ENGROSSED
Senate Bill No. 159
(By Senators Manchin, Anderson, Grubb and Minard)
__________
[Introduced January 31, 1994; referred to the
Committee on Health and Human Resources; and then to the
Committee on the Judiciary.]
__________
A BILL to amend and reenact sections eight, ten, eleven, sixteen,
eighteen, nineteen, and thirty one, article nine, chapter
sixty-four of the code of West Virginia, one thousand nine
hundred thirty-one, as amended; to further amend said
article by adding thereto six new sections, designated
sections thirty-six, thirty-seven, thirty-eight,
thirty-nine, forty, and forty-one, all relating generally to
the promulgation of administrative rules and regulations by
the various executive or administrative agencies and the
procedures relating thereto; the legislative mandate or
authorization for the promulgation of certain legislative
rules by various executive and administrative agencies of
the state; authorizing certain of the agencies to promulgate
certain legislative rules in the form that the rules were
filed in the state register; authorizing certain of the
agencies to promulgate legislative rules as amended by the
Legislature; authorizing certain of the agencies to
promulgate legislative rules with various modifications
presented to and recommended by the legislative rule-making
review committee; authorizing the board of examiners to
promulgate legislative rules relating to the board of
examiners in counseling, licensing, as modified; authorizing
the board of dental examiners to promulgate legislative
rules relating to the West Virginia board of dental
examiners, as modified; authorizing the board of embalmers
and funeral directors to promulgate legislative rules
relating to the West Virginia board of embalmers and funeral
directors, as modified; authorizing the board of medicine to
promulgate legislative rules relating to licensing,
disciplinary and complaint procedures, physicians,
podiatrists, as modified; authorizing the board of examiners
for registered professional nurses to promulgate legislative
rules relating to disciplinary action, as modified;
authorizing the board of examiners for registered
professional nurses to promulgate legislative rules relating
to standards for professional nursing practice, as modified;
authorizing the nursing home administrators licensing board
to promulgate legislative rules relating to rules and
regulations of the nursing home administrators licensing
board, as modified; authorizing the real estate appraiser
licensing and certification board to promulgate legislative
rules relating to requirements for licensure and
certification, as modified; authorizing the board of
osteopathy to promulgate legislative rules relating toosteopathic physician assistants, as amended; authorizing
the board of osteopathy to promulgate legislative rules
relating to the licensing, disciplinary and complaint
procedures for osteopathic physicians, as modified;
authorizing the board of physical therapy to promulgate
legislative rules relating to general provisions, as
modified; authorizing the board of examiners for
speech-language pathology and audiology to promulgate
legislative rules relating to the licensure of
speech-language pathology and audiology, as modified;
authorizing the board of examiners for speech pathology and
audiology to promulgate legislative rules relating to
licensure of speech-language pathology and audiology
assistants, as modified; authorizing the commercial
hazardous waste management facility siting board to
promulgate legislative rules relating to the commercial
hazardous waste management facility siting board
certification requirements, as modified; authorizing the
family protection services board to promulgate legislative
rules relating to operation of the family protection
services board and licensure and funding of domestic
violence programs, as modified and amended; authorizing the
board of investments to promulgate legislative rules
relating to the rules for the administration of the
consolidated pension fund, as modified; and authorizing the
board of investments to promulgate legislative rules
relating to the administration of the consolidated fund ofthe state board of investments.
Be it enacted by the Legislature of West Virginia:
That sections eight, ten, eleven, sixteen, eighteen,
nineteen, and thirty-one, article nine, chapter sixty-four of the
code of West Virginia, one thousand nine hundred thirty-one, as
amended be amended and reenacted; that said article be further
amended by adding thereto six new sections, designated sections
thirty-six, thirty-seven, thirty-eight, thirty-nine, forty and
forty-one, all to read as follows:
ARTICLE 9. AUTHORIZATION FOR MISCELLANEOUS AGENCIES AND BOARDS
TO PROMULGATE LEGISLATIVE RULES.
§64-9-8. West Virginia board of examiners in counseling.
(a) The legislative rules filed in the state register on the
twentieth day of March, one thousand nine hundred eighty-nine,
modified by the West Virginia board of examiners in counseling to
meet the objections of the legislative rule-making review
committee and refiled in the state register on the twelfth day of
September, one thousand nine hundred eighty-nine, relating to the
West Virginia board of examiners in counseling (licensing), are
authorized.
(b) The legislative rules filed in the state register on the
eighteenth day of July, one thousand nine hundred ninety-one,
modified by the board of examiners in counseling to meet the
objections of the legislative rule-making review committee and
refiled in the state register on the sixth day of December, one
thousand nine hundred ninety-one, relating to the board of
examiners in counseling (licensing), are authorized.
(c) The legislative rules filed in the state register on the
sixteenth day of August, one thousand nine hundred ninety-three,
modified by the board of examiners in counseling to meet the
objections of the legislative rule-making review committee and
refiled in the state register on the twenty-fifth day of January,
one thousand nine hundred ninety-four, relating to the board of
examiners in counseling (licensing), are authorized.
§64-9-10. West Virginia board of dental examiners.
(a) The legislative rules filed in the state register on the
eighth day of August, one thousand nine hundred eighty-nine,
modified by the West Virginia board of dental examiners to meet
the objections of the legislative rule-making review committee
and refiled in the state register on the twenty-third day of
October, one thousand nine hundred eighty-nine, relating to the
West Virginia board of dental examiners (rules and regulations of
the West Virginia board of dental examiners), are authorized.
(b) The legislative rules filed in the state register on the
twenty-seventh day of July, one thousand nine hundred ninety,
modified by the West Virginia board of dental examiners to meet
the objections of the legislative rule-making review committee
and refiled in the state register on the twenty-seventh day of
August, one thousand nine hundred ninety, relating to the West
Virginia board of dental examiners (rules and regulations of the
West Virginia board of dental examiners), are authorized.
(c) The legislative rules filed in the state register on the
twenty-third day of August, one thousand nine hundred
ninety-three, modified by the board of dental examiners to meetthe objections of the legislative rule-making review committee
and refiled in the state register on the twelfth day of October,
one thousand nine hundred ninety-three, relating to the board of
dental examiners (rules and regulations of the West Virginia
board of dental examiners), are authorized.
