| SENATE AMENDED |
| PRIOR PRINTER'S NOS. 287, 1444, 2631 | PRINTER'S NO. 2874 |
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| THE GENERAL ASSEMBLY OF PENNSYLVANIA |
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| HOUSE BILL |
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| INTRODUCED BY KILLION, CALTAGIRONE, GEIST, GINGRICH, MANN, MICOZZIE, MILLER, MILNE, MUSTIO, VULAKOVICH, FLECK AND MURT, JANUARY 31, 2011 |
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| SENATOR CORMAN, APPROPRIATIONS, IN SENATE, RE-REPORTED AS AMENDED, DECEMBER 12,2011 |
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| AN ACT |
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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," further providing for definitions; and |
10 | providing for regulation of genetic counselors. |
11 | The General Assembly of the Commonwealth of Pennsylvania |
12 | hereby enacts as follows: |
13 | Section 1. Section 2 of the act of December 20, 1985 (P.L. |
14 | 457, No.112), known as the Medical Practice Act of 1985, is |
15 | amended by adding definitions to read: |
16 | Section 2. Definitions. |
17 | The following words and phrases when used in this act shall |
18 | have the meanings given to them in this section unless the |
19 | context clearly indicates otherwise: |
20 | "ABGC." The American Board of Genetic Counseling. |
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1 | "ABMG." The American Board of Medical Genetics. |
2 | * * * |
3 | "Active candidate status." The designation awarded to |
4 | applicants who have received approval from the American Board of |
5 | Genetic Counseling or the American Board of Medical Genetics to |
6 | sit for their respective certification examinations. |
7 | * * * |
8 | "Genetic counselor." An individual who is licensed to |
9 | practice genetic counseling by the State Board of Medicine or |
10 | the State Board of Osteopathic Medicine. |
11 | "Genetic counseling." The provision of services to |
12 | individuals, couples, families and organizations by one or more |
13 | appropriately trained individuals to address the physical and |
14 | psychological issues associated with the occurrence or risk of |
15 | occurrence of a genetic disorder, birth defect or genetically |
16 | influenced condition or disease in an individual or a family. |
17 | * * * |
18 | Section 2. The act is amended by adding a section to read: |
19 | Section 13.4. Genetic counselor. |
20 | (a) License required.--Two years after the effective date of |
21 | this section, it shall be unlawful for any person to hold |
22 | himself out to the public as a genetic counselor or to practice |
23 | or offer to practice genetic counseling unless the person holds |
24 | an active license issued by the board or the State Board of | <-- |
25 | Osteopathic Medicine. a license issued by the board. | <-- |
26 | (b) Use of title.--An individual who holds an active license |
27 | as provided by this act may hold himself out to the public by |
28 | any title or description of services incorporating the term |
29 | "genetic counselor" or use any words or symbols indicating or | <-- |
30 | tending to indicate that the individual is a genetic counselor, |
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1 | except as otherwise provided by this act. |
2 | (c) Scope of practice.-- |
3 | (1) A genetic counselor may provide genetic counseling |
4 | to clients, which includes: |
5 | (i) Obtain and evaluate individual, family and and | <-- |
6 | family medical histories to determine genetic risk for |
7 | genetic or medical conditions and diseases in a patient, | <-- |
8 | the patient's offspring and other family members. |
9 | (ii) Discuss the features, natural history, means of |
10 | diagnosis, genetic and environmental factors and |
11 | management of risk for the genetic or medical conditions |
12 | and diseases. |
13 | (iii) Identify and coordinate genetic laboratory |
14 | tests and other diagnostic studies as appropriate for the |
15 | genetic assessment. |
16 | (iv) Integrate the genetic laboratory test results | <-- |
17 | and other diagnostic studies with personal and family |
18 | medical history to assess and communicate risk factors |
19 | for genetic or medical conditions and diseases. |
20 | (v) Explain the clinical implications of genetic |
21 | laboratory tests and other diagnostic studies and their |
22 | results. |
23 | (vi) Evaluate the client's or family's responses to |
24 | the condition or risk of the recurrence and provide |
25 | client-centered counseling and anticipatory guidance. | <-- |
26 | (vii) Identify and utilize community resources that |
27 | provide medical, educational, financial and psychosocial |
28 | support and advocacy. |
29 | (viii) Provide written documentation of medical, |
30 | genetic and counseling information for families and |
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1 | health care professionals. |
2 | (2) When in the course of providing genetic counseling |
3 | services to a client, if a genetic counselor finds any |
4 | indication of a disease or condition that requires |
5 | professional service diagnosis and treatment outside the | <-- |
