PRINTER'S NO. 475
No. 430 Session of 2007
INTRODUCED BY WONDERLING, KITCHEN, RAFFERTY, STOUT, O'PAKE, COSTA, FONTANA, GORDNER, RHOADES, BOSCOLA, STACK AND WAUGH, MARCH 14, 2007
REFERRED TO CONSUMER PROTECTION AND PROFESSIONAL LICENSURE, MARCH 14, 2007
AN ACT 1 Amending the act of October 5, 1978 (P.L.1109, No.261), entitled 2 "An act requiring the licensing of practitioners of 3 osteopathic medicine and surgery; regulating their practice; 4 providing for certain funds and penalties for violations and 5 repeals," providing for perfusionist licensing, 6 qualifications, supervision and scope of practice, 7 regulations and exemptions. 8 The General Assembly of the Commonwealth of Pennsylvania 9 hereby enacts as follows: 10 Section 1. Section 2 of the act of October 5, 1978 11 (P.L.1109, No.261), known as the Osteopathic Medical Practice 12 Act, is amended by adding definitions to read: 13 Section 2. Definitions. 14 The following words and phrases when used in this act shall 15 have, unless the context clearly indicates otherwise, the 16 meanings given to them in this section: 17 * * * 18 "Extracorporeal circulation." The diversion of a patient's 19 blood through a heart-lung machine or similar device that
1 assumes the functions of the patient's heart, lung, kidney, 2 liver or other organs. 3 * * * 4 "Perfusion." The functions necessary for the support, 5 treatment, measurement or supplementation of the cardiovascular 6 systems or other organs, or a combination of those functions, 7 and for ensuring the safe management of physiologic functions by 8 monitoring and analyzing the parameters of the systems under the 9 supervision of a physician licensed under this act or the act of 10 December 20, 1985 (P.L.457, No.112), known as the "Medical 11 Practice Act of 1985." 12 "Perfusionist." An individual who is licensed to practice 13 perfusion by the State Board of Osteopathic Medicine or the 14 State Board of Medicine. 15 * * * 16 Section 2. Section 2.1(a) of the act, amended December 10, 17 2001 (P.L.863, No.93), is amended and the section is amended by 18 adding subsections to read: 19 Section 2.1. State Board of Osteopathic Medicine. 20 (a) The State Board of Osteopathic Medicine shall consist of 21 the Commissioner of Professional and Occupational Affairs or his 22 designee; the Secretary of Health or his designee; two members 23 appointed by the Governor who shall be persons representing the 24 public at large; one member appointed by the Governor who shall 25 be a respiratory care practitioner, a perfusionist, a physician 26 assistant or a certified athletic trainer; and six members 27 appointed by the Governor who shall be graduates of a legally 28 incorporated and reputable college of [osteopathy] osteopathic 29 medicine and shall have been licensed to practice osteopathic 30 medicine under the laws of this Commonwealth and shall have been 20070S0430B0475 - 2 -
1 engaged in the practice of [osteopathy] osteopathic medicine in 2 this Commonwealth for a period of at least five years. All 3 professional and public members of the board shall be appointed 4 by the Governor with the advice and consent of a majority of the 5 members elected to the Senate. The Governor shall assure that 6 respiratory care practitioners, physician assistants and 7 certified athletic trainers are appointed to four-year terms on 8 a rotating basis. 9 * * * 10 (i) All application and licensure fees shall be set by the 11 board and submitted by applicants and licensees to the board. 12 (j) Any action to deny, suspend, restrict or rescind the 13 license of a perfusionist licensed by the State Board of 14 Medicine shall be referred to that board for appropriate action. 15 The State Board of Osteopathic Medicine shall convey any denial, 16 suspension, restriction or rescission to the State Board of 17 Medicine. 18 (k) The board shall adopt, promulgate and enforce rules and 19 regulations consistent with the provisions of this act 20 establishing requirements of continuing education to be met by 21 individuals holding licensure as perfusionists under this act as 22 a condition for license renewal. Individuals shall acquire a 23 minimum of thirty continuing education units as a condition of 24 biennial renewal. The regulations may include any fees necessary 25 for the board to carry out its responsibilities under this 26 section. 27 Section 3. The act is amended by adding a section to read: 28 Section 13.3. Perfusionist. 29 (a) License required.--Eighteen months after the effective 30 date of this section, it shall be unlawful for any person to 20070S0430B0475 - 3 -
1 hold himself out to the public as a perfusionist or to practice 2 or offer to practice perfusion unless the person holds a valid, 3 current license issued by the board or the State Board of 4 Osteopathic Medicine. 5 (b) Use of title.--A perfusionist who holds a valid, current 6 license issued by either board may use the title perfusionist or 7 licensed perfusionist, or an appropriate abbreviation of the 8 title, such as "LP." 9 (c) Regulations.--The board is authorized to promulgate 10 regulations to implement this section. 11 (d) Supervision and scope of practice.--A perfusionist may 12 perform perfusion to an individual being treated by a physician 13 licensed under this act or the act of December 20, 1985 14 (P.L.457, No.112), known as the "Medical Practice Act of 1985," 15 under medical supervision and approval consistent with standing 16 orders or protocols of a hospital that are promulgated and 17 approved by the physician designated as the medical director of 18 the cardiovascular surgery program. These services shall 19 include: 20 (1) The use of extracorporeal circulation, long-term 21 cardiopulmonary support techniques, including extracorporeal 22 carbon dioxide removal, extracorporeal membrane oxygenation 23 and associated therapeutic and diagnostic techniques. 24 (2) Counterpulsion, ventricular assistance, 25 autotransfusion, blood and blood component conservation 26 techniques, myocardial and organ preservation, extracorporeal 27 life support and isolated limb perfusion. 28 (3) Blood and blood component management techniques, 29 advanced life support and other related functions. 30 (4) In the performance of the acts described in 20070S0430B0475 - 4 -