§64-9-11. Board of embalmers and funeral directors.
(a) The legislative rules filed in the state register on the
twenty-seventh day of July, one thousand nine hundred eighty-
four, modified by the board of embalmers and funeral directors to
meet the objections of the legislative rule-making review
committee and refiled in the state register on the ninth day of
January, one thousand nine hundred eighty-five, relating to the
board of embalmers and funeral directors (apprenticeship), are
authorized.
(b) The legislative rules filed in the state register on the
sixteenth day of October, one thousand nine hundred eighty-five,
modified by the board of embalmers and funeral directors to meet
the objections of the legislative rule-making review committee
and refiled in the state register on the eighteenth day of July,
one thousand nine hundred eighty-six, relating to the board of
embalmers and funeral directors (governing the board of embalmers
and funeral directors), are authorized.
(c) The legislative rules filed in the state register on the
sixth day of May, one thousand nine hundred ninety-three,
modified by the board of embalmers and funeral directors to meet
the objections of the legislative rule-making review committee
and refiled in the state register on the fifteenth day ofNovember, one thousand nine hundred ninety-three, relating to the
board of embalmers and funeral directors (rules of the West
Virginia Board of embalmers and funeral directors), are
authorized.
§64-9-16. Board of medicine.
(a) The legislative rules filed in the state register on the
twelfth day of May, one thousand nine hundred eighty-three,
relating to the board of medicine (licensing, disciplinary and
complaint procedures; podiatry; physicians assistants), are
authorized with the modifications set forth below:
"§24.12.
(b) It shall be the responsibility of the supervising
physician to obtain consent in writing from the patient before
Type A physician assistants employed in a satellite clinic may
render general medical or surgical services, except in
emergencies.
§24.16.
(a) No physician assistant shall render nonemergency
outpatient medical services until the patient has been informed
that the individual providing care is a physician assistant."
(b) The legislative rules filed in the state register on the
twenty-sixth day of November, one thousand nine hundred eighty-
five, modified by the board of medicine to meet the objections of
the legislative rule-making review committee and refiled in the
state register on the seventeenth day of January, one thousand
nine hundred eighty-six, relating to the board of medicine
(licensing, disciplinary and complaint procedures; podiatry;physicians assistants), are authorized.
(c) The legislative rules filed in the state register on the
eighth day of March, one thousand nine hundred eighty-five,
modified by the West Virginia board of medicine to meet the
objections of the legislative rule-making review committee and
refiled in the state register on the eighteenth day of December,
one thousand nine hundred eighty-five, relating to the West
Virginia board of medicine (rules governing the approval of
medical schools not accredited by the liaison committee on
medical education), are authorized.
(d) The legislative rules filed in the state register on the
third day of June, one thousand nine hundred eighty-seven,
relating to the board of medicine (fees for services rendered by
the board of medicine), are authorized.
(e) The legislative rules filed in the state register on the
sixteenth day of September, one thousand nine hundred eighty-
eight, modified by the board of medicine to meet the objections
of the legislative rule-making review committee and refiled in
the state register on the twenty-fourth day of February, one
thousand nine hundred eighty-nine, relating to the board of
medicine (dispensing of legend drugs by physicians and
podiatrists), are authorized with the following amendments:
Section 2.6 to read as follows: "Dispense means to deliver
a legend drug to an ultimate user or research subject by or
pursuant to the lawful order of a physician or podiatrist,
including the prescribing, packaging, labeling, administering or
compounding necessary to prepare the drug for that delivery."
And,
Section 3.3 to read as follows: "Physicians or podiatrists
who are not registered with the Board as dispensing physicians
may not dispense legend drugs. However, the following activities
by a physician or podiatrist shall be exempt from the
requirements of sections 3 through 8 applicable to dispensing
physicians:
a. Legend drugs administered to the patient, which are not
controlled substances when an appropriate record is made in the
patient's chart;
b. Professional samples distributed free of charge by a
physician or podiatrist or certified physician assistant under
his or her supervision to the patient when an appropriate record
is made in the patient's chart; or
c. Legend drugs which are not controlled substances
provided by free clinics or under West Virginia state authorized
programs, including the Medicaid, family planning, maternal and
child health, and early and periodic screening and diagnosis and
treatment programs:
Provided,
That all labeling provisions of
section 8 shall be applicable except the requirements of section
8.3 (a)."
(f) The legislative rules filed in the state register on the
tenth day of August, one thousand nine hundred ninety, modified
by the board of medicine to meet the objections of the
legislative rule-making review committee and refiled in the state
register on the first day of October, one thousand nine hundred
ninety, relating to the board of medicine (fees for servicesrendered by the board of medicine), are authorized.
(g) The legislative rules filed in the state register on the
tenth day of August, one thousand nine hundred ninety, modified
by the board of medicine to meet the objections of the
legislative rule-making review committee and refiled in the state
register on the eleventh day of January, one thousand nine
hundred ninety-one, relating to the board of medicine (licensing
and disciplinary and complaint procedures: physicians;
podiatrists), are authorized.
(h) The legislative rules filed in the state register on the
tenth day of August, one thousand nine hundred ninety, modified
by the board of medicine to meet the objections of the
legislative rule-making review committee and refiled in the state
register on the eleventh day of January, one thousand nine
hundred ninety-one, relating to the board of medicine
(certification, disciplinary and complaint procedures: physician
assistants), are authorized.
(i) The legislative rules filed in the state register on the
tenth day of July, one thousand nine hundred ninety-one, modified
by the board of medicine to meet the objections of the
legislative rule-making review committee and refiled in the state
register on the third day of September, one thousand nine hundred
ninety-one, relating to the board of medicine (continuing
education for physicians and podiatrists), are authorized.
(j) The legislative rules filed in the state register on the
twenty-fifth day of March, one thousand nine hundred ninety-two,
modified by the board of medicine to meet the objections of thelegislative rule-making review committee and refiled in the state
register on the nineteenth day of May, one thousand nine hundred
ninety-two, relating to the board of medicine (licensing,
disciplinary and complaint procedures: physicians, podiatrists),
are authorized.
