perform these tasks in any setting authorized by the approved supervising physician and the board, pursuant to subsections E and F of this section, including clinics, hospitals, ambulatory surgical centers, patient homes, nursing homes and other health care institutions. These tasks may include:

1. Obtaining patient histories.

2. Performing physical examinations.

3. Ordering and performing diagnostic and therapeutic procedures.

4. Formulating a diagnostic impression.

5. Developing and implementing a treatment plan.

6. Monitoring the effectiveness of therapeutic interventions.

7. Assisting in surgery.

8. Offering counseling and education to meet patient needs.

9. Making appropriate referrals.

10. Prescribing schedule IV or V controlled substances as defined in the federal controlled substances act of 1970 (P.L. 91-513; 84 Stat. 1242; 21 United States Code section 802) and prescription-only medications.

11. Prescribing schedule II and III controlled substances as defined in the federal controlled substances act of 1970.

12. Performing minor surgery as defined in section 32-2501.

13. Performing other nonsurgical health care tasks that are normally taught in courses of training approved by the board, that are consistent with the training and experience of the physician assistant and that have been properly delegated by the approved supervising physician.

B. The approved supervising physician shall:

1. Meet the requirements established by the board for supervising a physician assistant and receive written board notification of this compliance.

2. Accept responsibility for all tasks and duties the physician delegates to a physician assistant.

3. Notify the board and the physician assistant in writing if the physician assistant exceeds the scope of the delegated health care tasks.

4. Notify the board if the physician has delegated authority to the physician assistant to prescribe medication. The physician shall also notify the board if the physician makes any changes to this authority.

C. Supervision does not require the personal presence of the physician at the place where health care tasks are performed. The board by order may require the personal presence of a physician when designated health care tasks are performed.

D. A physician assistant shall meet in person with the supervising physician at least once each week to discuss patient management. If the supervising physician is unavailable due to vacation, illness or continuing education programs, a physician assistant may meet with the supervising physician's agent. If the supervising physician is unavailable for any other reason, the fulfillment of this responsibility by the supervising physician's agent is subject to board approval.

E. A physician assistant shall not perform health care tasks in a place which is geographically separated from the supervising physician's primary place for meeting patients without the authorization of the supervising physician and the board.

F. The board may approve the performance of health care tasks by a physician assistant in a place which is geographically separated from the supervising physician's primary place for meeting patients if:

1. Adequate provision for immediate communication between the supervising physician or supervising physician's agent and the physician assistant exists.

2. The physician assistant's performance of health care tasks is adequately supervised and reviewed.

3. A printed announcement which contains the names of the physician assistant and supervising physician and states that the facility employs a physician assistant who is performing health care tasks under the supervision of a licensed physician is posted in the waiting room of the geographically separated site.

G. At all times while a physician assistant is on duty, he shall wear a name tag with the designation "physician assistant" on it.

H. The board by rule may prescribe a civil penalty for a violation of this article relating to charting, wearing tags, identifying prescriptions and posting signs in geographically separated locations. The penalty shall not exceed fifty dollars for each violation. The board shall deposit, pursuant to sections 35-146 and 35-147, all monies it receives from this penalty in the state general fund. A physician assistant and the supervising physician may contest the imposition of this penalty pursuant to board rule. The imposition of a civil penalty is public information, and the board may use this information in any future disciplinary actions.