PRIOR PRINTER'S NOS. 555, 1845 PRINTER'S NO. 1909
No. 500 Session of 2007
INTRODUCED BY SANTONI, BARRAR, BOYD, CALTAGIRONE, CURRY, FABRIZIO, GERGELY, HENNESSEY, KILLION, KOTIK, MARKOSEK, PALLONE, REICHLEY, WALKO, YOUNGBLOOD, SIPTROTH, JAMES, MURT AND SOLOBAY, FEBRUARY 26, 2007
AS AMENDED ON SECOND CONSIDERATION, HOUSE OF REPRESENTATIVES, JUNE 13, 2007
AN ACT 1 Amending the act of December 20, 1985 (P.L.457, No.112), 2 entitled "An act relating to the right to practice medicine 3 and surgery and the right to practice medically related acts; 4 reestablishing the State Board of Medical Education and 5 Licensure as the State Board of Medicine and providing for 6 its composition, powers and duties; providing for the 7 issuance of licenses and certificates and the suspension and 8 revocation of licenses and certificates; providing penalties; 9 and making repeals," providing for perfusionist licensing, 10 qualifications, supervision and scope of practice, 11 regulations and exemptions. 12 The General Assembly of the Commonwealth of Pennsylvania 13 hereby enacts as follows: 14 Section 1. Section 2 of the act of December 20, 1985 15 (P.L.457, No.112), known as the Medical Practice Act of 1985, is 16 amended by adding definitions to read: 17 Section 2. Definitions. 18 The following words and phrases when used in this act shall 19 have the meanings given to them in this section unless the 20 context clearly indicates otherwise: 21 * * *
1 "Extracorporeal circulation." The diversion of a patient's 2 blood through a heart-lung machine or similar device that 3 assumes the functions of the patient's heart, lung, kidney, 4 liver or other organs. 5 * * * 6 "Perfusion." The functions necessary for the support, 7 treatment, measurement or supplementation of the cardiovascular 8 systems or other organs, or a combination of those functions, 9 and for ensuring the safe management of physiologic functions by 10 monitoring and analyzing the parameters of the systems under the 11 supervision of a licensed physician. 12 "Perfusionist." An individual who is licensed to practice 13 perfusion by the State Board of Medicine or the State Board of 14 Osteopathic Medicine. 15 * * * 16 Section 2. Section 3(a) of the act, amended December 10, 17 2001 (P.L.859, No.92), is amended to read: 18 Section 3. State Board of Medicine. 19 (a) Establishment.--The State Board of Medicine shall 20 consist of the commissioner or his designee, the Secretary of 21 Health or his designee, two members appointed by the Governor 22 who shall be persons representing the public at large and seven 23 members appointed by the Governor, six of whom shall be medical 24 doctors with unrestricted licenses to practice medicine and 25 surgery in this Commonwealth for five years immediately 26 preceding their appointment and one who shall be a nurse 27 midwife, physician assistant, certified registered nurse 28 practitioner, respiratory care practitioner [or], certified 29 athletic trainer or perfusionist licensed or certified under the 30 laws of this Commonwealth. All professional and public members 20070H0500B1909 - 2 -
1 of the board shall be appointed by the Governor, with the advice 2 and consent of a majority of the members elected to the Senate. 3 * * * 4 Section 3. The act is amended by adding a section to read: 5 Section 13.3. Perfusionist. 6 (a) License required.--Eighteen months TWO YEARS after the <-- 7 effective date of this section, it shall be unlawful for any 8 person to hold himself out to the public as a perfusionist or to 9 practice or offer to practice perfusion unless the person holds 10 a valid, current license issued by the board or the State Board 11 of Osteopathic Medicine. 12 (b) Use of title.--A perfusionist who holds a valid, current 13 license issued by either board may use the title perfusionist or 14 licensed perfusionist, or an appropriate abbreviation of the 15 title, such as "LP." 16 (c) Regulations.--The board is authorized to promulgate 17 regulations to implement this section. 