(k) The legislative rules filed in the state register on the
seventeenth day of September, one thousand nine hundred ninety-
two, modified by the board of medicine to meet the objections of
the legislative rule-making review committee and refiled in the
state register on the sixteenth day of November, one thousand
nine hundred ninety-two, relating to the board of medicine
(certification, disciplinary and complaint procedures, continuing
education, physician assistants), are authorized, with the
following amendment:
On page six, section 11-1B-2, subsection 2.8 (c), after the
words "in writing" and the comma, by striking out the words
"prior to" and inserting in lieu thereof the words "within ten
days of".
(l) The legislative rules filed in the state register on the
sixteenth day of August, one thousand nine hundred ninety-three,
modified by the board of medicine to meet the objections of the
legislative rule-making review committee and refiled in the state
register on the twentieth day of October, one thousand nine
hundred ninety-three, relating to the board of medicine
(licensing, disciplinary and complaint procedures, physicians;
podiatrists), are authorized.
§64-9-18. Board of examiners for registered professional nurses.
(a) The legislative rules filed in the state register on the
thirteenth day of September, one thousand nine hundred eighty-
three, relating to the board of examiners for registered
professional nurses (qualifications of graduates of foreign
nursing schools for admission to the professional nurse licensing
examination), are authorized.
(b) The legislative rules filed in the state register on the
third day of August, one thousand nine hundred ninety, modified
by the board of examiners for registered professional nurses to
meet the objections of the legislative rule-making review
committee and refiled in the state register on the twenty-eighth
day of September, one thousand nine hundred ninety, relating to
the board of examiners for registered professional nurses
(announcement of advanced nursing practice), are authorized.
(c) The legislative rules filed in the state register on the
tenth day of September, one thousand nine hundred ninety-two,
modified by the board of examiners for registered professional
nurses to meet the objections of the legislative rule-making
review committee and refiled in the state register on the
nineteenth day of January, one thousand nine hundred ninety-
three, relating to the board of examiners for registered
professional nurses (limited prescriptive authority for nurses in
advanced practice), are authorized.
(d) The legislative rules filed in the state register on the
sixteenth day of August, one thousand nine hundred ninety-three,
modified by the board of examiners for registered professional
nurses to meet the objections of the legislative rule-makingreview committee and refiled in the state register on the
eleventh day of January, one thousand nine hundred ninety-four,
relating to the board of examiners for registered professional
nurses (disciplinary action), are authorized.
(e) The legislative rules filed in the state register on the
sixteenth day of August, one thousand nine hundred ninety-three,
modified by the board of examiners for registered professional
nurses to meet the objections of the legislative rule-making
review committee and refiled in the state register on the
eleventh day of January, one thousand nine hundred ninety-four,
relating to the board of examiners for registered professional
nurses (standards for professional nursing practice), are
authorized.
§64-9-19. Nursing home administrators licensing board.
(a) The legislative rules filed in the state register on the
eighteenth day of October, one thousand nine hundred eighty-five,
modified by the nursing home administrators licensing board to
meet the objections of the legislative rule-making review
committee and refiled in the state register on the twenty-eighth
day of January, one thousand nine hundred eighty-six, relating to
the nursing home administrators licensing board (governing
nursing home administrators), are authorized.
(b) The legislative rules filed in the state register on the
sixteenth day of August, one thousand nine hundred ninety-three,
modified by the nursing home administrators licensing board to
meet the objections of the legislative rule-making review
committee and refiled in the state register on the twenty-third day of November, one thousand nine hundred ninety-three, relating
to the nursing home administrators licensing board (rules and
regulations of the nursing home administrators licensing board),
are authorized.
§64-9-31. Real estate appraiser licensing and certification
board.
(a) The legislative rules filed in the state register on the
eighteenth day of July, one thousand nine hundred ninety-one,
modified by the real estate appraiser licensing and certification
board to meet the objections of the legislative rule-making
review committee and refiled in the state register on the
eighteenth day of November, one thousand nine hundred ninety-one,
relating to the real estate appraiser licensing and certification
board (rules and regulations of the real estate appraiser
licensing and certification board), are authorized.
(b) The legislative rules filed in the state register on the
eighteenth day of July, one thousand nine hundred ninety-one,
modified by the real estate appraiser licensing and certification
board to meet the objections of the legislative rule-making
review committee and refiled in the state register on the
eighteenth day of November, one thousand nine hundred ninety-one,
relating to the real estate appraiser licensing and certification
board (requirements of licensure and certification), are
authorized.
(c) The legislative rules filed in the state register on the
eighteenth day of July, one thousand nine hundred ninety-one,
modified by the real estate appraiser licensing and certificationboard to meet the objections of the legislative rule-making
review committee and refiled in the state register on the
eighteenth day of November, one thousand nine hundred ninety-one,
relating to the real estate appraiser licensing and certification
board (renewal of licensure or certification), are authorized.
(d) The legislative rules filed in the state register on the
seventh day of July, one thousand nine hundred ninety-two,
modified by the real estate appraiser licensing and certification
board to meet the objections of the legislative rule-making
review committee and refiled in the state register on the
fourteenth day of August, one thousand nine hundred ninety-two,
relating to the real estate appraiser licensing and certification
board (requirements of licensure and certification), are
authorized.
(e) The legislative rules filed in the state register on the
twenty-eighth day of May, one thousand nine hundred ninety-three,
modified by the real estate appraiser licensing and certification
board to meet the objections of the legislative rule-making
review committee and refiled in the state register on the seventh
day of July, one thousand nine hundred ninety-three, relating to
the real estate appraiser licensing and certification board
(requirements for licensure and certification), are authorized.
§64-9-36. Board of osteopathy.
(a) The legislative rules filed in the state register on the
sixth day of August, one thousand nine hundred ninety-three,
relating to the board of osteopathy (osteopathic physician
assistants), are authorized with amendment set forth below:
On page one by striking out the entire rule and inserting in
lieu thereof the following:
§11-1B-1. General.
