By:  Cain                                             S.B. No. 1302
                                 A BILL TO BE ENTITLED
                                        AN ACT
    1-1  relating to the regulation of physician assistants; providing a
    1-2  criminal penalty.
    1-3        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
    1-4        SECTION 1.  The Physician Assistant Licensing Act (Article
    1-5  4495b-1, Vernon's Texas Civil Statutes), is amended to read as
    1-6  follows:
    1-7        Sec. 1.  SHORT TITLE; LEGISLATIVE FINDINGS AND PURPOSE.
    1-8  (a)  This Act may be cited as the "Physician Assistant Licensing
    1-9  Act."
   1-10        (b)  The legislature finds that the health, safety, and
   1-11  welfare of the people of this state are best advanced by the
   1-12  establishment of an orderly system for licensing physician
   1-13  assistants.  The creation of a licensing mechanism and
   1-14  establishment of an entity dedicated to regulating physician
   1-15  assistants provides a means to ensure the competency of physician
   1-16  assistants without a financial burden to the people of this state.
   1-17        Sec. 2.  DEFINITIONS.  In this Act:
   1-18              (1)  "Board" means the Texas State Board of Physician
   1-19  Assistant <Medical> Examiners.
   1-20              (2)  "Medical Board" means the Texas State Board of
   1-21  Medical Examiners.  <"Council" means the Physician Assistant
   1-22  Advisory Council.>
   1-23              (3)  "Physician assistant" means a person who has
    2-1  graduated from a physician assistant or surgeon assistant training
    2-2  program accredited by the American Medical Association's Committee
    2-3  on Allied Health Education and Accreditation and <or> who has
    2-4  passed the certifying examination administered by the National
    2-5  Commission on Certification of Physician Assistants and who is
    2-6  licensed as a physician assistant by the board.
    2-7              (4)  "Supervising physician" means a physician <medical
    2-8  doctor or doctor of osteopathy> licensed by the medical board
    2-9  either as a doctor of medicine or doctor of osteopathic medicine
   2-10  who is assuming responsibility and legal liability for the services
   2-11  rendered by the physician assistant and who has received approval
   2-12  from the medical board to supervise <who supervises> a specific
   2-13  physician assistant.
   2-14              (5)  "Alternate physician" means that physician
   2-15  designated by the supervising physician to act in his or her stead.
   2-16              (6)  "Supervision" means overseeing the activities of,
   2-17  and accepting responsibility for, the medical services rendered by
   2-18  a physician assistant.  Supervision does not require the constant
   2-19  physical presence of a supervising physician <person providing
   2-20  supervision> but includes a situation where a supervising physician
   2-21  <person providing supervision> and the person being supervised are
   2-22  or can easily be in contact with one another by radio, telephone,
   2-23  or another telecommunication device.
   2-24              (7)  "State" means any state, territory, or insular
   2-25  possession of the United States and the District of Columbia.
    3-1        Sec. 3.  LICENSE REQUIRED.  A person may not practice as a
    3-2  physician assistant unless the person is licensed under this Act.
    3-3        Sec. 4.  BOARD OF PHYSICIAN ASSISTANT EXAMINERS <ADVISORY
    3-4  COUNCIL>.  (a)  The Texas State Board of Physician Assistant
    3-5  Examiners <Advisory Council> is created as an advisory board to the
    3-6  Texas State Board of Medical Examiners.
    3-7        (b)  The board <council> consists of nine members appointed
    3-8  by the governor as follows:
    3-9              (1)  three members who are currently legally practicing
   3-10  as physician assistants and who have at least five years of
   3-11  clinical experience as practicing physician assistants;
   3-12              (2)  three members who are physicians licensed in this
   3-13  state who currently supervise physician assistants; and
   3-14              (3)  three members who are members of the general
   3-15  public who are not licensed either as physicians or physician
   3-16  assistants.
   3-17        (c)  A person is not eligible for appointment as a public
   3-18  member of the board <council> if the person or the person's spouse:
   3-19              (1)  is licensed by an occupational regulatory agency
   3-20  in the field of health care; or
   3-21              (2)  is employed by or participates in the management
   3-22  of a business entity or other organization that provides health
   3-23  care services or that sells, manufactures, or distributes health
   3-24  care supplies or equipment.
