PRIOR PRINTER'S NO. 555 PRINTER'S NO. 1845
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 REPORTED FROM COMMITTEE ON PROFESSIONAL LICENSURE, HOUSE OF REPRESENTATIVES, AS AMENDED, JUNE 6, 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 Medical Examiners 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 20070H0500B1845 - 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 after the effective 7 date of this section, it shall be unlawful for any person to 8 hold himself out to the public as a perfusionist or to practice 9 or offer to practice perfusion unless the person holds a valid, 10 current license issued by the board or the State Board of 11 Osteopathic Medical Examiners 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 20070H0500B1845 - 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. 20070H0500B1845 - 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 <-- 20070H0500B1845 - 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 (3) (5) The person has completed an application form <-- 7 provided by the board AND PAID THE APPROPRIATE FEE. <-- 8 (4) The person has successfully completed a perfusion <-- 9 education program approved by the board 10 (5) The person is certified as a certified clinical 11 perfusionist by a certifying agency approved by the board. 12 The certification shall include an examination approved by 13 the board. 14 (g) Certain certified persons not graduates of accredited 15 programs.--Within two years of the effective date of this 16 section, an applicant who was not a graduate of an accredited 17 program prior to 1981, but met the then-current eligibility 18 requirements for certification as a certified clinical 19 perfusionist and subsequently was certified, shall be licensed 20 as a perfusionist if the applicant otherwise complies with the 21 provisions of this act. 22 (H) TEMPORARY GRADUATE LICENSE TO PRACTICE PERFUSION.-- <-- 23 (1) THE BOARD MAY ISSUE A TEMPORARY GRADUATE LICENSE TO 24 PRACTICE PERFUSION TO AN INDIVIDUAL WHO HAS GRADUATED FROM AN 25 EDUCATIONAL PROGRAM THAT COMPLIES WITH THE EDUCATION 26 REQUIREMENTS OF THIS ACT. THE FOLLOWING SHALL APPLY: 27 (I) THE INDIVIDUAL HAS APPLIED FOR THE EXAMINATION 28 AND IS ELIGIBLE TO TAKE THE REQUIRED EXAMINATION. 29 (II) THE INDIVIDUAL'S AUTHORIZATION TO PRACTICE 30 PERFUSION IS GRANTED ONLY UNDER THE SUPERVISION AND 20070H0500B1845 - 6 -
1 DIRECTION OF A PERFUSIONIST LICENSED UNDER THIS ACT. 2 (III) THE LICENSE SHALL BE ISSUED FOR A PERIOD OF 3 TWO YEARS AND SHALL BE NONRENEWABLE. 4 (IV) THE LICENSE SHALL EXPIRE IMMEDIATELY UPON 5 NOTICE THAT THE INDIVIDUAL HAS FAILED THE REQUIRED 6 EXAMINATION UNDER THIS ACT. 7 (I) TEMPORARY PROVISIONAL LICENSE TO PRACTICE PERFUSION.-- 8 (1) THE BOARD MAY ISSUE A TEMPORARY PROVISIONAL LICENSE 9 TO PRACTICE PERFUSION IF ALL THE FOLLOWING REQUIREMENTS ARE 10 MET: 11 (I) THE INDIVIDUAL HOLDS A CURRENT LICENSE WHICH IS 12 IN GOOD STANDING UNDER THE LAWS OF ANOTHER STATE, 13 DISTRICT OF COLUMBIA OR TERRITORY OF THE UNITED STATES 14 WHICH INCLUDES CERTIFICATION BY A CERTIFYING AGENCY 15 APPROVED BY A NATIONALLY RECOGNIZED ACCREDITING AGENCY. 16 (II) THE INDIVIDUAL MEETS THE REQUIREMENTS AS SET 17 FORTH IN SUBSECTION (F)(1), (2) AND (3). 18 (2) THE LICENSE SHALL BE ISSUED FOR A PERIOD OF ONE YEAR 19 AND SHALL BE NONRENEWABLE. 20 (J) PROFESSIONAL LIABILITY.-- 21 (1) A LICENSED PERFUSIONIST PRACTICING IN THIS 22 COMMONWEALTH SHALL MAINTAIN A LEVEL OF PROFESSIONAL LIABILITY 23 INSURANCE COVERAGE AS REQUIRED FOR A NONPARTICIPATING HEALTH 24 CARE PROVIDER UNDER THE ACT OF MARCH 20, 2002 (P.L.154, 25 NO.13), KNOWN AS THE MEDICAL CARE AVAILABILITY AND REDUCTION 26 OF ERROR (MCARE) ACT, BUT SHALL NOT BE ELIGIBLE TO 27 PARTICIPATE IN THE MEDICAL CARE AVAILABILITY AND REDUCTION OF 28 ERROR FUND. 29 (2) A LICENSE APPLICANT SHALL PROVIDE PROOF THAT THE 30 APPLICANT HAS OBTAINED PROFESSIONAL LIABILITY INSURANCE IN 20070H0500B1845 - 7 -
