Chapter 130

2006 -- H 7311 SUBSTITUTE B AS AMENDED

Enacted 06/16/06

A N A C T

RELATING TO NURSES

Introduced By: Representative Peter T. Ginaitt

Date Introduced: February 15, 2006

It is enacted by the General Assembly as follows:

SECTION 1. Chapter 5-34 of the General Laws entitled "Nurses" is hereby amended by

adding thereto the following section:

5-34-42. Global signature authority of certified registered nurse practitioners. --

Whenever any provision of the general or public law, or regulation requires a signature,

certification, stamp, verification, affidavit or endorsement by a physician, it shall be deemed to

include a signature, certification, stamp, verification, affidavit or endorsement by a certified

registered nurse practitioner; provided, however, that nothing in this section shall be construed to

expand the scope of practice of nurse practitioners.

SECTION 2. Section 5-54-8 of the General Laws in Chapter 5-54 entitled "Physician

Assistants" is hereby amended to read as follows:

5-54-8. Permitted health care practices by physician assistants. -- (a) Physician

assistants shall practice with physician supervision. and shall be considered the agents of their

supervising physicians in the performance of all practice-related activities. Whenever any

provision of general or public law, or regulation, requires a signature, certification, stamp,

verification, affidavit or endorsement by a physician, it shall be deemed to include a signature,

certification, stamp, verification, affidavit or endorsement by a physician assistant; provided,

however, that nothing in this section shall be construed to expand the scope of practice of

physician assistants. Physician assistants may perform those duties and responsibilities consistent

with the limitations of this section, including prescribing of drugs and medical devices, which are

delegated by their supervising physician(s). Physician assistants may request, receive, sign for

and distribute professional samples of drugs and medical devices to patients only within the

limitations of this section. Notwithstanding any other provisions of law, a physician assistant may

perform health care services when those services are rendered under the supervision of a licensed

physician.

(b) Physician assistants, depending upon their level of professional training and

experience, as determined by a supervising physician, may perform health care services

consistent with their expertise and that of the supervising physician, who is a licensed physician

in solo practice, in group practice, or in health care facilities.

provided in this paragraph. When employed by or extended medical staff privileges by a licensed

hospital or other licensed health care facility a physician assistant may write medical orders for

inpatients as ~~governing~~ delineated by the medical staff bylaws of the facility as well as its

credentialing process and applicable governing authority. Physician assistants employed directly

by physicians, health maintenance organizations or other health care delivery organizations may

prescribe legend medications including schedule II, III, IV and V medications under chapter 28 of

title 21 of the Rhode Island Uniform Controlled Substances Act, medical therapies, medical

devices and medical diagnostics according to guidelines established by the employing physician,

health maintenance organization or other health care delivery organization.

(d) When supervised by a physician licensed under chapter 29 of this title, the service

rendered by the physician assistant shall be limited to the foot. The " foot" is defined as the pedal

extremity of the human body and its articulations, and includes the tendons and muscles of the

lower leg only as they are involved in conditions of the foot.

(e) Hospitals and other licensed health care facilities have discretion to grant privileges

to a physician assistant and to define the scope of privileges or services which a physician

assistant may deliver in a facility. In no event shall those privileges, if granted, exceed the

privileges granted to the supervising physician.

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LC01441/SUB B

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