   3-25        (d)  Each member of the board <council> is entitled to a per
    4-1  diem as set by legislative appropriation for each day that the
    4-2  member engages in the business of the board <council>.  If the
    4-3  General Appropriations Act does not prescribe the amount of the per
    4-4  diem, the per diem shall consist of actual expenses for meals,
    4-5  lodging, and transportation plus $100.  <A member may not receive
    4-6  compensation for travel expenses, including expenses for meals and
    4-7  lodging, other than transportation expenses.  A member is entitled
    4-8  to compensation for transportation expenses as provided by the
    4-9  General Appropriations Act.>
   4-10        (e)  It is a ground for removal from the board <council> if a
   4-11  member:
   4-12              (1)  does not have at the time of appointment the
   4-13  qualifications required by this section for appointment to the
   4-14  board <council>;
   4-15              (2)  does not maintain during the service on the board
   4-16  <council> the qualifications required by this section for
   4-17  appointment to the board <council>; or
   4-18              (3)  fails to attend at least one-half of the regularly
   4-19  scheduled board <council> meetings held in a calendar year,
   4-20  excluding meetings held while the person was not a board
   4-21  <committee> member.
   4-22        (f)  A person who is required to register as a lobbyist under
   4-23  Chapter 305, Government Code, and its subsequent amendments may not
   4-24  serve as a member of the board <council>.
   4-25        (g)  The validity of an action of the board <council> is not
    5-1  affected by the fact that it is taken when a ground for removal of
    5-2  a member of the board <council> exists.
    5-3        (h)  The board <council> is subject to the open meetings law,
    5-4  Chapter 551, Government Code <271, Acts of the 60th Legislature,
    5-5  Regular Session, 1967 (Article 6252-17, Vernon's Texas Civil
    5-6  Statutes)>, and its subsequent amendments, and Chapter 2001,
    5-7  Government Code (<the> Administrative Procedure <and Texas
    5-8  Register> Act), <(Article 6252-13a, Vernon's Texas Civil Statutes)>
    5-9  and its subsequent amendments.
   5-10        (i)  Members of the board <council> hold office for staggered
   5-11  terms of six years expiring February 1 of each odd-numbered year.
   5-12  A member is ineligible to serve more than two consecutive full
   5-13  terms and may not serve more than a total of three full terms.
   5-14        (j)  In the case of a vacancy on the board <council>, the
   5-15  governor shall appoint a new member to complete an unexpired term.
   5-16        (k)  The board <council> is subject to Chapter 325,
   5-17  Government Code (Texas Sunset Act), and its subsequent amendments.
   5-18  Unless continued in existence as provided by that chapter, the
   5-19  board <council> is abolished and this Act expires September 1,
   5-20  2005.
   5-21        (l)  The board <council> shall select from its membership a
   5-22  presiding officer and a secretary to serve for one-year terms.
   5-23        (m)  A majority of the <Five> members of the board <council>
   5-24  constitute a quorum for the transaction of the business of the
   5-25  board <council>.
    6-1        Sec. 5.  POWERS AND DUTIES OF THE BOARD <COUNCIL>.  The board
    6-2  <council> shall:
    6-3              (1)  adopt rules as provided by Section 22 of this Act;
    6-4              (2)  review and approve or reject applications for a
    6-5  license;
    6-6              (3)  review and approve or reject applications for
    6-7  renewal of a license;
    6-8              (4)  issue all licenses;
    6-9              (5)  deny, suspend, or revoke a license or otherwise
   6-10  discipline a license holder;
   6-11              (6)  prescribe and collect fees authorized under this
   6-12  Act; and
   6-13              (7)  take any action necessary to carry out the
   6-14  functions and duties of the board <council> under this Act.
   6-15        Sec. 6.  FEES.  (a)  The board <council> shall establish fees
   6-16  that are reasonable and necessary to defray the cost of
   6-17  administering this Act.
   6-18        (b)  The board <council> may not maintain unnecessary fund
   6-19  balances, and fee amounts shall be set in accordance with this
   6-20  requirement.