1 ACCORDANCE WITH PARAGRAPH (1). IT IS SUFFICIENT IF THE 2 APPLICANT FILES WITH THE APPLICATION A COPY OF A LETTER FROM 3 THE APPLICANT'S PROFESSIONAL LIABILITY INSURANCE CARRIER 4 INDICATING THAT THE APPLICANT WILL BE COVERED AGAINST 5 PROFESSIONAL LIABILITY IN THE REQUIRED AMOUNTS EFFECTIVE UPON 6 THE ISSUANCE OF THE APPLICANT'S LICENSE TO PRACTICE PERFUSION 7 IN THIS COMMONWEALTH. UPON ISSUANCE OF THE LICENSE, THE 8 LICENSEE HAS 30 DAYS TO SUBMIT TO THE BOARD THE CERTIFICATE 9 OF INSURANCE OR A COPY OF THE POLICY DECLARATION PAGE. 10 (K) LICENSURE FEES.--ALL APPLICATION AND LICENSURE FEES 11 SHALL BE SET BY THE BOARD BY REGULATION. 12 (L) RECIPROCAL DISCIPLINARY ACTION.--DISCIPLINARY ACTION 13 TAKEN BY THE STATE BOARD OF MEDICINE AGAINST A PERFUSIONIST 14 LICENSED BY IT SHALL BE ENFORCEABLE BY THE STATE BOARD OF 15 OSTEOPATHIC MEDICINE AGAINST THAT SAME INDIVIDUAL IF THE 16 INDIVIDUAL HOLDS OR SEEKS A LICENSE TO PRACTICE AS A 17 PERFUSIONIST WITH THE STATE BOARD OF OSTEOPATHIC MEDICINE. 18 (M) CONTINUING EDUCATION.-- 19 (1) THE BOARD SHALL ADOPT, PROMULGATE AND ENFORCE RULES 20 AND REGULATIONS CONSISTENT WITH THE PROVISIONS OF THIS ACT 21 ESTABLISHING REQUIREMENTS OF CONTINUING EDUCATION TO BE MET 22 BY INDIVIDUALS LICENSED AS PERFUSIONISTS UNDER THIS ACT AS A 23 CONDITION FOR RENEWAL OF THEIR LICENSES. THE REGULATIONS 24 SHALL INCLUDE ANY FEES NECESSARY FOR THE BOARD TO CARRY OUT 25 ITS RESPONSIBILITIES UNDER THIS SECTION. 26 (2) BEGINNING WITH THE LICENSE PERIOD DESIGNATED BY 27 REGULATION, LICENSEES SHALL BE REQUIRED TO ATTEND AND 28 COMPLETE 30 HOURS OF MANDATORY CONTINUING EDUCATION DURING 29 EACH TWO-YEAR LICENSE PERIOD. NATIONALLY CERTIFIED EDUCATION 30 COURSES SHALL BE CONSIDERED AS CREDITABLE, IN ADDITION TO ANY 20070H0500B1845 - 8 -
1 OTHER COURSES THE BOARD DEEMS CREDITABLE TOWARD MEETING THE 2 REQUIREMENTS FOR CONTINUING EDUCATION. 3 (3) AN INDIVIDUAL APPLYING FOR THE FIRST TIME FOR 4 LICENSURE IN THIS COMMONWEALTH SHALL BE EXEMPTED FROM THE 5 CONTINUING EDUCATION REQUIREMENTS FOR THE BIENNIAL RENEWAL 6 PERIOD FOLLOWING INITIAL LICENSURE. 7 (4) (I) THE BOARD MAY WAIVE ALL OR A PORTION OF THE 8 CONTINUING EDUCATION REQUIREMENT FOR BIENNIAL RENEWAL FOR 9 A LICENSEE WHO SHOWS TO THE SATISFACTION OF THE BOARD 10 THAT THE LICENSEE WAS UNABLE TO COMPLETE THE REQUIREMENTS 11 DUE TO SERIOUS ILLNESS, MILITARY SERVICE OR OTHER 12 DEMONSTRATED HARDSHIP. 13 (II) THE REQUEST SHALL BE MADE IN WRITING WITH 14 APPROPRIATE DOCUMENTATION AND SHALL INCLUDE A DESCRIPTION 15 OF CIRCUMSTANCES SUFFICIENT TO SHOW WHY THE LICENSEE IS 16 UNABLE TO COMPLY WITH THE CONTINUING EDUCATION 17 REQUIREMENT. 18 (5) A LICENSEE SEEKING TO REINSTATE AN INACTIVE OR 19 LAPSED LICENSE SHALL SHOW PROOF OF COMPLIANCE WITH THE 20 CONTINUING EDUCATION REQUIREMENT FOR THE PRECEDING BIENNIUM. 21 (6) ALL COURSES, LOCATIONS, INSTRUCTORS AND PROVIDERS 22 SHALL BE APPROVED BY THE BOARD. NO CREDIT SHALL BE GIVEN FOR 23 ANY COURSE IN OFFICE MANAGEMENT. 24 SECTION 4. THE STATE BOARD OF MEDICINE SHALL PROMULGATE 25 REGULATIONS TO CARRY OUT THE PROVISIONS OF THIS ACT WITHIN 18 26 MONTHS OF THE EFFECTIVE DATE OF THIS SECTION. 27 Section 4 5. This act shall take effect in 60 days. <-- A19L63JS/20070H0500B1845 - 9 -