1.1. Scope. -- W. Va. Code §30-14A-1 requires the Board of
Osteopathy to adopt rules governing the extent to which
osteopathic physician assistants may function in this State.
1.2. Authority. -- W. Va. Code §30-14A-1.
1.3. Filing Date. --
1.4. Effective Date. --
§11-1B-2. Rules For Osteopathic physician Assistants.
2.1. For purposes of this section, the following definitions
are in effect:
2.1.1. Licensure -- The approval of individuals by the
Board to serve as osteopathic physician assistants. It also
means the approval of programs by the Board for the training and
education of osteopathic physician assistants.
2.1.2. Crimes involving moral turpitude. -- Those crimes
which have dishonesty as a fundamental and necessary element;
including, but not limited to, crimes involving theft,
embezzlement, false swearing perjury, fraud or misrepresentation.
2.1.3. NCCPA. -- The National Commission on the
Certification of Physician Assistants.
2.1.4. Protocol. -- Written treatment instructions
prepared by a supervising osteopathic physician for use by a
osteopathic physician assistant. Such instructions should be
flexible, in accordance with the setting where the osteopathic
physician assistant is employed.
2.1.5. Satellite operation. -- An office or clinic
separate and apart from the office of the supervising osteopathic
physician, established by the osteopathic physician and manned in
part by a osteopathic physician assistant.
2.1.6. Supervision. -- The opportunity or ability of the
osteopathic physician to provide or exercise control and
direction over the services of osteopathic physician assistants.
Constant physical presence of the supervising osteopathic
physician of a osteopathic physician assistant certified by the
NCCPA is not required so long as the supervising osteopathic
physician and the osteopathic physician assistant are or can
easily be in contact with each other by radio, telephone or
telecommunication. Supervision requires the availability of the
supervising osteopathic physician. An appropriate degree of
supervision includes:
a. Personal supervision by the osteopathic physician of
a minimum of twenty-five percent of the weekly hours worded by
each osteopathic physician assistant;
b. The active and continuing overview of the osteopathic
physician assistant's activities to determine that the
supervising osteopathic physician's directions are being
implemented;
c. The availability of the supervising osteopathic
physician to the osteopathic physician assistant for all
necessary consultations;
d. Personal and regular (at least monthly) review by the
supervising osteopathic physician of selected patient recordsupon which entries are made by the osteopathic physician
assistant. Patient records shall be selected for review on the
basis of written criteria established by the supervising
osteopathic physician and the osteopathic physician assistant and
shall be of sufficient number to assure adequate review of the
osteopathic physician assistant's scope of practice, and;
e. Periodic (at least monthly) education and review
sessions discussing specific conditions, protocols, procedures
and specific patients, held by the supervising osteopathic
physician for the osteopathic physician assistant under his or
her supervision.
In the case of a osteopathic physician assistant who has
not been certified by the NCCPA, the presence of the supervising
osteopathic physician or alternate supervising osteopathic
physician is required on the premises where the noncertified
osteopathic physician assistant performs delegated medical tasks.
2.2. Employment of osteopathic physician assistants by
licensed osteopathic physician; services that may be performed by
osteopathic physician assistants.
2.2.1. A osteopathic physician fully licensed under W. Va.
Code §30-14-1 et. seq. may submit a job description to the Board
to employ a osteopathic physician assistant.
2.2.2. The delegation of certain acts to a osteopathic
physician assistant shall be stated on the job description in a
manner consistent with sound medical practice and with the
protection of the health and safety of the patient in mind. The
services shall be limited to those which are educational,diagnostic, therapeutic or preventive in nature and may,
according to the standards set by his or her supervising
osteopathic physician, allow the osteopathic physician assistant
to formulate a provisional diagnosis and treatment plan which may
be set by standard protocols of his or her supervising
osteopathic physician and are under his or her direction.
2.3. Submission of application; job description. -- An
application completed by the applicant and a job description
written and signed by the supervising osteopathic physician
listing in numerical order the duties which will be performed by
the assistant must be in the office of the Board of Osteopathy,
thirty (30) days prior to a Board meeting. The filing of an
application and job description does not entitle a osteopathic
physician assistant to licensure. The only legal authority for
such approval must be given by the Board.
2.4. Biennial report of osteopathic physician assistant's
performance; biennial report of the Board. -- Osteopathic
physician assistants and their supervising osteopathic physicians
must submit biennial signed reports either individually or
combined, on the professional conduct, capabilities and
performance of the osteopathic physician assistant. The report
must accompany each application for licensure and must be
submitted to the office of the Board by April 1. In addition
thereto, the Board shall compile and publish a biennial report
that includes a list of currently licensed osteopathic physician
assistants, their employers and location in the state and a list
of approved programs in West Virginia, the number of graduatesper year of the approved programs and the number of osteopathic
physician assistants from other states' approved programs
practicing in West Virginia.
2.5. Supervision and control of osteopathic physician
assistant. -- The osteopathic physician assistant, whether
employed by a health care facility or the supervising osteopathic
physician, shall perform only under the supervision and control
of the supervising osteopathic physician. Supervision and
control of a osteopathic physician assistant certified by the
NCCPA requires the availability of a osteopathic physician for
consultation and direction of the actions of the assistant, but
does not necessarily require the personal presence of the
supervising osteopathic physician at the place or places where
services are rendered, if the osteopathic physician assistant
certified by the NCCPA is performing (specified) duties at the
direction of the supervising osteopathic physician. In the case
of a osteopathic physician assistant who has not been certified
by the NCCPA, the presence of the supervising osteopathic
physician or alternate supervising osteopathic physician on the
premises where the noncertified assistant performs delegated
medical tasks is required. The osteopathic physician assistant
may function in any setting within which the supervising
osteopathic physician routinely practices, but in no instance
shall a separate place of work for the osteopathic physician
assistant be established. The supervising osteopathic physician
shall be a osteopathic physician permanently licensed in this
State.
2.6. Limitations on employment and scope of duties of
osteopathic physician assistants.
2.6.1. A supervising osteopathic physician shall not
employ at any one time more than two (2) osteopathic physician
assistants.
