SENATE AMENDED

THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

INTRODUCED BY KILLION, CALTAGIRONE, GEIST, GINGRICH, MANN, MICOZZIE, MILLER, MILNE, MUSTIO, VULAKOVICH, FLECK AND MURT, JANUARY 31, 2011

SENATOR CORMAN, APPROPRIATIONS, IN SENATE, RE-REPORTED AS AMENDED, DECEMBER 12, 2011   

AN ACT

Amending the act of October 5, 1978 (P.L.1109, No.261), entitled

"An act requiring the licensing of practitioners of

osteopathic medicine and surgery; regulating their practice;

providing for certain funds and penalties for violations and

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 October 5, 1978

(P.L.1109, No.261), known as the Osteopathic Medical Practice

Act, is amended by adding definitions to read:

Section 2.  Definitions.

The following words and phrases when used in this act shall

have, unless the context clearly indicates otherwise, the

meanings given to them in this section:

"ABGC."  The American Board of Genetic Counseling.

"ABMG."  The American Board of Medical Genetics.

"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 10.3.  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

an active A license issued by the board or the State Board of

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Medicine.

(b)  Use of title.--An individual who holds an active license

as 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

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tending to indicate that the individual is a genetic counselor,

except as otherwise provided by this act.

(c)  Scope of practice.--

(1)  A genetic counselor may provide genetic counseling

to clients, which includes:

(i)  Obtain and evaluate individual, and family and 

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medical histories to determine genetic risk for genetic

or medical conditions and diseases in a patient, the

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patient's offspring and other family members.

(ii)  Discuss the features, natural history, means of

diagnosis, genetic and environmental factors and

management of risk for the genetic or medical conditions

and diseases.

(iii)  Identify and coordinate genetic laboratory

tests and other diagnostic studies as appropriate for the

genetic assessment.

(iv)  Integrate the genetic laboratory test results

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and other diagnostic studies with personal and family

medical histories to assess and communicate risk factors

for genetic or medical conditions and diseases.

(v)  Explain the clinical implications of genetic

laboratory tests and other diagnostic studies and their

results.

(vi)  Evaluate the client's or family's responses to

the condition or risk of the recurrence and provide

client-centered counseling and anticipatory guidance.

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(vii)  Identify and utilize community resources that

provide medical, educational, financial and psychosocial

support and advocacy.

(viii)  Provide written documentation of medical,

genetic and counseling information for families and

health care professionals.

(2)  When in the course of providing genetic counseling

services to a client, if a genetic counselor finds any

indication of a disease or condition that requires

professional service diagnosis and treatment outside the

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scope of practice defined in this section, the genetic

counselor shall refer the client to a licensed physician or

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appropriate health care practitioner.

(3)  Nothing in this subsection shall be construed to

authorize a genetic counselor to diagnose, test or treat any

genetic disease or condition or other disease or condition.

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(d)  Exemptions.--The following persons may provide 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 or a graduate

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nursing education program in genetics, 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, certified registered nurse

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practitioner with a specialty or subspecialty in genetics or

clinical nurse specialist with a specialty or subspecialty in

genetics.

(4)  A person trained as a genetic counselor who

reapplies for the ABGC certification examination and is

working under general supervision in 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 

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logbook cases documents the number of cases in a logbook 

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under a supervisor identified in the training program's ABMG

accreditation documents as a member of the training faculty.

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

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 or

doctoral degree in human genetics or genetic counseling from

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

has met the requirements for certification by the ABGC or

ABMG.

(4)  The person has passed the examination for

certification as a genetic counselor by the ABGC or the ABMG 

or has passed the examination for certification as a Ph.D.

medical geneticist by the ABMG, as approved by the board.

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(5)  The person has completed an application form

provided by the board and paid the appropriate fee.

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

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 (e)(3) and (4), provided:

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

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

as a genetic counselor for a minimum of three continuous

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years preceding the enactment of this section or has received

a bachelor of science degree in genetics or a related field

of study and has been employed as a genetic counselor for at

least ten continuous years prior to the enactment of this

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section.

(2)  The person submits at least three letters of

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 continuous years

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and can attest to the applicant's competency in providing

genetic counseling services.

(g)  Provisional license.--

(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 (e)(4), provided the person has

been granted active candidate status establishing eligibility

to sit for the next available certification examination by

the ABGC or the ABMG.

(2)  A provisional license shall allow the person to

practice under the supervision of a genetic counselor or a 

licensed physician 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 upon notification that the

person has not passed the examination within two examination

cycles after receiving the provisional license.

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

shall be set by the board by regulation. Until such time as the

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board adopts a fee by regulation, applicants shall pay a

biennial fee of $125.

(i)  Reciprocal disciplinary action.--Disciplinary action

taken by the board against a person who is a genetic counselor

shall be enforceable by the State Board of Medicine against the 

person if the person holds or seeks a license to practice as a

genetic counselor with the State Board of Medicine.

(j)  Continuing education.--

(1)  The board shall promulgate regulations establishing

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requirements of continuing education to be met by persons

licensed as genetic counselors under this section as a

condition for renewal of their licenses.

(1)  For each license renewal, a licensee shall complete

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within the immediately preceding two-year period at least 30

hours of continuing education as approved by the board. The

licensee shall provide the board with evidence of the

completion of the continuing education. No credit shall be

given for any course in office management or practice

building.

(2)  A person who applies for initial licensure in this

Commonwealth shall be exempt from the continuing education

requirements for the biennial renewal period following

initial licensure.

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

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.

(4)  Continuing education programs and program providers

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under this subsection shall be approved by the board in

accordance with standards and criteria established by the

board by regulation. The regulation shall include any fees

necessary to implement this provision and provide for waiver

of the continuing education requirement due to illness or

hardship in any licensing renewal period.

(k)  Liability insurance.--

(1)  A licensee under this section, practicing in this

Commonwealth, shall maintain a level of professional

liability insurance coverage in the minimum amount of

$1,000,000 per occurrence or claims made. Failure to maintain

insurance coverage as required shall subject the licensee to

disciplinary proceedings. The board shall accept as

satisfactory evidence of insurance coverage any of the

following:

(i)  self-insurance;

(ii)  personally purchased liability insurance; or

(iii)  professional liability insurance coverage

provided by the genetic counselor's employer or similar

insurance coverage acceptable to the board.

(2)  An applicant shall provide proof that the applicant

has obtained professional liability insurance in accordance

with paragraph (1). It is sufficient if the applicant files

with the application a copy of a letter from the applicant's

professional liability insurance carrier indicating that the

applicant will be covered against professional liability in

the required amounts effective upon the issuance of the

applicant's license to practice genetic counseling in this

Commonwealth.

(3)  Upon issuance of a license, a licensee has 30 days

to submit to the board the certificate of insurance or a copy

of the policy declaration page.

(4)  The board shall adopt by regulation standards and

procedures established by the Insurance Commissioner for

self-insurance. In the absence of these standards and

procedures, the board, after consultation with the Insurance

Commissioner, shall establish standards and procedures by

regulation for self-insurance under this subsection.

Section 3.  The State Board of Osteopathic Medicine shall

promulgate regulations to carry out the provisions of this act

within 18 12 months of the effective date of this section. 

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Pending the promulgation of regulations, the board shall

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promulgate a statement of policy setting forth the application

form for initial licensure under this act. The statement of

policy shall expire upon the approval of the final regulations.

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