1 paragraphs (1) through (3): 2 (i) The administration of: 3 (A) Pharmacological and therapeutic agents. 4 (B) Blood products or anesthetic agents through 5 the extracorporeal circuit or through an intravenous 6 line in conjunction with extracorporeal support, 7 under the supervision of the treating physician. 8 (ii) The performance and use of: 9 (A) Anticoagulation monitoring and analysis. 10 (B) Physiologic monitoring and analysis. 11 (C) Blood gas and chemistry monitoring and 12 analysis. 13 (D) Hematologic monitoring and analysis. 14 (E) Hypothermia. 15 (F) Hyperthermia. 16 (G) Normothermia. 17 (H) Hemoconcentration and hemodilution. 18 (I) Hemodialysis in conjunction with perfusion 19 service. 20 (iii) The observation of signs and symptoms related 21 to perfusion services, the determination of whether the 22 signs and symptoms exhibit abnormal characteristics and 23 the implementation of appropriate reporting, perfusion 24 protocols or changes in or the initiation of emergency 25 procedures. 26 (e) Exemptions.--The following persons may perform 27 perfusion, as indicated: 28 (1) A person licensed under any other section of this 29 act or any other law of this Commonwealth, while engaging in 30 the practice for which the person is licensed. 20070S0430B0475 - 5 -
1 (2) A student enrolled in an accredited perfusion 2 education program if perfusion performed by the student: 3 (i) is an integral part of the student's course of 4 study; and 5 (ii) is performed under the direct supervision of a 6 perfusionist who is assigned to supervise the student and 7 who is on duty and immediately available in the assigned 8 patient care area. 9 (3) A legally qualified person employed by the Federal 10 Government to practice perfusion while in the discharge of 11 the person's official duties. 12 (f) Qualifications.--An applicant shall be licensed to 13 practice perfusion under this act if the applicant meets all of 14 the following qualifications and has otherwise complied with the 15 provisions of this act: 16 (1) The person is at least 18 years of age. 17 (2) The person is of good moral character. 18 (3) The person has completed an application form 19 provided by the board. 20 (4) The person has successfully completed a perfusion 21 education program approved by the board. 22 (5) The person is certified as a certified clinical 23 perfusionist by a certifying agency approved by the board. 24 The certification shall include an examination approved by 25 the board. 26 (6) The person complies with the course of continuing 27 education prescribed by the board. 28 (g) Certain certified persons not graduates of accredited 29 programs.--Within two years of the effective date of this 30 section, an applicant who was not a graduate of an accredited 20070S0430B0475 - 6 -
1 program prior to 1981, but met the then-current eligibility 2 requirements for certification as a certified clinical 3 perfusionist and subsequently was certified, shall be licensed 4 as a perfusionist if the applicant otherwise complies with the 5 provisions of this act. 6 (h) Temporary license.-- 7 (1) The board may issue a temporary graduate license to 8 practice perfusion to an individual who has graduated from an 9 educational program that complies with the education 10 requirements of this act. The following shall apply: 11 (i) The individual has applied for the examination 12 and is eligible to take the required examination. 13 (ii) The license authorizes the practice of 14 perfusion only under the supervision and direction of a 15 perfusionist licensed under this act. The license shall 16 be for a period of two years, unless extended by the 17 board and shall be nonrenewable. 18 (iii) The license shall expire immediately upon 19 notice that the individual has failed the required 20 examination under this act. 21 (2) The board may issue a temporary provisional license 22 to practice perfusion to an individual who practices 23 perfusion and is a nonresident of this Commonwealth and not 24 licensed under this act. The following shall apply: 25 (i) The individual will perform perfusion in this 26 Commonwealth for a period of no more than six months from 27 the date the license is issued. 28 (ii) The license shall authorize the practice of 29 perfusion only in association with a perfusionist 30 licensed under this act. 20070S0430B0475 - 7 -
1 (iii) The individual shall maintain a current 2 license under the laws of another state, District of 3 Columbia or territory of the United States which the 4 board determines the licensure requirements are 5 substantially equal to the requirements of this act. 6 (iv) The individual meets the requirements for 7 certification as a perfusionist established by the board. 8 (i) Temporary emergency exemption.--An individual who holds 9 a current license as a perfusionist in another state, the 10 District of Columbia or a territory of the United States or has 11 obtained national certification may provide emergency perfusion 12 services in this Commonwealth without first obtaining a license 13 from the board if all of the following conditions are met: 14 (1) A health care facility licensed by the Department of 15 Health certifies to the board within 36 hours of the 16 emergency perfusion services that all of the following apply: 17 (i) The emergency perfusion services were provided 18 for a patient of the health care facility. 19 (ii) The Commonwealth licensed perfusionist retained 20 by the health care facility that would normally perform 21 the emergency perfusion services was not available or 22 incapable of providing the services. 23 (iii) No other Commonwealth licensed perfusionist 24 was available to provide or capable of providing the 25 emergency service. 26 (iv) The out-of-State licensed perfusionist provided 27 only the emergency perfusion services for the patient of 28 the health care facility and no other perfusionist 29 services at the health care facility. 30 (2) The out-of-State licensed perfusionist shall obtain 20070S0430B0475 - 8 -
1 a license from the board if the health care facility or any 2 other health care facility licensed by the Department of 3 Health retains the perfusionist for or the perfusionist 4 provides any future perfusionist services unless the 5 conditions in paragraph (1) are met. 6 Section 4. This act shall take effect in 60 days. A18L63MSP/20070S0430B0475 - 9 -