2.6.2. A osteopathic physician assistant shall not sign
prescriptions except in the case of certain osteopathic physician
assistants authorized to do so by the Board in accordance with
the provisions of 2.13 of this rule.
2.6.3. A osteopathic physician assistant shall not perform
any services which his or her supervising osteopathic physician
is not qualified to perform.
2.6.4. A osteopathic physician assistant may sign orders
to be countersigned later by his or her supervising osteopathic
physician: Provided, That they are not in conflict with hospital
regulations.
2.6.5. A osteopathic physician assistant shall not perform
any services which are not included in his or her job description
and approved by the Board.
2.6.6. No osteopathic physician assistant shall be
supervised by and work for more than three supervising
osteopathic physicians at one time.
2.7. Identification of osteopathic physician assistant. --
When functioning as a osteopathic physician assistant, the
osteopathic physician assistant shall wear a name tag which
identifies the osteopathic physician assistant as a osteopathic
physician assistant.
2.8. Supervising osteopathic physician; responsibilities.
2.8.1. The supervising osteopathic physician is
responsible for observing, directing and evaluating the work,
records and practices performed by the osteopathic physician
assistant.
2.8.2. The supervising osteopathic physician shall notify
the Board in writing of any termination of the employment of his
or her osteopathic physician assistant within ten (10) days of
the termination.
2.8.3. The legal responsibility for any osteopathic
physician assistant remains that of his or her supervising
osteopathic physician at all times, except in temporary
situations not to exceed twenty one days, in cases when a
licensed and fully qualified osteopathic physician assistant is
substituting for another licensed osteopathic physician
assistant, the acts and omissions of the substituting osteopathic
physician assistant are the legal responsibility of the absent
osteopathic physician assistant's designated supervising
osteopathic physician. The temporary change in supervisory
responsibility shall be provided to the Board in writing, within
ten (10) days of the effective date of the substitution, signed
by the affected supervising osteopathic physicians and
osteopathic physician assistants, and clearly specifying the
dates of substitution.
2.9. The license of a osteopathic physician assistant shall
be restricted, suspended or revoked by the Board in accordance
with all the alternatives set out at W. Va. Code §30-14A-1 when,after due notice and a hearing in accordance with the manner and
form prescribed by the contested case hearing procedure, W. Va.
Code §29A-5-1 et seq. and regulations of the Board set out at 24
CSR 1 if it is found:
2.9.1. That the assistant has held himself or herself out
or permitted another person to represent him or her as a licensed
osteopathic physician;
2.9.2. That the assistant has in fact performed other than
at the direction and under the supervision of a supervising
osteopathic physician licensed by the Board;
2.9.3. That the assistant has been delegated and performed
a task or tasks beyond his or her competence and not in
accordance with his or her job description as approved by the
Board;
2.9.4. That the assistant is a habitual user of
intoxicants or drugs to such an extent that he or she is unable
to safely perform as an assistant to the osteopathic physician;
2.9.5. That the assistant has been convicted in any court,
state or federal, of any felony or other criminal offense
involving moral turpitude;
2.9.6. That the assistant has been adjudicated a mental
incompetent or his or her mental condition renders him or her
unable to safely perform as an assistant to a osteopathic
physician;
2.9.7. That the assistant has failed to comply with any of
the provisions of this rule or W. Va. Code §30-14-1 et seq.; and
2.9.8. That the assistant is guilty of unprofessionalconduct which includes, but is not limited to, the following:
a. Misrepresentation or concealment of any material fact
in obtaining any certificate or license or a reinstatement
thereof;
b. The commission of an offense against any provision
of state law related to the practice of osteopathic physician
assistants, or any rule or regulation promulgated thereunder;
c. The commission of any act involving moral turpitude,
dishonesty or corruption, when the act directly or indirectly
affects the health, welfare or safety of citizens of this State.
If the act constitutes a crime, conviction thereof in a criminal
proceeding is not a condition precedent to disciplinary action;
d. Conviction of a felony, as defined under the laws of
this State or under the laws of any other state, territory or
country;
e. Misconduct in his or her practice as a osteopathic
physician assistant or performing tasks fraudulently, beyond his
or her authorized scope, with incompetence or with negligence on
a particular occasion or negligence on repeated occasions;
f. Performing tasks as a osteopathic physician assistant
while the ability to do so is impaired by alcohol, drugs,
physical disability or mental instability;
g. Impersonation of a licensed osteopathic physician or
another certified or licensed osteopathic physician assistant;
h. Offering, undertaking or agreeing to cure or treat
disease by a secret method, procedure, treatment or medicine;
treating or prescribing for any human condition by a method,means or procedure which the osteopathic physician assistant
refuses to divulge upon demand of the Board; or using such
methods or treatment processes not accepted by a reasonable
segment of the medical profession;
i. Prescribing a prescription drug, including any
controlled substance under state or federal law, other than in
good faith and a therapeutic manner in accordance with accepted
medical standards;
j. Prescribing a controlled substance under state or
federal law, to or for himself or herself, or to or for any
member of his or her immediate family; and
k. Prescribing a prescription drug, including any
controlled substance under state or federal law, which is not
included in the approved job description for that osteopathic
physician assistant or which is not included in the approved
state formulary for osteopathic physician assistants.
2.10. Denial of licensure of osteopathic physician assistant.
Whenever the Board determines that an applicant has failed to
satisfy the Board that he or she should be licensed, the Board
shall immediately notify the applicant of its decision and
indicate in what respect the applicant has failed to satisfy the
Board. The applicant shall be given a formal hearing before the
Board upon request of the applicant filed with or mailed by
registered or certified mail to the Secretary of the Board, which
request must be filed within thirty (30) days after receipt of
the Board's decision, stating the reasons for the request. The
Board shall within twenty (20) days of receipt of the request,notify the applicant of the time and place of a public hearing,
which shall be held within a reasonable time. The burden of
satisfying the Board of his or her qualifications for licensure
is upon the applicant. Following the hearing, the Board shall
determine on the basis of this rule whether the applicant is
qualified to be licensed, and this decision of the Board is final
as to that application.
