HOUSE BILL NO. 4023

January 10, 2019, Introduced by Rep. Farrington and referred to the Committee on Military, Veterans and Homeland Security.

"Public health code,"

by amending section 16215 (MCL 333.16215), as amended by 2005 PA 211, and by adding section 16215a.

the people of the state of michigan enact:

Sec. 16215. (1) Subject to subsections (2) to (6) and section 16215a, a licensee who holds a license other than a health profession subfield license may delegate to a licensed or unlicensed individual who is otherwise qualified by education, training, or experience the performance of selected acts, tasks, or functions where the acts, tasks, or functions fall within the scope of practice of the licensee's profession and will be performed under the licensee's supervision. A licensee shall not delegate an act, task, or function under this section if the act, task, or function, under standards of acceptable and prevailing practice, requires the level of education, skill, and judgment required of the licensee under this article.

(2) Subject to subsection (1) and except as otherwise provided in this subsection and subsections (3) and (4), a licensee who is an allopathic physician or osteopathic physician and surgeon shall delegate an act, task, or function that involves the performance of a procedure that requires the use of surgical instrumentation only to an individual who is licensed under this article. A licensee who is an allopathic physician or osteopathic physician and surgeon may delegate an act, task, or function described in this subsection to an individual who is not licensed under this article if the unlicensed individual is 1 or more of the following and if the procedure is directly supervised by a licensed allopathic physician or osteopathic physician and surgeon who is physically present during the performance of the procedure:

(a) A student enrolled in a school of medicine or osteopathic medicine approved by the Michigan board of medicine or the Michigan board of osteopathic medicine and surgery.

(b) A student enrolled in a physician's assistant training program approved by the joint physician's assistant task force created under part 170.

(3) Subject to subsection (1), a licensee who is an allopathic physician or osteopathic physician and surgeon may delegate an act, task, or function described in subsection (2) to an individual who is not licensed under this article and who is 1 of the following:

(a) Performing acupuncture.

(b) Surgically removing only bone, skin, blood vessels, cartilage, dura mater, ligaments, tendons, pericardial tissue, or heart valves only from a deceased individual for transplantation, implantation, infusion, injection, or other medical or scientific purpose.

(4) Subject to subsection (1), a licensee who is an allopathic physician or osteopathic physician and surgeon may delegate an act, task, or function described in subsection (2) to an individual who is not licensed under this article if the procedure is directly supervised by a licensed allopathic physician or osteopathic physician and surgeon who is physically present during the performance of the procedure, the delegation of such procedure is not prohibited or otherwise restricted by the board or that health facility or agency, and the delegation of that act, task, or function is specifically authorized by that health facility or agency to be delegated and performed by either of the following unlicensed individuals:

(a) A surgical technologist who meets the qualifications established by the health facility or agency with which he or she is employed or under contract with.

(b) A surgical first assistant who meets the qualifications established by the health facility or agency with which he or she is employed or under contract with.

(5) A board may promulgate rules to further prohibit or otherwise restrict delegation of specific acts, tasks, or functions to a licensed or unlicensed individual if the board determines that the delegation constitutes or may constitute a danger to the health, safety, or welfare of the patient or public.

(6) To promote safe and competent practice, a board may promulgate rules to specify conditions under which, and categories and types of licensed and unlicensed individuals for whom, closer supervision may be required for acts, tasks, and functions delegated under this section.

(7) An individual who performs acts, tasks, or functions delegated pursuant to this section does not violate the part that regulates the scope of practice of that health profession.

(8) The amendatory act that added this subsection does not require new or additional third party reimbursement or mandated worker's compensation benefits for services rendered by an individual authorized to perform those services under subsection (4).

Sec. 16215a. (1) Subject to section 16215(1), a physician or podiatrist may delegate an act, task, or function to military medical personnel while that individual is participating in the pilot program described in subsection (2).

(2) The department, in collaboration with the department of military and veterans affairs, shall establish a pilot program in which military medical personnel may practice and perform certain delegated acts, tasks, or functions under the supervision of a physician or podiatrist who is licensed under this article. All of the following apply to the pilot program described in this subsection:

(a) The delegation of an act, task, or function to military medical personnel must reflect his or her level of training and experience.

(b) The supervising physician or podiatrist retains responsibility for the care of the patient.

(c) Any licensed physician or podiatrist, a professional corporation, professional limited liability company, or partnership of a licensed physician or podiatrist, any hospital that is licensed under article 17, or any commercial enterprise that has medical facilities for its employees that are supervised by 1 or more physicians or podiatrists may participate in the pilot program.

(d) The department, in collaboration with the department of military and veterans affairs, shall establish general requirements for participating military medical personnel, licensees, and employers.

(3) As used in this section:

(a) "Military medical personnel" means an individual who has recently served as a medic in the United States Army, medical technician in the United States Air Force, or corpsman in the United States Navy or the United States Coast Guard and who was discharged or released from that service under conditions other than dishonorable.

(b) "Physician" means an individual who is licensed as a physician under part 170 or part 175.

Enacting section 1. This amendatory act takes effect 90 days after the date it is enacted into law.