18 (d) Supervision and scope of practice.--A perfusionist may 19 perform perfusion to an individual being treated by a licensed 20 physician under medical supervision and approval consistent with 21 standing orders or protocols of a hospital that are promulgated 22 and approved by the physician designated as the medical director 23 of the cardiovascular surgery program. These services shall 24 include: 25 (1) The use of extracorporeal circulation, long-term 26 cardiopulmonary support techniques, including extracorporeal 27 carbon dioxide removal, extracorporeal membrane oxygenation 28 and associated therapeutic and diagnostic techniques. 29 (2) Counterpulsion, ventricular assistance, 30 autotransfusion, blood and blood component conservation 20070H0500B1909 - 3 -
1 techniques, myocardial and organ preservation, extracorporeal 2 life support and isolated limb perfusion. 3 (3) Blood and blood component management techniques, 4 advanced life support and other related functions. 5 (4) In the performance of the acts described in 6 paragraphs (1), (2) and (3): 7 (i) The administration of: 8 (A) Pharmacological and therapeutic agents. 9 (B) Blood products or anesthetic agents through 10 the extracorporeal circuit or through an intravenous 11 line in conjunction with extracorporeal support, 12 under the supervision of the treating physician. 13 (ii) The performance and use of: 14 (A) Anticoagulation monitoring and analysis. 15 (B) Physiologic monitoring and analysis. 16 (C) Blood gas and chemistry monitoring and 17 analysis. 18 (D) Hematologic monitoring and analysis. 19 (E) Hypothermia. 20 (F) Hyperthermia. 21 (G) Normothermia. 22 (H) Hemoconcentration and hemodilution. 23 (I) Hemodialysis in conjunction with perfusion 24 service. 25 (iii) The observation of signs and symptoms related 26 to perfusion services, the determination of whether the 27 signs and symptoms exhibit abnormal characteristics and 28 the implementation of appropriate reporting, perfusion 29 protocols or changes in or the initiation of emergency 30 procedures. 20070H0500B1909 - 4 -
1 (e) Exemptions.--The following persons may perform 2 perfusion, as indicated: 3 (1) A person licensed under any other section of this 4 act or any other law of this Commonwealth, while engaging in 5 the practice for which the person is licensed. 6 (2) A student enrolled in an accredited perfusion 7 education program if perfusion performed by the student: 8 (i) is an integral part of the student's course of 9 study; and 10 (ii) is performed under the direct supervision of a 11 perfusionist who is assigned to supervise the student and 12 who is on duty and immediately available in the assigned 13 patient care area. 14 (3) A graduate of an accredited perfusion education 15 program, if perfusion services: 16 (i) are necessary to fulfill the eligibility 17 requirements for a certification examination; and 18 (ii) are performed under the supervision and 19 responsibility of a perfusionist who is on duty and 20 assigned to supervise the graduate. 21 (4) A legally qualified person employed by the Federal 22 Government to practice perfusion while in the discharge of 23 the person's official duties. 24 (f) Qualifications.--An applicant shall be licensed to 25 practice perfusion under this act if the applicant meets all of 26 the following qualifications and has otherwise complied with the 27 provisions of this act: 28 (1) The person is at least 18 years of age. 29 (2) The person is of good moral character. 30 (3) The person has graduated from an accredited 20070H0500B1909 - 5 -