   6-21        Sec. 7.  LICENSURE <LICENSE> QUALIFICATIONS.  The board
   6-22  <council> shall issue a license under this Act to an applicant who:
   6-23              (1)  submits an application on a form prescribed by the
   6-24  board <council>;
   6-25              (2)  pays the application fee as prescribed by the
    7-1  board <council>;
    7-2              (3)  has successfully completed an educational program
    7-3  for physician assistants or surgeon assistants accredited by the
    7-4  Committee on Allied Health Education and Accreditation or by that
    7-5  committee's predecessor or successor entities and <or> has passed
    7-6  the Physician Assistant National Certifying Examination
    7-7  administered by the National Commission on Certification of
    7-8  Physician Assistants;
    7-9              (4)  certifies that the applicant is mentally and
   7-10  physically able to function safely as a physician assistant;
   7-11              (5)  does not have a license, certification, or
   7-12  registration as a physician assistant in this state or from any
   7-13  other licensing authority that is currently revoked or suspended or
   7-14  the applicant is not subject to probation or other disciplinary
   7-15  action for cause resulting from the applicant's acts as a physician
   7-16  assistant, unless the board <council> takes that fact into
   7-17  consideration in determining whether to issue the license;
   7-18              (6)  is of good moral character; <and>
   7-19              (7)  submits to the board <council> any other
   7-20  information the board <council> considers necessary to evaluate the
   7-21  applicant's qualifications; and
   7-22              (8)  meets any other requirement established by rules
   7-23  adopted by the board.
   7-24        Sec. 8.  TEMPORARY LICENSE.  (a)  The board <council> may
   7-25  issue a temporary license to an applicant who:
    8-1              (1)  meets all the qualifications for a license under
    8-2  this Act but is waiting for the next scheduled meeting of the board
    8-3  <council> for the license to be issued; <or>
    8-4              (2)  seeks to temporarily substitute for a licensed
    8-5  physician assistant during the licensee's absence, if the
    8-6  applicant:
    8-7                    (A)  is licensed or registered in good standing
    8-8  in another state, territory, or the District of Columbia;
    8-9                    (B)  submits an application on a form prescribed
   8-10  by the board <council>; and
   8-11                    (C)  pays the appropriate fee prescribed by the
   8-12  board; or
   8-13              (3)  has graduated from an educational program for
   8-14  physician assistants or surgeon assistants accredited by the
   8-15  Committee on Allied Health Education and Accreditation or by that
   8-16  committee's predecessor or successor entities no later than six
   8-17  months previous to the application for temporary licensure and is
   8-18  waiting for examination results from the National Commission on
   8-19  Certification of Physician Assistants <council>.
   8-20        (b)  A temporary license is valid for 100 <45> days from the
   8-21  date issued and may be extended only for another 30 <45> days after
   8-22  the date the initial temporary license expires.
   8-23        Sec. 9.  INACTIVE LICENSE.  (a)  A license holder may have
   8-24  the license holder's license placed on inactive status by applying
   8-25  to the board <council>.  A physician assistant with an inactive
    9-1  license is excused from paying renewal fees on the license and may
    9-2  not practice as a physician assistant.
    9-3        (b)  A license holder who practices as a physician assistant
    9-4  while on inactive status is considered to be practicing without a
    9-5  license.
    9-6        (c)  A physician assistant may return to active status by
    9-7  applying to the board <council>, paying the license renewal fee,
    9-8  and complying with the requirements for license renewal under
    9-9  Section 10 of this Act.
   9-10        Sec. 10.  RENEWAL.  A person who holds a license under this
   9-11  Act may, on notification from the board <council>, renew the
   9-12  license by:
   9-13              (1)  paying the renewal fee prescribed by the board
   9-14  <council>;
   9-15              (2)  submitting the appropriate form; and
   9-16              (3)  meeting any other requirement established by rules
   9-17  adopted by the board <council>.