2.11. Disciplinary procedures. -- The disciplinary process
and procedures set forth in the contested case hearing procedure,
W. Va. Code §29A-5-1 et seq. and in regulations of the Board set
out at 24 CSR 1 also apply to disciplinary actions instituted
against osteopathic physician assistants with the same provisions
regarding the appeal of decisions made to circuit courts.
2.12. Osteopathic physician assistant utilization.
2.12.1. The osteopathic physician assistant shall, under
appropriate direction and supervision by a osteopathic physician,
augment the osteopathic physician's data gathering abilities in
order to assist the supervising osteopathic physician in reaching
decisions and instituting care plans for the osteopathic
physician's patients. A osteopathic physician assistant shall
have, as a minimum, the knowledge and competency to perform the
following functions and may under appropriate supervision perform
them; this list is not intended to be specific or all-inclusive:
a. Screen patients to determine the need for medical
attention;
b. Review patient records to determine health status;
c. Take a patient history;
d. Perform a physical examination;
e. Perform development screening examinations on
children;
f. Record pertinent patient data;
g. Make decisions regarding data gathering and
appropriate management and treatment of patients being seen for
the initial evaluation of a problem or the follow-up evaluation
of a previously diagnosed and stabilized condition;
h. Prepare patient summaries;
i. Initiate requests for commonly performed initial
laboratory studies;
j. Collect specimens for and carry out commonly
performed blood, urine and stool analyses and cultures;
k. Identify normal and abnormal findings in history
physical examination and commonly performed laboratory studies;
l. Initiate appropriate evaluation and emergency
management for emergency situations; for example, cardiac arrest,
respiratory distress, injuries, burns and hemorrhage;
m. Perform clinical procedures such as:
A. Venipuncture;
B. Electrocardiogram;
C. Care and suturing of minor lacerations;
D. Casting and splinting;
E. Control of external hemorrhage;
F. Application of dressings and bandages;
G. Removal of superficial foreign bodies;
H. Cardiopulmonary resuscitation;
I. Audiometry screening;
J. Visual screening; and
K. Aseptic and isolation techniques; and
n. Provide counseling and instruction regarding common
patient problems.
2.12.2. The tasks a osteopathic physician assistant may
perform are those which require technical skill, execution of
standing orders, routine patient care tasks and such diagnostic
and therapeutic procedures as the supervising osteopathic
physician may wish to delegate to the osteopathic physician
assistant after the supervising osteopathic physician has
satisfied himself or herself as to the ability and competence of
the osteopathic physician assistant. The supervising osteopathic
physician may, with due regard for the safety of the patient and
in keeping with sound medical practice, delegate to the
osteopathic physician assistant such medical procedures and other
tasks as are usually performed within the normal scope of the
supervising osteopathic physician's practice, subject to the
limitations set forth in this section and W. Va. Code §30-14-1 et
seq., and the training and expertise of the osteopathic physician
assistant.
2.12.3. A supervising osteopathic physician shall not
permit a osteopathic physician assistant to independently
practice medicine. Supervision must be maintained at all times.
2.12.4. A osteopathic physician assistant shall not:
a. Maintain or manage an office separate and apart from
the supervising osteopathic physician's primary office fortreating patients, unless the Board has granted the supervising
osteopathic physician specific permission to establish a
satellite operation;
b. Independently bill patients for services provided;
c. Independently delegate a task assigned to him or her
by his or her supervising osteopathic physician to another
individual;
d. Perform acupuncture in any form; or
e. Pronounce a patient dead, except in a setting where
state or federal government regulations permit a registered nurse
or a osteopathic physician assistant to do so.
2.12.5. The supervising osteopathic physician shall
monitor and supervise the activities of the osteopathic physician
assistant and require documentation, including organized medical
records with symptoms, pertinent physical findings, impressions
and treatment plans indicated. The supervising osteopathic
physician may also provide written protocols for the use of the
osteopathic physician assistant in the performance of delegated
tasks. The established protocols shall be available for public
inspection upon request and may be reviewed by the Board as
required.
2.12.6. If the supervising osteopathic physician absents
himself or herself in such a manner or to such an extent that he
or she is unavailable to aid the osteopathic physician assistant
when required, the supervising osteopathic physician shall not
delegate patient care to his or her osteopathic physician
assistant unless he or she has made appropriate arrangements foran alternate supervising osteopathic physician. The legal
responsibility for the acts and omissions of the osteopathic
physician assistant remains with the supervising osteopathic
physician at all times.
2.12.7. It is the responsibility of the supervising
osteopathic physician to ensure that supervision is maintained in
his or her absence.
2.12.8. No osteopathic physician assistant may be utilized
in an office or clinic separate and apart from the supervising
osteopathic physician's primary place for meeting patients unless
the supervising osteopathic physician has obtained specific
approval from the Board. A supervising osteopathic physician may
supervise only two (2) satellite operations. The criteria for
granting approval is that the supervising osteopathic physician
demonstrate the following to the satisfaction of the Board:
a. That the osteopathic physician assistant will be
utilized in a designated manpower shortage area or an area of
medical need as defined by the Board;
b. That there is adequate provision for direct
communication between the osteopathic physician assistant and the
supervising osteopathic physician and that the distance between
the main office and the satellite operation is not so great as to
prohibit or impede appropriate emergency services;
c. That provision is made for the supervising
osteopathic physician to see each regular patient periodically;
for example, every third visit; and
d. That the supervising osteopathic physician visit theremote office at least once every fourteen days and demonstrate
that he or she spends enough time on site to provide supervision
and personal and regular review of the selected records upon
which entries are made by the osteopathic physician assistant.
Patient records shall be selected on the basis of written
criteria established by the supervising osteopathic physician and
the osteopathic physician assistant and shall be of sufficient
number to assure adequate review of the osteopathic physician
assistant's scope of practice.
2.12.9. Appropriate records of supervisory contact must be
maintained and made available for Board review if required.
Failure to maintain the standards required for such an operation
may result in the loss of the privilege to maintain a satellite
operation.