1 perfusion program approved by the board. 2 (4) The person is certified by a certifying agency 3 approved by a nationally recognized accrediting agency 4 approved by the board. The certification shall include an 5 examination approved by the board. 6 (5) The person has completed an application form 7 provided by the board and paid the appropriate fee. 8 (g) Certain certified persons not graduates of accredited 9 programs.--Within two years of the effective date of this 10 section, an applicant who was not a graduate of an accredited 11 program prior to 1981, but met the then-current eligibility 12 requirements for certification as a certified clinical 13 perfusionist and subsequently was certified, shall be licensed 14 as a perfusionist if the applicant otherwise complies with the 15 provisions of this act. 16 (h) Temporary graduate license to practice perfusion.-- 17 (1) The board may issue a temporary graduate license to 18 practice perfusion to an individual who has graduated from an 19 educational program that complies with the education 20 requirements of this act. The following shall apply: 21 (i) The individual has applied for the examination 22 and is eligible to take the required examination. 23 (ii) The individual's authorization to practice 24 perfusion is granted only under the supervision and 25 direction of a perfusionist licensed under this act. 26 (iii) The license shall be issued for a period of 27 two years and shall be nonrenewable. 28 (iv) The license shall expire immediately upon 29 notice that the individual has failed the required 30 examination under this act. 20070H0500B1909 - 6 -
1 (i) Temporary provisional license to practice perfusion.-- 2 (1) The board may issue a temporary provisional license 3 to practice perfusion if all the following requirements are 4 met: 5 (i) The individual holds a current license which is 6 in good standing under the laws of another state, 7 District of Columbia or territory of the United States 8 which includes certification by a certifying agency 9 approved by a nationally recognized accrediting agency. 10 (ii) The individual meets the requirements as set 11 forth in subsection (f)(1), (2) and (3). 12 (2) The license shall be issued for a period of one year 13 and shall be nonrenewable. 14 (J) TEMPORARY EMERGENCY EXEMPTION.-- <-- 15 (1) AN INDIVIDUAL WHO HOLDS A CURRENT LICENSE AS A 16 PERFUSIONIST IN ANOTHER STATE, THE DISTRICT OF COLUMBIA OR A 17 TERRITORY OF THE UNITED STATES OR HAS OBTAINED NATIONAL 18 CERTIFICATION MAY PROVIDE A ONE-TIME EMERGENCY PERFUSIONIST 19 SERVICE IN THIS COMMONWEALTH WITHOUT FIRST OBTAINING A 20 LICENSE FROM THE BOARD IF: 21 (I) PRIOR TO THE OUT-OF-STATE PERFUSIONIST 22 PERFORMING THE EMERGENCY PERFUSIONIST SERVICES IN THIS 23 COMMONWEALTH, THE OUT-OF-STATE PERFUSIONIST SUBMITS BY 24 ELECTRONIC MEANS AND ON FORMS APPROVED BY THE BOARD, 25 NOTIFICATION OF EMERGENCY PRACTICE WHICH SHALL INCLUDE AN 26 ACKNOWLEDGMENT THAT THE OUT-OF-STATE PERFUSIONIST IS 27 SUBJECT TO THE JURISDICTION OF THE BOARD IN THE SAME 28 MANNER AS IF THE OUT-OF-STATE PERFUSIONIST WERE LICENSED 29 BY THE BOARD. 30 (II) THE HEALTH CARE FACILITY LICENSED BY THE 20070H0500B1909 - 7 -
1 DEPARTMENT OF HEALTH CERTIFIES TO THE BOARD, BY 2 ELECTRONIC MEANS AND ON FORMS APPROVED BY THE BOARD, 3 PRIOR TO THE OUT-OF-STATE PERFUSIONIST PERFORMING THE 4 EMERGENCY PERFUSIONIST SERVICES IN THIS COMMONWEALTH THAT 5 ALL OF THE FOLLOWING APPLY: 6 (A) THE EMERGENCY PERFUSIONIST SERVICES WERE 7 PROVIDED FOR A PATIENT OF THE HEALTH CARE FACILITY. 8 (B) THE PERFUSIONIST LICENSED BY THE BOARD AND 9 RETAINED BY THE HEALTH CARE FACILITY THAT WOULD 10 NORMALLY PERFORM THE EMERGENCY PERFUSIONIST SERVICES 11 WAS NOT AVAILABLE OR INCAPABLE OF PROVIDING THE 12 PERFUSIONIST SERVICES. 13 (C) NO OTHER PERFUSIONIST LICENSED BY THE BOARD 14 WAS AVAILABLE TO PROVIDE OR CAPABLE OF PROVIDING THE 15 EMERGENCY PERFUSION SERVICE. 16 (D) THE OUT-OF-STATE PERFUSIONIST PROVIDED ONLY 17 THE EMERGENCY PERFUSIONIST SERVICES FOR THE PATIENT 18 OF THE HEALTH CARE FACILITY AND NO OTHER PERFUSIONIST 19 SERVICES AT THE HEALTH CARE FACILITY. 20 (2) THE OUT-OF-STATE PERFUSIONIST SHALL OBTAIN A LICENSE 21 FROM THE BOARD IF A HEALTH CARE FACILITY LICENSED BY THE 22 DEPARTMENT OF HEALTH RETAINS THE PERFUSIONIST OR IF THE 23 PERFUSIONIST PROVIDES ANY FUTURE PERFUSIONIST SERVICES. 24 (3) THE OUT-OF-STATE PERFUSIONIST SHALL NOT PERFORM ANY 25 OTHER PERFUSIONIST SERVICES OTHER THAN THE EMERGENCY 26 PERFUSIONIST SERVICES. 27 (j) (K) Professional liability.-- <-- 28 (1) A licensed perfusionist practicing in this 29 Commonwealth shall maintain a level of professional liability 30 insurance coverage as required for a nonparticipating health 20070H0500B1909 - 8 -