   9-18        Sec. 11.  EXEMPTION.  This Act does not require a license
   9-19  for:
   9-20              (1)  a physician assistant student enrolled in a
   9-21  physician assistant or surgeon assistant educational program
   9-22  accredited by the Committee on Allied Health Education and
   9-23  Accreditation of the American Medical Association or, in the event
   9-24  these entities go out of existence, successor entities as approved
   9-25  and designated by the board through rulemaking;
   10-1              (2)  a physician assistant employed in the service of
   10-2  the federal government while performing duties related to that
   10-3  employment;
   10-4              (3)  a technician, assistant, or employee of a
   10-5  physician who performs delegated tasks in the office of a physician
   10-6  or elsewhere but who does not act as a physician assistant or
   10-7  represent that the person is a physician assistant; or
   10-8              (4)  any other licensed health care worker acting
   10-9  within the scope of that person's license if the person does not
  10-10  use the title "physician assistant" or "P.A." or is not represented
  10-11  or designated as a physician assistant.
  10-12        Sec. 12.  SCOPE OF PRACTICE.  (a)  The practice of a
  10-13  physician assistant includes medical services within the education,
  10-14  training, and experience of the physician assistant that are
  10-15  delegated by the supervising physician.
  10-16        (b)  Medical services provided by a physician assistant may
  10-17  include but are not limied to:
  10-18              (1)  obtaining patient histories and performing
  10-19  physical examinations;
  10-20              (2)  ordering or performing diagnostic and therapeutic
  10-21  procedures;
  10-22              (3)  formulating a working diagnosis;
  10-23              (4)  developing and implementing a treatment plan;
  10-24              (5)  monitoring the effectiveness of therapeutic
  10-25  interventions;
   11-1              (6)  assisting at surgery;
   11-2              (7)  offering counseling and education to meet patient
   11-3  needs <patients>;
   11-4              (8)  <requesting,> receiving<,> and signing for the
   11-5  receipt of professional samples which have been requested and
   11-6  presigned for by the supervising physician and distributing the
   11-7  samples to patients at a site serving medically underserved
   11-8  populations, as provided by Section 3.06(d)(5), Medical Practice
   11-9  Act (Article 4495b, Vernon's Texas Civil Statutes), and its
  11-10  subsequent amendments, or as otherwise authorized by state law,
  11-11  federal law, or board rule; and
  11-12              (9)  making appropriate referrals.
  11-13        (c)  The activities listed in Subsection (b) of this section
  11-14  may be performed in any place authorized by a supervising
  11-15  physician, including but not limited to a clinic, hospital,
  11-16  ambulatory surgical center, patient home, nursing home, or other
  11-17  institutional setting.
  11-18        Sec. 13.  SUPERVISION REQUIREMENTS.  (a)  Supervision by a
  11-19  supervising physician must be continuous but does not require the
  11-20  physical presence of the supervising physician at the place where
  11-21  physician assistant services are performed while the services are
  11-22  performed.
  11-23        (b)  Each team of a physician and physician assistant must
  11-24  ensure that:
  11-25              (1)  the physician assistant's scope of function is
   12-1  identified;
   12-2              (2)  delegation of medical tasks is appropriate to the
   12-3  physician assistant's level of competence;
   12-4              (3)  the relationship between the members of the team
   12-5  and the access of the physician assistant to the supervising
   12-6  physician is defined; and
   12-7              (4)  a process for evaluating the physician assistant's
   12-8  performance is established.
   12-9        (c)  A physician assistant may have more than one supervising
  12-10  physician.
  12-11        Sec. 14.  SUPERVISING PHYSICIAN.  A supervising physician
  12-12  must:
  12-13              (1)  be currently licensed as a physician in this state
  12-14  by the medical board with a license that is unrestricted and
  12-15  active;
  12-16              (2)  notify the board <council> of the physician's
  12-17  intent to supervise a physician assistant; and
  12-18              (3)  submit a statement to the board <council> that the
  12-19  physician will:
  12-20                    (A)  supervise the physician assistant according
  12-21  to rules adopted by the board <council>; and
  12-22                    (B)  retain professional and legal responsibility
  12-23  for the care rendered by the physician assistant.
  12-24        Sec. 15.  NOTIFICATION OF INTENT TO PRACTICE.  (a)  A
  12-25  physician assistant licensed under this Act must, before beginning
   13-1  practice, submit on a form prescribed by the board <council>
   13-2  notification of the license holder's intent to begin practice.
   13-3  Notification under this section must include:
   13-4              (1)  the name, business address, Texas license number,
   13-5  and telephone number of the physician assistant's supervising
   13-6  physician; and
   13-7              (2)  the name, business address, Texas license number,
   13-8  and telephone number of the physician assistant.
