THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

INTRODUCED BY KILLION, ADOLPH, BEYER, CLYMER, GEIST, MANN, MELIO, MILLER, MUSTIO, SIPTROTH, VULAKOVICH, MURT, HARPER AND GINGRICH, JANUARY 30, 2009

AS REPORTED FROM COMMITTEE ON PROFESSIONAL LICENSURE, HOUSE OF REPRESENTATIVES, AS AMENDED, OCTOBER 7, 2009   

AN ACT

Amending the act of December 20, 1985 (P.L.457, No.112),

entitled "An act relating to the right to practice medicine

and surgery and the right to practice medically related acts;

reestablishing the State Board of Medical Education and

Licensure as the State Board of Medicine and providing for

its composition, powers and duties; providing for the

issuance of licenses and certificates and the suspension and

revocation of licenses and certificates; providing penalties;

and making repeals," further providing for definitions; and

providing for regulation of genetic counselors.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1.  Section 2 of the act of December 20, 1985 (P.L.

457, No.112), known as the Medical Practice Act of 1985, is

amended by adding definitions to read:

Section 2.  Definitions.

The following words and phrases when used in this act shall

have the meanings given to them in this section unless the

context clearly indicates otherwise:

"ABGC."  The American Board of Genetic Counseling.

"ABMG."  The American Board of Medical Genetics.

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"Active candidate status."  The designation awarded to

applicants who have received approval from the American Board of

Genetic Counseling or the American Board of Medical Genetics to

sit for their respective certification examinations.

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"Genetic counselor."  An individual who is licensed to

practice genetic counseling by the State Board of Medicine or

the State Board of Osteopathic Medicine.

"Genetic counseling."  The provision of services to

individuals, couples, families and organizations by one or more

appropriately trained individuals to address the physical and

psychological issues associated with the occurrence or risk of

occurrence of a genetic disorder, birth defect or genetically

influenced condition or disease in an individual or a family.

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Section 2.  The act is amended by adding a section to read:

Section 13.4.  Genetic counselor.

(a)  License required.--Two years after the effective date of

this section, it shall be unlawful for any person to hold

himself out to the public as a genetic counselor or to practice

or offer to practice genetic counseling unless the person holds

a valid, current an active license issued by the board or the

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State Board of Osteopathic Medicine.

(b)  Use of title.--An individual who holds a valid, current

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license issued by either board may use the title genetic

counselor. No other person shall have that right.

(c)  Regulations.--The board is authorized to promulgate

regulations to implement this section an active license as

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provided by this act may hold himself out to the public by any

title or description of services incorporating the term "genetic

counselor" or use any words or symbols indicating or tending to

indicate that the individual is a genetic counselor, except as

otherwise provided by this act.

(d) (c)  Scope of practice.--

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(1)  A genetic counselor may provide genetic counseling

to clients, which shall include includes:

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(i)  Obtaining and interpreting individual and family

medical, developmental and reproductive histories.

(ii)  Determining the mode of inheritance and risk of

transmission of genetic conditions and birth defects.

(iii)  Explaining the inheritance, features, natural

history, diagnosis and management of these conditions.

(iv)  Identifying, coordinating, interpreting and

explaining genetic tests and other diagnostic studies.

(v)  Assessing psychosocial factors, recognizing

social, educational and cultural issues.

(vi)  Evaluating the client's or family's responses

to the condition or risk of occurrence and providing

client-centered counseling and anticipatory guidance.

(vii)  Facilitating informed decision making about

testing, management and reproductive alternatives.

(viii)  Identifying and facilitating access to

resources that provide medical, educational, financial

and psychosocial support and advocacy.

(ix)  Providing accurate written documentation of

medical, genetic and counseling information for families

and health care professionals as authorized by written

consent of the client.

(2)  When in the course of providing genetic counseling

services to a client, if a genetic counselor finds any

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indication of a disease or condition that requires

professional service outside the scope of practice defined in

this section, the genetic counselor shall refer the client to

a licensed physician licensed to practice medicine and

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surgery without restriction.

 (3)  Nothing in this subsection shall be construed to

authorize a genetic counselor to diagnose, test or treat any

genetic or other disease or condition.

(e) (d)  Exemptions.--The following persons may provide

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genetic counseling without holding the license required by this

section as indicated:

(1)  A person licensed under any other section of this

act or any other law of this Commonwealth, while acting

within the scope of practice of the person's license and

training, provided the person does not hold himself out to

the public as a genetic counselor.

(2)  A person employed by the Federal Government to

provide genetic counseling while in the discharge of the

person's official duties.

(3)  A student enrolled in an ABGC-accredited or ABMG-

accredited genetic counseling educational program or an ABMG-

accredited medical genetics educational program, if the

counseling is an integral part of the student's course of

study and is performed under the direct supervision of a

genetic counselor or a licensed physician licensed to

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practice medicine and surgery without restriction assigned to

supervise the student.

(4)  A person trained as a genetic counselor who

reapplies for the ABCG ABGC certification examination and

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gathers logbook cases is working under general supervision in

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an approved genetic counseling training site.

