§ 1770. | § 1770A. | §§ 3-5; | § 1771. | § 1772. | § 1773. | § 1774. | § 1774A. | § 1774B. | § 1774C.
§ 1770. The Regulatory Council for Physician Assistants.
To assist the Board of Medical Practice in the performance of its duties
relating to the regulation of physician assistants, the President of the
Board, with advice and approval of the Board, shall appoint members to the
Regulatory Council for Physician Assistants. The Regulatory Council is chaired
by a member of the Board appointed by the President and has 6 other members,
including 1 physician who regularly supervises physician assistants appointed
by the Board of Medical Practice and 1 pharmacist appointed by the Board of
Pharmacy. The 4 remaining members must be practicing physician assistants,
subject to the same causes for removal as a physician member of the Board,
except that the requirement for certification and registration to practice
medicine is replaced by licensure as a physician assistant. Terms of service
for members of the Regulatory Council are the same as terms of service for
members of the Board. The chairperson of the Regulatory Council is compensated
and reimbursed in the same amount as a Board member is compensated and
reimbursed. The other 6 members of the Regulatory Council are compensated at
an appropriate and reasonable level as determined by the Division and may be
reimbursed for meeting-related travel and expenses at the State's current
approved rate. The Regulatory Council shall meet at least quarterly each
calendar year to review the regulation of physician assistants and to advise
the Board of policy, rules, and regulations relating to the regulation of
physician assistants. The Board may consult Regulatory Council members for
advice on particular issues, including issues relating to disciplinary matters
for physician assistants. The Board shall determine the specific functions of
the Regulatory Council.
(75 Del. Laws, c. 141, § 1.)
§ 1770A. Physician assistants.
As used in this section:
(1) "Delegated medical acts" means healthcare activities and duties delegated
to a physician assistant by a supervising physician.
(2) "Physician assistant" or "PA" means an individual who:
a. Has graduated from a physician or surgeon assistant program which is
accredited by the Committee on Allied Health Education and Accreditation
(CAHEA) of the American Medical Association (AMA), or a successor agency
acceptable to and approved by the Board;
b. Has passed a national certifying examination acceptable to the Regulatory
Council for Physician Assistants and approved by the Board;
c. Is licensed under this chapter to practice as a physician assistant; and
d. Has completed any continuing education credits required by rules and
regulations developed under this chapter;
(3) "Supervision of physician assistants" means the ability of the supervising
physician to provide or exercise control and direction over the services,
activities, and duties of a physician assistant. The constant physical
presence of the supervising physician is not required in the supervision of a
physician assistant, provided that the supervising physician is readily
accessible by some form of electronic communication and that the supervising
physician can be physically present with the physician assistant within 30
minutes. Depending upon the specific clinical activity of the physician
assistant, a shorter response time may be required; and
(68 Del. Laws, c. 147, § 2; 68 Del. Laws, c. 345, § 1; 69 Del. Laws, c. 355,
§§ 3-5; 71 Del. Laws, c. 102, § 26; 74 Del. Laws, c. 262, § 30A; 75 Del. Laws,
c. 141, § 1.)
§ 1771. Physician's duties in supervision of a physician assistant .
(a) A physician who delegates medical acts to a physician assistant is
responsible for the physician assistant's medical acts and must provide
adequate supervision.
(b) A supervising physician may not delegate a medical act to a physician
assistant who, by statute or professional regulation, is prohibited from
performing the act.
(c) A supervising physician may not be involved in patient care in name only.
(d) A supervising physician may not delegate medical acts to a physician
assistant that exceed the physician's scope of practice.
(e) A supervising physician may not at any given time supervise more than 2
physician assistants, unless a regulation of the Board increases or decreases
the number.
(f) A physician who supervises a physician assistant in violation of the
provisions of this subchapter or of regulations adopted pursuant to this
subchapter is subject to disciplinary action by the Board of Medical Practice
for permitting the unauthorized practice of medicine.
(g) A supervising physician who has supervising physician's patients followed
by a physician assistant shall reevaluate within 6 months every patient
receiving controlled substances and within 12 months every patient receiving
other prescription medications or therapeutics.
(h) Prescription and nonprescription medications may be initiated by standing
orders if these standing orders have been approved by the supervising
physician.
(i) Hospitals, clinics, medical groups and other healthcare facilities may
employ physician assistants; however, no more than 2 physician assistants may
at any given time be employed and supervised for each physician practicing in
the same facility unless a regulation of the Board increases or decreases the
number.
(75 Del. Laws, c. 141, § 1; 70 Del. Laws, c. 186, § 1.)
§ 1772. Prohibited acts by a physician assistant.
(a) A physician assistant may not maintain or manage an office separate and
apart from the office of the physician assistant's supervising physician.