   13-9        (b)  A physician assistant must notify the board <council> of
  13-10  any changes in, or additions to, the person acting as a supervising
  13-11  physician for the physician assistant not later than the 30th day
  13-12  after the date the change or addition is made.
  13-13        Sec. 16.  EXCLUSION OF LIMITATION ON EMPLOYMENT.  This Act
  13-14  does not limit the employment arrangement of a physician assistant
  13-15  licensed under this Act.
  13-16        Sec. 17.  ASSUMPTION OF PROFESSIONAL LIABILITY.  (a)  A
  13-17  physician assistant employed by a physician or a group of
  13-18  physicians must be supervised by and be the legal responsibility of
  13-19  each supervising <employing> physician.  The legal responsibility
  13-20  for the physician assistant's patient care activities remains the
  13-21  responsibility of the supervising <employing> physician, including
  13-22  when the physician assistant provides care and treatment for a
  13-23  patient in a health care facility.
  13-24        (b)  A physician assistant employed by a health care facility
  13-25  or other entity shall be supervised by a licensed physician.  A
   14-1  health care facility or other entity that employs a physician
   14-2  assistant shares the legal responsibility for the physician
   14-3  assistant's acts or omissions with the physician assistant's
   14-4  supervising physician.
   14-5        Sec. 18.  DISCIPLINARY PROCEEDINGS.  The board <council> may
   14-6  refuse to issue a license, publicly or privately reprimand a
   14-7  license holder, or suspend, revoke, or place other restrictions on
   14-8  a license of a person who:
   14-9              (1)  fraudulently or deceptively obtains or attempts to
  14-10  obtain a license;
  14-11              (2)  fraudulently or deceptively uses a license;
  14-12              (3)  violates any provision of this Act or any rule
  14-13  adopted under this Act;
  14-14              (4)  is convicted of a felony;
  14-15              (5)  is a habitual user of intoxicants or
  14-16  nontherapeutic drugs to the extent that the person cannot safely
  14-17  perform as a physician assistant;
  14-18              (6)  has been adjudicated as mentally incompetent or
  14-19  has a mental or physical condition that renders the person unable
  14-20  to safely perform as a physician assistant;
  14-21              (7)  has committed an act of moral turpitude; <or>
  14-22              (8)  represents that the person is a physician;
  14-23              (9)  has acted in an unprofessional or dishonorable
  14-24  manner which is likely to deceive, defraud, or injure any member of
  14-25  the public;
   15-1              (10)  has failed to practice as a physician assistant
   15-2  in an acceptable manner consistent with pubic health and welfare;
   15-3              (11)  has committed any act that is in violation of the
   15-4  laws of the State of Texas if the act is connected with practice as
   15-5  a physician assistant; a complaint, indictment, or conviction of a
   15-6  law violation is not necessary for the enforcement of this
   15-7  provision; proof of the commission of the act while in practice as
   15-8  a physician assistant or under the guise of practice as a physician
   15-9  assistant is sufficient for action by the board under this section;
  15-10  or
  15-11              (12)  has been suspended, revoked, restricted, or had
  15-12  other disciplinary action taken by another state regarding practice
  15-13  as a physician assistant or had disciplinary action taken by the
  15-14  uniformed services of the United States, based on acts by the
  15-15  licensee similar to acts described in this section; a certified
  15-16  copy of the record of the state or uniformed services of the United
  15-17  States taking the action is conclusive evidence of it.
  15-18        Sec. 19.  ADDITIONAL DISCIPLINARY AUTHORITY.  In addition to
  15-19  the authority under Section 18 of this Act, the board <council>
  15-20  may, on finding that a physician assistant has committed an offense
  15-21  described in Section 18 of this Act:
  15-22              (1)  require a physician assistant to submit to the
  15-23  care, counseling, or treatment of a health care practitioner
  15-24  <physician> designated by the board <council>;
  15-25              (2)  stay enforcement of an order and place the
   16-1  physician assistant on probation with the board <council> retaining
   16-2  the right to vacate the probationary stay and enforce the original
   16-3  order for noncompliance with the terms of probation or impose any
   16-4  other remedial measures or sanctions authorized by this section;
   16-5              (3)  restore or reissue a license or remove any
   16-6  disciplinary or corrective measure that the board <council> may
   16-7  have imposed;
   16-8              (4)  order the physician assistant to perform public
   16-9  service; or
  16-10              (5)  require the physician assistant to complete
  16-11  additional training.