6 | scope of practice defined in this section, the genetic |
7 | counselor shall refer the client to a licensed physician or | <-- |
8 | appropriate health care practitioner. |
9 | (3) Nothing in this subsection shall be construed to |
10 | authorize a genetic counselor to diagnose, test or treat any |
11 | genetic disease or condition or other disease or condition. | <-- |
12 | (d) Exemptions.--The following persons may provide genetic |
13 | counseling without holding the license required by this section |
14 | as indicated: |
15 | (1) A person licensed under any other section of this |
16 | act or any other law of this Commonwealth, while acting |
17 | within the scope of practice of the person's license and |
18 | training, provided the person does not hold himself out to |
19 | the public as a genetic counselor. |
20 | (2) A person employed by the Federal Government to |
21 | provide genetic counseling while in the discharge of the |
22 | person's official duties. |
23 | (3) A student enrolled in an ABGC-accredited or ABMG- |
24 | accredited genetic counseling educational program or, an | <-- |
25 | ABMG-accredited medical genetics educational program or a | <-- |
26 | graduate nursing education program in genetics, if the |
27 | counseling is an integral part of the student's course of |
28 | study and is performed under the direct supervision of a |
29 | genetic counselor or a, licensed physician, certified | <-- |
30 | registered nurse practitioner with a specialty or |
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1 | subspecialty in genetics or clinical nurse specialist with a |
2 | specialty or subspecialty in genetics. |
3 | (4) A person trained as a genetic counselor who |
4 | reapplies for the ABGC certification examination and is |
5 | working under general supervision in an approved genetic |
6 | counseling training site. |
7 | (5) A person trained as a Ph.D. medical geneticist who |
8 | reapplies for the ABMG certification examination and gathers | <-- |
9 | logbook cases documents the number of cases in a logbook | <-- |
10 | under a supervisor identified in the training program's ABMG |
11 | accreditation documents as a member of the training faculty. |
12 | (e) Qualifications.--An applicant shall be licensed to |
13 | practice genetic counseling under this act if the applicant |
14 | meets all of the following qualifications and has otherwise |
15 | complied with the provisions of this act: |
16 | (1) The person is at least 21 years of age. |
17 | (2) The person is of good moral character. |
18 | (3) The person has received a master's degree or |
19 | doctoral degree in human genetics or genetic counseling from |
20 | an ABGC-accredited or ABMG-accredited educational program, or |
21 | has met the requirements for certification by the ABGC or |
22 | ABMG. |
23 | (4) The person has passed the examination for |
24 | certification as a genetic counselor by the ABGC or the ABMG |
25 | or has passed the examination for certification as a Ph.D. |
26 | medical geneticist by the ABMG, as approved by the board. | <-- |
27 | (5) The person has completed an application form |
28 | provided by the board and paid the appropriate fee. |
29 | (f) Licensure of noncertified persons.--For a period of |
30 | three years after the effective date of this section, the board |
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1 | may issue a license to a person who meets all of the |
2 | qualifications for licensure except for the requirements of |
3 | subsection (e)(3) and (4), provided: |
4 | (1) The person has received a master's or higher degree |
5 | in genetics or a related field of study and has worked as a |
6 | genetic counselor for a minimum of three continuous years | <-- |
7 | preceding the enactment of this section or has received a |
8 | bachelor's degree in genetics or a related field of study and |
9 | has been employed as a genetic counselor for at least ten |
10 | continuous years prior to the enactment of this section. | <-- |
11 | (2) The person submits at least three letters of |
12 | recommendation, one of which must be from a genetic counselor |
13 | certified by ABGC or ABMG and one must be from either a |
14 | clinical geneticist certified by ABMG or a medical geneticist |
15 | certified by ABMG. A person who submits a letter of |
16 | recommendation must have worked with the applicant in an |
17 | employment setting during the previous ten continuous years | <-- |
18 | and can attest to the applicant's competency in providing |
19 | genetic counseling services. |
20 | (g) Provisional license.-- |
21 | (1) The board may issue a provisional license to |
22 | practice genetic counseling to a person who meets all of the |
23 | qualifications for licensure except for the certification |
24 | requirement of subsection (e)(4), provided the person has |
25 | been granted active candidate status establishing eligibility |
26 | to sit for the next available certification examination by |
27 | the ABGC or the ABMG. |
28 | (2) A provisional license shall allow the person to |
29 | practice under the supervision of a genetic counselor or a |
30 | licensed physician until the person receives certification |