(5)  A person trained as a Ph.D. medical geneticist who

reapplies for the ABMG certification examination and gathers 

logbook cases under a supervisor identified in the training

program's ABMG accreditation documents as a member of the

training faculty.

(f) (e)  Qualifications.--An applicant shall be licensed to

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practice genetic counseling under this act if the applicant

meets all of the following qualifications and has otherwise

complied with the provisions of this act:

(1)  The person is at least 21 years of age.

(2)  The person is of good moral character.

(3)  The person has received a master's degree in or

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doctoral degree in human genetics or genetic counseling from

an ABGC-accredited or ABMG-accredited educational program, or

the person has received a doctoral degree and has

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successfully completed an ABMG-accredited medical genetics

educational program has met the requirements for

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certification by the ABGC or ABMG.

(4)  The person has passed the examination for

certification as a genetic counselor by the American Board of

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Genetic Counseling ABGC or the American Board of Medical

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Genetics ABMG or has passed the examination for certification

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as a Ph.D. medical or clinical geneticist by the American

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Board of Medical Genetics ABMG.

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(5)  The person has completed an application form

provided by the board and paid the appropriate fee.

(g) (f)  Licensure of noncertified persons.--For a period of

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three years after the effective date of this section, the board

may issue a license to a person who meets all of the

qualifications for licensure except for the requirements of

subsection (f)(3) (e)(3) and (4), provided:

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(1) The person has worked as a genetic counselor for a

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minimum of ten years preceding the enactment of this section. 

(2)  The person has received a master's or higher degree

in genetics or a related field of study.

(3)  The person has never failed the ABGC or ABMG

certification examination.

(1)  The person has received a master's or higher degree

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in genetics or a related field of study and has worked as a

genetic counselor for a minimum of three years preceding the

enactment of this section or has received a bachelor's degree

in genetics or a related field of study and has been employed

as a genetic counselor for at least ten years prior to the

enactment of this section.

(4) (2)  The person submits at least three letters of

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recommendation, one of which must be from a genetic counselor

certified by ABGC or ABMG and one must be from either a

clinical geneticist certified by ABMG or a medical geneticist

certified by ABMG. A person who submits a letter of

recommendation must have worked with the applicant in an

employment setting during the previous ten years and can

attest to the applicant's competency in providing genetic

counseling services.

(5)  The person provides documentation of attending ABGC-

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approved continuing education programs within the previous

five years.

(h) (g)  Provisional license.--

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(1)  The board may issue a provisional license to

practice genetic counseling to a person who meets all of the

qualifications for licensure except for the certification

requirement of subsection (f)(4) (e)(4), provided the person

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has been granted active candidate status establishing

eligibility to sit for the next available certification

examination by the American Board of Genetic Counseling or

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the American Board of Medical Genetics ABGC or the ABMG.

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(2)  A provisional license shall allow the person to

practice under the supervision of a genetic counselor or a 

licensed physician licensed to practice medicine and surgery

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without restriction until the person receives certification

from the ABGC or the ABMG or two examination cycles have

elapsed, whichever comes first.

(3)  Under no circumstances shall a person continue to

practice on a provisional license for more than 30 days after 

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upon notification that the person has not passed the

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examination within two examination cycles after receiving the

provisional license.

(i) (h)  Licensure fees.--All application and licensure fees

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shall be set by the board by regulation.

(j) (i)  Reciprocal disciplinary action.--Disciplinary action

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taken by the State Board of Medicine against a person who is a 

genetic counselor licensed by it shall be enforceable by the

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State Board of Osteopathic Medicine against the person if the

person holds or seeks a license to practice as a genetic

counselor with the State Board of Osteopathic Medicine.

(k) (j)  Continuing education.--

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(1)  The board shall adopt, promulgate and enforce rules

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and regulations consistent with the provisions of this

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section establishing requirements of continuing education to

be met by persons licensed as genetic counselors under this

section as a condition for renewal of their licenses. The

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regulations shall include any fees necessary for the board to

carry out its responsibilities under this section.

(2)  Beginning with the license period designated by

regulation, licensees shall attend and complete 30 hours of

mandatory continuing education during each two-year license

period. Nationally certified education courses shall be

considered as creditable, in addition to any other courses

the board deems creditable toward meeting the requirements

for continuing education.

(3) (2)  A person who applies for the first time for 

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initial licensure in this Commonwealth shall be exempt from

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the continuing education requirements for the biennial

renewal period following initial licensure.

(4)  (i)  The board may waive all or a portion of the

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continuing education requirement for biennial renewal for a

licensee who shows to the satisfaction of the board that the

licensee was unable to complete the requirements due to

serious illness, military service or other demonstrated

hardship.

(ii)  The request must be in writing with appropriate

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documentation and include a description of circumstances

sufficient to show why the licensee was unable to comply

with the continuing education requirement.

(5)  A licensee seeking to reinstate an inactive or

lapsed license must present proof of compliance with the

continuing education requirement for the preceding biennium.

(6)  All courses, locations, instructors and providers

shall be approved by the board. No credit shall be given for

any course in office management.

Section 3.  The State Board of Medicine shall promulgate

regulations to carry out the provisions of this act within 18

months of the effective date of this section.

Section 4.  This act shall take effect in 60 days.