  16-12        Sec. 20.  OFFENSE.  (a)  A person commits an offense if,
  16-13  without holding a license under this Act, the person:
  16-14              (1)  holds the person out as a physician assistant;
  16-15              (2)  uses any combination or abbreviation of the term
  16-16  "physician assistant" to indicate or imply that the person is a
  16-17  physician assistant; or
  16-18              (3)  acts as a physician assistant without being
  16-19  licensed by the board <council>.
  16-20        (b)  An offense under this section is a felony of the third
  16-21  degree.
  16-22        Sec. 21.  IDENTIFICATION REQUIREMENTS.  A physician assistant
  16-23  licensed under this Act shall:
  16-24              (1)  keep the physician assistant's Texas license
  16-25  available for inspection at the physician assistant's primary place
   17-1  of business; and
   17-2              (2)  when engaged in the physician assistant's
   17-3  professional activities, wear a name tag identifying the physician
   17-4  assistant as a physician assistant.
   17-5        Sec. 22.  RULE-MAKING AUTHORITY.  (a)  The board <council>
   17-6  shall adopt rules that are reasonable and necessary for the
   17-7  performance of the board's <council's> duties under this Act, as
   17-8  provided by Chapter 2001, Government Code (<the> Administrative
   17-9  Procedure <and Texas Register> Act <(Article 6252-13a, Vernon's
  17-10  Texas Civil Statutes>), and its subsequent amendments, including
  17-11  rules:
  17-12              (1)  setting licensing and other fees;
  17-13              (2)  establishing renewal dates for licenses; and
  17-14              (3)  establishing rules and procedures for disciplinary
  17-15  actions.
  17-16        (b)  Rules adopted by the board <council> must:
  17-17              (1)  be approved or rejected by a majority vote of the
  17-18  medical board; and
  17-19              (2)  if rejected, be returned to the board <council>
  17-20  for revision.
  17-21        Sec. 23.  RURAL PHYSICIAN ASSISTANT LOAN REIMBURSEMENT
  17-22  PROGRAM.  (a)  The board <council> shall designate annually a
  17-23  portion of the revenue generated under this Act from physician
  17-24  assistant licensing fees to be set aside to provide student loan
  17-25  reimbursement for graduates of physician assistant training
   18-1  programs in this state who practice in rural health professional
   18-2  shortage areas identified by the Texas Department of Health.
   18-3        (b)  The Center for Rural Health Initiatives shall establish
   18-4  policies for and adopt rules to administer the loan program under
   18-5  this section.
   18-6        (c)  The board <council> shall authorize and the medical
   18-7  board shall transfer annually the funds designated in Subsection
   18-8  (a) of this section to the Center for Rural Health Initiatives to
   18-9  administer the loan program under this section.
  18-10        Sec. 24.  CONFIDENTIALITY.  (a)  All complaints, adverse
  18-11  reports, investigation files, other investigation reports, and
  18-12  other investigative information in the possession of or received or
  18-13  gathered by the board or its employees or agents relating to a
  18-14  licensee, an application for license, or a criminal investigation
  18-15  or proceeding are privileged and confidential and are not subject
  18-16  to discovery, subpoena, or other means of legal compulsion for
  18-17  their release to anyone other than the board or its employees or
  18-18  agents involved in licensee discipline.
  18-19        (b)  Not later than 30 days after receiving a written request
  18-20  from a licensee who is the subject of a formal complaint initiated
  18-21  and filed under this Act or from the licensee's counsel of record
  18-22  and subject to any other privileges or restrictions set forth by
  18-23  rule, statute, or legal precedent, unless good cause is shown for
  18-24  delay the board shall provide the licensee with access to all
  18-25  information in its possession that the board intends to offer into
   19-1  evidence in presenting its case in chief at the contested hearing
   19-2  on the complaint.  However, the board is not required to provide
   19-3  board investigative reports or investigative memoranda, the
   19-4  identity of a nontestifying complainant, attorney-client
   19-5  communications, attorney work product, or other materials covered
   19-6  by a privilege recognized by the Texas Rules of Civil Procedure or
   19-7  the Texas Rules of Civil Evidence.  The furnishing of information
   19-8  shall not constitute a waiver of privilege or confidentiality under
   19-9  this section, this Act, or other applicable law.