1 care provider under the act of March 20, 2002 (P.L.154, 2 No.13), known as the Medical Care Availability and Reduction 3 of Error (Mcare) Act, but shall not be eligible to 4 participate in the Medical Care Availability and Reduction of 5 Error Fund. 6 (2) A license applicant shall provide proof that the 7 applicant has obtained professional liability insurance in 8 accordance with paragraph (1). It is sufficient if the 9 applicant files with the application a copy of a letter from 10 the applicant's professional liability insurance carrier 11 indicating that the applicant will be covered against 12 professional liability in the required amounts effective upon 13 the issuance of the applicant's license to practice perfusion 14 in this Commonwealth. Upon issuance of the license, the 15 licensee has 30 days to submit to the board the certificate 16 of insurance or a copy of the policy declaration page. 17 (k) (L) Licensure fees.--All application and licensure fees <-- 18 shall be set by the board by regulation. 19 (l) (M) Reciprocal disciplinary action.--Disciplinary action <-- 20 taken by the State Board of Medicine against a perfusionist 21 licensed by it shall be enforceable by the State Board of 22 Osteopathic Medicine against that same individual if the 23 individual holds or seeks a license to practice as a 24 perfusionist with the State Board of Osteopathic Medicine. 25 (m) (N) Continuing education.-- <-- 26 (1) The board shall adopt, promulgate and enforce rules 27 and regulations consistent with the provisions of this act 28 establishing requirements of continuing education to be met 29 by individuals licensed as perfusionists under this act as a 30 condition for renewal of their licenses. The regulations 20070H0500B1909 - 9 -
1 shall include any fees necessary for the board to carry out 2 its responsibilities under this section. 3 (2) Beginning with the license period designated by 4 regulation, licensees shall be required to attend and 5 complete 30 hours of mandatory continuing education during 6 each two-year license period. Nationally certified education 7 courses shall be considered as creditable, in addition to any 8 other courses the board deems creditable toward meeting the 9 requirements for continuing education. 10 (3) An individual applying for the first time for 11 licensure in this Commonwealth shall be exempted from the 12 continuing education requirements for the biennial renewal 13 period following initial licensure. 14 (4) (i) The board may waive all or a portion of the 15 continuing education requirement for biennial renewal for 16 a licensee who shows to the satisfaction of the board 17 that the licensee was unable to complete the requirements 18 due to serious illness, military service or other 19 demonstrated hardship. 20 (ii) The request shall be made in writing with 21 appropriate documentation and shall include a description 22 of circumstances sufficient to show why the licensee is 23 unable to comply with the continuing education 24 requirement. 25 (5) A licensee seeking to reinstate an inactive or 26 lapsed license shall show proof of compliance with the 27 continuing education requirement for the preceding biennium. 28 (6) All courses, locations, instructors and providers 29 shall be approved by the board. No credit shall be given for 30 any course in office management. 20070H0500B1909 - 10 -
1 Section 4. The State Board of Medicine shall promulgate 2 regulations to carry out the provisions of this act within 18 3 months of the effective date of this section. 4 Section 5. This act shall take effect in 60 days. A19L63JS/20070H0500B1909 - 11 -