2.12.10. Designated representatives of the Board will be
authorized to make on-site visits to the offices of supervising
osteopathic physicians and medical care facilities utilizing
osteopathic physician assistants to review the following:
a. The supervision of osteopathic physician assistants;
b. The maintenance of and compliance with, any
protocols;
c. Utilization in conformity with the provisions of this
section;
d. Identification of osteopathic physician assistants;
and
e. Compliance with licensure and registration
requirements.
2.12.11. The Board reserves the right to review
osteopathic physician assistant utilization without prior notice
to either the osteopathic physician assistant or the supervising
osteopathic physician. It is a violation of this rule for a
supervising osteopathic physician or a osteopathic physician
assistant to refuse to undergo a review by the Board.
2.12.12. The provisions of this section shall not be
construed to require medical care facilities to accept
osteopathic physician assistants or to use them within their
premises. It is appropriate for the osteopathic physician
assistant to provide services to the hospitalized patients of his
or her supervising osteopathic physician under the supervision of
the osteopathic physician, if the medical care facility permits
it.
2.12.13. Osteopathic physician assistants employed
directly by medical care facilities shall perform services only
under the supervision of a clearly identified supervising
osteopathic physician, and the osteopathic physician shall
supervise no more than two (2) osteopathic physician assistants,
except that a supervising osteopathic physician may supervise up
to four (4) hospital employed osteopathic physician assistants.
2.12.14. So long as the facility permits, a osteopathic
physician assistant may:
a. Assess and record the patient's progress within the
parameters of an established protocol or regimen and report the
patient's progress to the supervising osteopathic physician; and
b. Make entries in medical records and patient chartsso long as an appropriate mechanism is established for
authentication by the supervising osteopathic physician through
countersignature.
2.12.15. A osteopathic physician assistant may provide
medical care or services in an emergency department so long as he
or she has training in emergency medicine, functions under
specific protocols which govern his or her performance and is
under the supervision of a osteopathic physician with whom he or
she has ready contact and who is willing to assume full
responsibility for the osteopathic physician assistant's
performance.
2.12.16. No osteopathic physician assistant shall render
nonemergency outpatient medical services until the patient has
been informed that the individual providing care is a osteopathic
physician assistant.
2.12.17. It is the supervising osteopathic physician's
responsibility to be alert to patient complaints concerning the
type or quality of services provided by the osteopathic physician
assistant.
2.12.18. In the supervising osteopathic physician's office
and any satellite operation, a notice plainly visible to all
patients shall be posted in a prominent place explaining the
meaning of the term "Osteopathic physician Assistant". The
osteopathic physician assistant's license must be prominently
displayed in the office and any satellite operation in which he
or she may function. Duplicate licenses may be obtained from the
Board if required.
2.12.19. The osteopathic physician assistant is required
to notify the Board of changes in his or her employment within
thirty (30) days. The osteopathic physician assistant must
provide the Board with his or her new address and telephone
number of residence, address and telephone number of employment
and name of supervising osteopathic physician.
2.12.20. The supervising osteopathic physician is required
to notify the Board of any changes in his or her supervision of
a osteopathic physician assistant within ten (10) days.
2.13. Limited prescriptive privileges for osteopathic
physician assistants.
2.13.1. A osteopathic physician assistant may be
authorized by the Board to issue written or oral prescriptions
for certain medicinal drugs at the direction of his or her
supervising osteopathic physician if all of the following
conditions are met:
a. The osteopathic physician assistant has performed
patient care services for a minimum of two (2) years immediately
preceding the submission to the Board of the job description
requesting limited prescriptive privileges;
b. The osteopathic physician assistant has successfully
completed an accredited course of instruction in clinical
pharmacology approved by the Board of not less than four (4)
semester hours;
c. The osteopathic physician assistant obtains Board
approval of his or her job description which includes the
categories of drugs the osteopathic physician assistant proposesto prescribe at the direction of his or her supervising
osteopathic physician.
d. The osteopathic physician assistant continues to
maintain national certification as a osteopathic physician
assistant, and in meeting such national certification
requirements, completes a minimum of ten (10) hours of continuing
education in rational drug therapy in each certification period.
2.13.2. Evidence of completion of all conditions for the
granting of limited prescriptive privileges shall be included
with the osteopathic physician assistant's biennial renewal
application and report to the Board.
2.13.3. The Board shall approve a formulary classifying
pharmacologic categories of all drugs which may be prescribed by
a osteopathic physician assistant authorized by the Board to
prescribe drugs. The formulary shall exclude Schedules I and II
of the Uniform Controlled Substances Act, anticoagulants,
antineoplastics, radiopharmaceuticals, general anesthetics and
radiographic contrast materials. The formulary may be revised
annually, and shall include the following designated sections:
a. Section a. -- A choice of drugs commonly used in
primary care outpatient settings to be prescribable by
osteopathic physician assistants who have completed an additional
accredited course of study in clinical pharmacology approved by
the Board of not less than four (4) semester hours; and
b. Section b. -- Additional drugs used less commonly in
primary care outpatient settings to be prescribable by
osteopathic physician assistants who have satisfied therequirements set forth under Section 2.13.3.a of this rule. In
addition, Section b. drugs may be prescribed by osteopathic
physician assistants only under the following limited situations:
A. On a direct order from the supervising osteopathic
physician to the osteopathic physician assistant during
consultation at the time of the patient's examination by the
osteopathic physician assistant, and specifically noted in the
patient's chart; or
B. On a refill prescription for a previously
diagnosed and stable patient whose prescription was initiated by
the supervising osteopathic physician.
2.13.4. A prescription drug not included in the approved
formulary shall not be contained in the job description of any
osteopathic physician assistant.
2.13.5. Prescriptions issued by a osteopathic physician
assistant shall be issued consistent with the supervising
osteopathic physician's directions or treatment protocol provided
to his or her osteopathic physician assistant. The maximum
dosage shall be indicated in the protocol and in no case may the
dosage exceed the manufacturer's recommended average therapeutic
dose for that drug.
2.13.6. Each prescription and subsequent refills given by
the osteopathic physician assistant shall be entered on the
patient's chart.