  19-10        (c)  Investigative information in the possession of the board
  19-11  or its employees or agents which relates to licensee discipline may
  19-12  be disclosed to the appropriate licensing authority in another
  19-13  state or a territory or country in which the licensee is licensed
  19-14  or has applied for a license or to a peer review committee
  19-15  reviewing an application for privileges or the qualifications of
  19-16  the licensee with respect to retaining privileges.  If the
  19-17  investigative information in the possession of the board or its
  19-18  employees or agents indicates a crime may have been committed, the
  19-19  information shall be reported to the proper law enforcement agency.
  19-20  The board shall cooperate with and assist all law enforcement
  19-21  agencies conducting criminal investigations of licensees by
  19-22  providing information relevant to the criminal investigation to the
  19-23  investigating agency.  Any information disclosed by the board to an
  19-24  investigative agency shall remain confidential and shall not be
  19-25  disclosed by the investigating agency except as necessary to
   20-1  further the investigation.
   20-2        (d)  The board shall provide information on the written
   20-3  request of a health care entity about a complaint filed against a
   20-4  licensee that was resolved after investigation by a disciplinary
   20-5  order of the board or by an agreed settlement and shall provide the
   20-6  basis of and current status of any complaint under active
   20-7  investigation.
   20-8        (e)  The board shall keep information on file about each
   20-9  complaint filed with the board, consistent with this Act.  If a
  20-10  written complaint is filed with the board relating to a person
  20-11  licensed by the board, the board, at least as often as quarterly
  20-12  and until final determination of the action to be taken relative to
  20-13  the complaint, shall notify, in a manner consistent with this Act,
  20-14  the parties to the complaint of the status of the complaint unless
  20-15  the notice would jeopardize an active investigation.
  20-16        Sec. 25.  PATIENT IDENTITY.  In any disciplinary
  20-17  investigation or proceeding regarding a physician assistant
  20-18  conducted under or pursuant to this Act, the board shall protect
  20-19  the identity of any patient whose medical records are examined and
  20-20  utilized in a public proceeding except for those patients who
  20-21  testify in the public proceeding or who submit a written release in
  20-22  regard to their records or identity.
  20-23        Sec. 26.  SUBPOENAS.  (a)  On behalf of the board, the
  20-24  executive director or the secretary-treasurer of the medical board
  20-25  may issue subpoenas and subpoenas duces tecum for purposes of
   21-1  investigations or contested proceedings related to alleged
   21-2  misconduct by physician assistants or alleged violations of this
   21-3  Act or other laws related to practice as a physician assistant or
   21-4  to the provision of health care under authority of this Act; for
   21-5  purposes of issuing, suspending, restricting, revoking, or
   21-6  cancelling any license, permit, or certification authorized by this
   21-7  Act; and for purposes of denying or granting applications for such
   21-8  licenses, permits, or certifications.
   21-9        (b)  Failure to timely comply with a subpoena issued pursuant
  21-10  to this Act shall be grounds for disciplinary action by the board
  21-11  or other licensing or regulatory agencies with jurisdiction over
  21-12  the individual or entity subject to such a subpoena and grounds for
  21-13  denial of an application for a license, permit, or certification.
  21-14        Sec. 27.  IMMUNITY.  A person, health care entity, medical
  21-15  peer review committee, or other entity that without malice
  21-16  furnishes records, information, or assistance to the board is
  21-17  immune from any civil liability arising from such act.
  21-18        SECTION 2.  The importance of this legislation and the
  21-19  crowded condition of the calendars in both houses create an
  21-20  emergency and an imperative public necessity that the
  21-21  constitutional rule requiring bills to be read on three several
  21-22  days in each house be suspended, and this rule is hereby suspended,
  21-23  and that this Act take effect and be in force from and after its
  21-24  passage, and it is so enacted.