HOUSE BILL No. 4591


     April 17, 2001, Introduced by Reps. Hart, George, Hansen, DeWeese, Tabor, Kowall, Woodward, Pestka, Kooiman, Vander
Roest, Gilbert, Koetje, Schauer and Jansen and referred to the Committee on Health Policy.


        A bill to amend 1978 PA 368, entitled

   "Public health code,"

   by amending section 16215 (MCL 333.16215), as amended by 1999

   PA 60.

               THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

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           Sec. 16215.  (1) Subject to subsections (2) to  (5)  (8), a

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      licensee who holds a license other than a health profession sub-

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      field license may delegate to a licensed or unlicensed individual

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      who is otherwise qualified by education, training, or experience

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      the performance of selected acts, tasks, or functions where the

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      acts, tasks, or functions fall within the scope of practice of

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      the licensee's profession and will be performed under the

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      licensee's supervision.  A licensee shall not delegate an act,

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      task, or function under this section if the act, task, or

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      function, under standards of acceptable and prevailing practice,


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      requires the level of education, skill, and judgment required of

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      the licensee under this article.

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           (2) Subject to subsection (1) and except as otherwise pro-

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      vided in this subsection and subsection (3), a licensee who is an

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      allopathic physician or osteopathic physician and surgeon shall

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      delegate an act, task, or function that involves the performance

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      of a procedure that requires the use of surgical instrumentation

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      only to an individual who is licensed under this article.  A

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      licensee who is an allopathic physician or osteopathic physician

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      and surgeon may delegate an act, task, or function described in

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      this subsection to an individual who is not licensed under this

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      article if the unlicensed individual is 1 or more of the follow-

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      ing and if the procedure is directly supervised by a licensed

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      allopathic physician or osteopathic physician and surgeon who is

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      physically present during the performance of the procedure:

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           (a) A student enrolled in a school of medicine or osteo-

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      pathic medicine approved by the Michigan board of medicine or the

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      Michigan board of osteopathic medicine and surgery.

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           (b) A student enrolled in a physician's assistant training

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      program approved by the joint physician's assistant task force

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      created under part 170.

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           (3) Subject to subsection (1), a licensee who is an allo-

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      pathic physician or osteopathic physician and surgeon may dele-

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      gate an act, task, or function described in subsection (2) to an

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      individual who is not licensed under this article and who is 1 of

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      the following:





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           (a) Performing acupuncture.

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           (b) Surgically removing only bone, skin, blood vessels,

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      cartilage, dura mater, ligaments, tendons, pericardial tissue, or

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      heart valves only from a deceased individual for transplantation,

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      implantation, infusion, injection, or other medical or scientific

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      purpose.

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           (4) ONLY A LICENSED ALLOPATHIC PHYSICIAN OR OSTEOPATHIC PHY-

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      SICIAN AND SURGEON MAY DELEGATE AN ACT, TASK, OR FUNCTION THAT

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      INVOLVES THE ADMINISTRATION OF SURGICAL ANESTHESIA, AND ONLY

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      UNDER 1 OF THE FOLLOWING CONDITIONS:

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           (A) THE DELEGATING ALLOPATHIC PHYSICIAN OR OSTEOPATHIC PHY-

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      SICIAN AND SURGEON HAS ANESTHESIA PRIVILEGES AT THE HEALTH FACIL-

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      ITY AT WHICH THE SURGERY IS BEING PERFORMED AND IS PHYSICALLY

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      AVAILABLE IN THE HEALTH FACILITY DURING THE TIME THE SURGERY IS

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      BEING PERFORMED.

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           (B) AT THE TIME THE SURGERY IS PERFORMED, THE DELEGATING

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      ALLOPATHIC PHYSICIAN OR OSTEOPATHIC PHYSICIAN AND SURGEON IS PER-

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      FORMING THE SURGERY.

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           (5) AS USED IN SUBSECTION (4):

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           (A) "GENERAL ANESTHESIA" MEANS THE ELIMINATION OF ALL SENSA-

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      TIONS ACCOMPANIED BY A STATE OF UNCONSCIOUSNESS AND LOSS OF

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      REFLEXES NECESSARY TO MAINTAIN A PATIENT AIRWAY.

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           (B) "SURGERY" MEANS A PROCEDURE THAT REQUIRES THE USE OF

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      SURGICAL INSTRUMENTATION.

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           (C) "SURGICAL ANESTHESIA" MEANS GENERAL ANESTHESIA THAT

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      ENTAILS DRUG-INDUCED LOSS OF CONSCIOUSNESS AND IMPAIRMENT OF





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      VENTILATORY REFLEXES, OR MAJOR CONDUCTIVE REGIONAL ANESTHESIA IF

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      ADMINISTERED FOR THE PURPOSE OF FACILITATING SURGERY.

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           (6)  (4)  A board may promulgate rules to further prohibit

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      or otherwise restrict delegation of specific acts, tasks, or

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      functions to a licensed or unlicensed individual if the board

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      determines that the delegation constitutes or may constitute a

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      danger to the health, safety, or welfare of the patient or

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      public.

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           (7)  (5)  To promote safe and competent practice, a board

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      may promulgate rules to specify conditions under which, and cate-

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      gories and types of licensed and unlicensed individuals for whom,

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      closer supervision may be required for acts, tasks, and functions

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      delegated under this section.

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           (8)  (6)  An individual who performs acts, tasks, or func-

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      tions delegated pursuant to this section does not violate the

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      part that regulates the scope of practice of  that  THE

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      DELEGATING health  profession  PROFESSIONAL.























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