2.13.7. The prescription form utilized by a osteopathic
physician assistant approved for limited prescriptive privileges
shall be imprinted with the name of the supervising osteopathicphysician, the name of the approved osteopathic physician
assistant, the address of the health care facility, the telephone
number of the health care facility, the categories of drugs or
drugs within a category which the assistant may prescribe and the
statement, "Osteopathic physician Assistant Prescription - it is
a violation of state law to dispense drugs not imprinted on this
prescription." The osteopathic physician assistant shall write
the name of the patient, the patient's address and the date on
each prescription form. The osteopathic physician assistant
shall sign his or her name to each prescription followed by the
letters "PA-C." The supervising osteopathic physician must
provide the Board with a copy of the prescription form utilized
by his or her osteopathic physician assistant prior to its use.
A copy of this prescription form shall be provided by the
osteopathic physician assistant to area pharmacies where the
osteopathic physician assistant may issue a prescription by word
of mouth, telephone or other means of communication in his or her
name at the direction of the supervising osteopathic physician.
2.13.8. Osteopathic physician assistants authorized to
issue prescriptions for Schedules III through V controlled
substances shall write on the prescription form the Federal Drug
Enforcement Administration number issued to that osteopathic
physician assistant. Prescriptions written for Schedule III
drugs shall be limited to a seventy-two (72) hour supply and may
not authorize a refill. The maximum amount of Schedule IV or
Schedule V drugs shall be no more than ninety (90) dosage units
or a thirty (30) day supply, whichever is less.
2.13.9. Other prescription drugs shall not be prescribed
or refillable for a period exceeding six (6) months.
2.13.10. The Board of Osteopathy shall provide the Board
of Pharmacy with a list of osteopathic physician assistants with
limited prescriptive privileges and shall update the list within
ten (10) days after additions or deletions are made.
2.13.11. Nothing in this rule shall be construed to permit
any osteopathic physician assistant to independently prescribe or
dispense drugs.
2.14. Continuing Education.
2.14.1. Each osteopathic physician assistant, as a
condition of biennial renewal of osteopathic physician assistant
license, shall provide written documentation of participation in
and successful completion during the preceding two (2) year
period of a minimum of twenty (20) hours of continuing education
in courses approved by the Board for the purposes of continuing
education of osteopathic physician assistants
2.14.2. All written documentation must be submitted to and
received by the Board, with the completed biennial renewal form,
prior to the first day of April of the year of renewal of the
osteopathic physician assistant license.
2.14.3. Failure to timely submit written documentation as
set forth in subsection 2.14.3 of this rule shall result in the
automatic suspension of the license of a osteopathic physician
assistant until such time as the written documentation is
submitted to and approved by the Board.
§11-2B-3. Severability.
If any provision of these rules or the application thereof to
any person or circumstance is held invalid, the invalidity shall
not affect the provisions or application of this rules which can
be given effect without the invalid provisions or application and
to this end the provisions of this rule are declared to be
severable.
(b) The legislative rules filed in the state register on the
sixth day of August, one thousand nine hundred ninety-three,
modified by the board of osteopathy to meet the objections of the
legislative rule-making review committee and refiled in the state
register on the twenty-fifth day of January, one thousand nine
hundred ninety-four, relating to the board of osteopathy
(licensing, disciplinary and complaint procedures for osteopathic
physicians), are authorized.
§64-9-37. Board of physical therapy.
The legislative rules filed in the state register on the
nineteenth day of July, one thousand nine hundred ninety-three,
modified by the board of physical therapy to meet the objections
of the legislative rule-making review committee and refiled in
the state register on the twenty-seventh day of October, one
thousand nine hundred ninety-three, relating to the board of
physical therapy (general provisions), are authorized.
§64-9-38. Board of examiners for speech-language pathology and
audiology.
(a) The legislative rules filed in the state register on the
fourteenth day of July, one thousand nine hundred ninety-three,
modified by the board of examiners for speech-language pathologyand audiology to meet the objections of the legislative
rule-making review committee and refiled in the state register on
the first day of September, one thousand nine hundred
ninety-three, relating to the board of examiners for
speech-language pathology and audiology (licensure of
speech-language pathology and audiology), are authorized.
(b) The legislative rules filed in the state register on the
fourteenth day of July, one thousand nine hundred ninety-three,
modified by the board of examiners for speech-language pathology
and audiology to meet the objections of the legislative
rule-making review committee and refiled in the state register on
the first day of September, one thousand nine hundred
ninety-three, relating to the board of examiners for
speech-language pathology and audiology (licensure of
speech-language pathology and audiology assistants), are
authorized.
§64-9-39. Commercial hazardous waste management facility siting
board.
The legislative rules filed in the state register on the
sixteenth day of August, one thousand nine hundred ninety-three,
modified by the commercial hazardous waste management facility
siting board to meet the objections of the legislative
rule-making review committee and refiled in the state register on
the twenty-first day of January, one thousand nine hundred
ninety-four, relating to the commercial hazardous waste
management facility siting board (commercial hazardous waste
management facility siting board certification requirements), areauthorized.
§64-9-40. Family protection services board.
The legislative rules filed in the state register on the
thirteenth day of August, one thousand nine hundred ninety-three,
modified by the family protection services board to meet the
objections of the legislative rule-making review committee and
refiled in the state register on the eighth day of October, one
thousand nine hundred ninety-three, relating to the family
protection services board (operation of the family protection
services board and licensure and funding of domestic violence
programs), are authorized with the amendment set forth below:
On page twelve, section 5.5.3, after the word "suspended" by
striking out the word "or" and inserting in lieu thereof the
following words "but the board shall provide funds to a
shelter/program".
§64-9-41. Board of investments.
(a) The legislative rules filed in the state register on the
sixteenth day of August, one thousand nine hundred ninety-three,
modified by the board of investments to meet the objections of
the legislative rule-making review committee and refiled in the
state register on the eighteenth day of January, one thousand
nine hundred ninety-four, relating to the board of investments
(administration of the consolidated pension fund), are
authorized.
(b) The legislative rules filed in the state register on the
sixteenth day of August, one thousand nine hundred ninety-three,
relating to the board of investments (administration of theconsolidated fund by the West Virginia state board of
investments), are authorized.
Email
Webmaster | © 2024 West Virginia Legislature **