(b) A physician assistant may not engage in diagnosis, prescribe or dispense
legend drugs or therapeutics, or practice medicine or surgery or perform
refractions in any setting independent of the supervision of a physician who
is certified to practice medicine.
(c) A physician assistant may not assign a delegated medical act to another
individual without the supervising physician's authorization.
(d) A physician assistant may not independently bill a patient for services
rendered at the request of the supervising physician.
(e) Nothing in this chapter may be construed to authorize a physician
assistant to practice independent of a supervising physician.
(f) Except as otherwise provided in this chapter or in a medical emergency, a
physician assistant may not perform any medical act which has not been
delegated by a supervising physician.
(g) A physician assistant may not practice as a member of any other health
profession regulated under this code unless the physician assistant is
certified, licensed, registered, or otherwise authorized to practice the other
profession.
(75 Del. Laws, c. 141, § 1; 70 Del. Laws, c. 186, § 1.)
§ 1773. Regulation of physician assistants.
(a) The Board, in conjunction with the Regulatory Council for Physician
Assistants established under § 1770 of this title, shall adopt regulations
regarding activities which may be undertaken by physician assistants, and
shall license all physician assistants with the Board.
(b) The Board, in conjunction with the Regulatory Council for Physician
Assistants, shall define the scope of practice of physician assistants
including:
(1) The licensing of physician assistants to allow:
a. The performance of delegated medical acts within the education, training,
and experience of physician assistants; and
b. The performance of services customary to the practice of the supervising
physician;
(2) Delegated medical acts provided by physician assistants to include, but
not be limited to:
a. The performance of complete patient histories and physical examinations;
b. The recording of patient progress notes in an outpatient setting;
c. The relaying, transcribing, or executing of specific diagnostic or
therapeutic orders, so long as all such notes, orders, and other writings are
reviewed and countersigned by the supervising physician within 72 hours,
barring extraordinary events or circumstances;
d. Delegated medical acts of diagnosis and prescription of therapeutic drugs
and treatments within the scope of physician assistant practice, as defined in
the regulations promulgated by the Regulatory Council for Physician
Assistants and approved by the Board of Medical Practice;
e. Prescriptive authority for therapeutic drugs and treatments within the
scope of physician assistant practice, as defined in the regulations
promulgated by the Regulatory Council for Physician Assistants and approved by
the Board of Medical Practice. The physician assistant's prescriptive
authority and authority to make medical diagnoses and treatment decisions, if
any, are subject to biennial renewal upon application to the Physician
Assistant Regulatory Council;
(c)(1) The Board, in conjunction with the Regulatory Council for Physician
Assistants, shall suspend, revoke, or restrict the license of a physician
assistant or take disciplinary action or other action against a physician
assistant for engaging in unprofessional conduct as defined in § 1731(b) of
this title; or for the inability to render delegated medical acts with
reasonable skill or safety to patients because of the physician assistant's
physical, mental, or emotional illness or incompetence, including but not
limited to deterioration through the aging process, or loss of motor skills,
or excessive use of drugs, including alcohol; or for representing himself or
herself as a physician, or for knowingly allowing himself or herself to be
represented as a physician. Disciplinary action or other action undertaken
against a physician assistant must be in accordance with the procedures,
including appeal procedures, applicable to disciplinary actions against
physicians pursuant to Subchapter IV of this chapter, except that a hearing
panel for a complaint against a physician assistant consists of 3 unbiased
members of the Regulatory Council, the 3 members being 2 physician assistant
members and 1 physician or pharmacist member if practicable.
(2)a. If the Board or the Regulatory Council for Physician Assistants receives
a formal or informal complaint concerning the activity of a physician
assistant and the Regulatory Council members reasonably believe that the
activity presents a clear and immediate danger to the public health, the
Regulatory Council, with the approval of the Board, may issue an order
temporarily suspending the physician assistant's license to practice pending a
hearing. An order temporarily suspending a license to practice may not be
issued by the Council, with the approval of the Board, unless the physician
assistant or the physician assistant's attorney received at least 24 hours'
written or oral notice prior to the temporary suspension so that the physician
assistant or the physician assistant's attorney can be heard in opposition to
the proposed suspension, and unless at least 4 members of the Council and 7
members of the Board vote in favor of the temporary suspension. An order of
temporary suspension pending a hearing may remain in effect for no longer than
60 days from the date of the issuance of the order unless the temporarily
suspended physician assistant requests a continuance of the hearing date. If
the physician assistant requests a continuance, the order of temporary
suspension remains in effect until the hearing panel convenes and a decision
is rendered.
b. A physician assistant whose license to practice has been temporarily
suspended pursuant to this section must be notified of the temporary
suspension immediately and in writing. Notification consists of a copy of the
complaint and the order of temporary suspension pending a hearing personally
served upon the physician assistant or sent by certified mail, return receipt
requested, to the physician assistant's last known address.