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1 | from the ABGC or the ABMG or two examination cycles have |
2 | elapsed, whichever comes first. |
3 | (3) Under no circumstances shall a person continue to |
4 | practice on a provisional license upon notification that the |
5 | person has not passed the examination within two examination |
6 | cycles after receiving the provisional license. |
7 | (h) Licensure fees.--All application and licensure fees |
8 | shall be set by the board by regulation. Until such a time as | <-- |
9 | the board adopts a fee by regulation, applicants shall pay a |
10 | biennial fee of $125. |
11 | (i) Reciprocal disciplinary action.--Disciplinary action |
12 | taken by the board against a person who is a genetic counselor |
13 | shall be enforceable by the State Board of Osteopathic Medicine |
14 | against the person if the person holds or seeks a license to |
15 | practice as a genetic counselor with the State Board of |
16 | Osteopathic Medicine. |
17 | (j) Continuing education.-- |
18 | (1) The board shall promulgate regulations establishing | <-- |
19 | requirements of continuing education to be met by persons |
20 | licensed as genetic counselors under this section as a |
21 | condition for renewal of their licenses. |
22 | (1) For each license renewal, a licensee shall complete | <-- |
23 | within the immediately preceding two-year period at least 30 |
24 | hours of continuing education as approved by the board. The |
25 | licensee shall provide the board with evidence of the |
26 | completion of the continuing education. No credit shall be |
27 | given for any course in office management or practice |
28 | building. |
29 | (2) A person who applies for initial licensure in this |
30 | Commonwealth shall be exempt from the continuing education |
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1 | requirements for the biennial renewal period following |
2 | initial licensure. |
3 | (3) The board may waive all or a portion of the |
4 | continuing education requirement for biennial renewal for a |
5 | licensee who shows to the satisfaction of the board that the |
6 | licensee was unable to complete the requirements due to |
7 | serious illness, military service or other demonstrated |
8 | hardship. |
9 | (4) Continuing education programs and program providers | <-- |
10 | under this subsection shall be approved by the board in |
11 | accordance with standards and criteria established by the |
12 | board by regulation. The regulation shall include any fees |
13 | necessary to implement this provision and provide for waiver |
14 | of the continuing education requirement due to illness or |
15 | hardship in any licensing renewal period. |
16 | (k) Liability insurance.-- |
17 | (1) A licensee under this section, practicing in this |
18 | Commonwealth, shall maintain a level of professional |
19 | liability insurance coverage in the minimum amount of |
20 | $1,000,000 per occurrence or claims made. Failure to maintain |
21 | insurance coverage as required shall subject the licensee to |
22 | disciplinary proceedings. The board shall accept as |
23 | satisfactory evidence of insurance coverage any of the |
24 | following: |
25 | (i) self-insurance; |
26 | (ii) personally purchased liability insurance; or |
27 | (iii) professional liability insurance coverage |
28 | provided by the genetic counselor's employer or similar |
29 | insurance coverage acceptable to the board. |
30 | (2) An applicant shall provide proof that the applicant |
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1 | has obtained professional liability insurance in accordance |
2 | with paragraph (1). It is sufficient if the applicant files |
3 | with the application a copy of a letter from the applicant's |
4 | professional liability insurance carrier indicating that the |
5 | applicant will be covered against professional liability in |
6 | the required amounts effective upon the issuance of the |
7 | applicant's license to practice genetic counseling in this |
8 | Commonwealth. |
9 | (3) Upon issuance of a license, a licensee has 30 days |
10 | to submit to the board the certificate of insurance or a copy |
11 | of the policy declaration page. |
12 | (4) The board shall adopt by regulation standards and |
13 | procedures established by the Insurance Commissioner for |
14 | self-insurance. In the absence of these standards and |
15 | procedures, the board, after consultation with the Insurance |
16 | Commissioner, shall establish standards and procedures by |
17 | regulation for self-insurance under this subsection. |
18 | Section 3. The State Board of Medicine shall promulgate |
19 | regulations to carry out the provisions of this act within 18 12 | <-- |
20 | months of the effective date of this section. Pending the | <-- |
21 | promulgation of regulations, the board shall promulgate a |
22 | statement of policy setting forth the application form for |
23 | initial licensure under this act. The statement of policy shall |
24 | expire upon the approval of the final regulations. |
25 | Section 4. This act shall take effect in 60 days. |
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