CHAPTER 355

FORMERLY

HOUSE BILL NO. 536

AS AMENDED BY SENATE AMENDMENT NO. 1 AND
HOUSE AMENDMENT NOS. 1 AND 2

AN ACT TO AMEND, CHAPTER 17, TITLE 24 OF THE DELAWARE CODE RELATING TO THE PHYSICIAN'S ASSISTANT REGULATORY COUNCIL, PRESCRIPTIVE AUTHORITY AND SCOPE OF PRACTICE OF LICENSED PHYSICIAN'S ASSISTANTS.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF DELAWARE:

Section 1. Amend §1703(g) of Title 24 of the Delaware Code by striking the phrase "4 other members" after "and shall have" in the second sentence and substituting "6 other members, including one physician appointed by the Board of Medical Practice and one pharmacist appointed by the Board of Pharmacy" in lieu thereof.

Section 2. Amend §1703(g) of Title 24 of the Delaware Code by striking the number "4" after "other" and before "members" in the sixth sentence and substituting "6" in lieu thereof.

Section 3. Amend §1770A(a)(1) of Title 24 of the Delaware Code by

inserting the words "or a successor agency acceptable to and approved by the Board," after "(AMA)," and before "has passed a" as they appear therein.

Section 4. Amend §1770A(a) of Title 24 by striking subsection (2) and

substituting in lieu thereof the following:

'(2) 'Supervision of physician's assistants' means the ability of the supervising physician to provide or exercise control and direction over the services of physician's assistants. The constant physical presence of the supervising physician is not required, provided that the supervising physician is readily accessible by some form of electronic communication and that the supervising physician can be physically present within 30 minutes if necessary.

a. Any physician who delegates medical responsibility to a

physician's assistant is responsible for that individual's medical

activities and must provide adequate supervision. No function may be delegated to a physician's assistant who by statute or professional regulation is prohibited from performing that function. The delegating physician cannot be involved in patient care in name only. A physician's assistant shall not maintain or manage an office separate and apart from the supervision physician. No regulation of the Board shall purport to authorize physician's assistants to engage in diagnosis, to prescribe or dispense legend drugs or therapeutics, to practice medicine or surgery or refractions or to pronounce a patient dead in any setting independent of the supervision of a physician who is licensed to practice medicine and surgery. Such licensed physician's assistants shall not delegate an assigned task to any other individual, nor shall they independently bill a patient for services rendered at the request of the physician.

a. For the purpose of clarification, the terms 'guidelines', 'standing orders', 'protocols' and 'algorithms' are synonymous in their application under these regulations. Hereafter, the term 'standing orders' will be used. Prescription and non-prescription medications may be
initiated by standing orders if these standing orders have been approved by the responsible delegating physician and by the Physician's Assistant Regulatory Council. Emergency care as defined in the Medical Practices Act is exempted from these regulations.

a. It is appropriate and good medical procedure for all responsible physicians who choose to have their patients followed by physician's assistants to personally re-evaluate at least every 3 months any patient receiving controlled substances or at least every 6 months any patient receiving other prescription medications or therapeutics.

d. A supervising physician may not delegate responsibilities in assisting the physician to a physician's assistant that exceed the physician's specialty.

a. A supervising physician who fails to adhere to these regulations would be considered to be permitting the unauthorized practice of medicine (as defined under §1703, subsection (c) of the Medical Practices Act) and would be subject to disciplinary action by the Board of Medical Practice.

A physician's assistant will at all times be under the control of a licensed physician, as defined in this chapter."

Section 5. Amend §1770A(b)(2)b of Title 24 of the Delaware Code by adding the following new subparagraphs:

"4. Delegated acts of diagnosis and prescription of therapeutic drugs and treatments within the scope of physician's assistant practice defined within the Rules and Regulations promulgated by the Physician's Assistant Regulatory Council and approved by the Board of Medical Practice.

5. Prescriptive authority for therapeutic drugs and treatments within the scope of physician's assistant practice defined within Rules and Regulations promulgated by the Physician's Assistant Regulatory Council and approved by the Board of Medical Practice. The physician's assistant's prescriptive authority and authority to make independent medical diagnoses and treatment decisions shall be subject to biennial renewal upon application to the Physician's Assistant Regulatory Council."

Section 6. Amend §1703(g) of Title 24 by striking the language Each of those 4" as it appears at the beginning of the third sentence thereof and substituting in lieu thereof "Four".

Approved July 12, 1994.