c. A physician assistant whose license to practice has been temporarily
suspended pursuant to this section may request an expedited hearing. The
Council shall schedule the hearing on an expedited basis, provided that the
Council receives the request within 5 calendar days from the date on which the
physician assistant received notification of the decision of the Council,
with the approval of the Board, to temporarily suspend the physician
assistant's license to practice.
d. As soon as possible after the issuance of an order temporarily suspending a
physician assistant's license to practice pending a hearing, the Executive
Director shall appoint a 3-member hearing panel. After notice to the physician
assistant pursuant to subsection (b) of this section, the hearing panel shall
convene within 60 days of the date of the issuance of the order of temporary
suspension to consider the evidence regarding the matters alleged in the
complaint. If the physician assistant requests in a timely manner an expedited
hearing, the hearing panel shall convene within 15 days of the receipt of the
request by the Council. The 3-member panel shall proceed to a hearing in
accordance with the procedures set forth in § 1734 of this title and shall
render a decision within 30 days of the hearing.
e. In addition to making findings of fact, the hearing panel shall also
determine whether the facts found by it constitute a clear and immediate
danger to public health. If the hearing panel determines that the facts found
constitute a clear and immediate danger to public health, the order of
temporary suspension must remain in effect until the Board, pursuant to §
1734(f) of this title, deliberates and reaches conclusions of law based upon
the findings of fact made by the hearing panel. An order of temporary
suspension may not remain in effect for longer than 60 days from the date of
the decision rendered by the hearing panel unless the suspended physician
assistant requests an extension of the order pending a final decision of the
Board. Upon the final decision of the Board, an order of temporary suspension
is vacated as a matter of law and is replaced by the disciplinary action, if
any, ordered by the Board.
(75 Del. Laws, c. 141, § 1; 70 Del. Laws, c. 186, § 1.)
§ 1774. Temporary licensing of physician assistants.
(a) Notwithstanding any provision of this subchapter to the contrary, the
Executive Director, with the approval of a physician member of the Board, may
grant a temporary license to an individual who has graduated from a physician
or surgeon assistant program which has been accredited by the Committee on
Allied Health Education and Accreditation (CAHEA) of the American Medical
Association (AMA) or a successor agency and who otherwise meets the
qualifications for licensure but who has not yet taken a national certifying
examination, provided that the individual is registered to take and takes the
next scheduled national certifying examination. A temporary license granted
pursuant to this subsection is valid until the results of the examination are
available from the certifying agency. If the individual fails to pass the
national certifying examination, the temporary license granted pursuant to
this subsection must be immediately rescinded until the individual
successfully qualifies for licensure pursuant to this subchapter.
(b) An individual who is temporarily licensed pursuant to this section may not
have a prescriptive practice and may not perform delegated medical acts
except in the physical presence of the individual's supervising physician.
(75 Del. Laws, c. 141, § 1; 70 Del. Laws, c. 186, § 1.)
The Division of Professional Regulation shall establish fees for licensing
physician assistants, for renewing licenses on a biennial basis, and for other
regulatory purposes. The fees must approximate the costs reasonably necessary
to defray the actual expenses of the Board and the regulatory council, as
well as the proportional expenses incurred by the Division in administering
the issuance and renewal of licenses, and other regulation of physician
assistants.
(75 Del. Laws, c. 141, § 1.)
§ 1774B. Prohibited acts; penalties; enforcement.
(a) A person may not practice as a physician assistant in this State or
represent that the person is a physician assistant or knowingly allow himself
or herself to be represented as a physician assistant unless the person is
licensed under this subchapter, except as otherwise provided in this chapter.
(b) A person who, contrary to the provisions of this subchapter, practices or
attempts to practice as a physician assistant within the State or represents
that the person is a physician assistant or knowingly allows himself or
herself to be represented as a physician assistant shall be fined not less
than $500 nor more than $2,000 or imprisoned not more than 1 year, or both.
(c) The Attorney General of this State or a deputy attorney general shall
enforce the provisions of this subchapter.
(75 Del. Laws, c. 141, § 1; 70 Del. Laws, c. 186, § 1.)
§ 1774C. Procedure or action not prescribed.
This subchapter governs the practice of physician assistants. If a procedure
or action is not specifically prescribed in this subchapter, but is prescribed
in the subchapters relating to the practice of medicine, and the procedure or
action would be useful or necessary for the regulation of physician
assistants, the Board or Council may, in its discretion, proceed in a manner
prescribed for physicians in the practice of medicine.
(75 Del. Laws, c. 141, § 1.)
NOTICE: The Delaware Code appearing on this site was prepared by the Division of Research of Legislative Council of the General Assembly with the assistance of the Government Information Center, under the supervision of the Delaware Code Revisors and the editorial staff of LexisNexis, includes all acts up to and including 76 Del. Laws, c. 421, effective August 21, 2008.
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