SB1271 - 551R - Senate Fact Sheet

Purpose

An emergency measure that directs the Arizona Medical Board (AMB) and the Arizona Board of Osteopathic Examiners in Medicine and Surgery (ABOE) to grant a one-year transitional training permit (transitional training permit) to qualified applicants. Establishes training permittee eligibility, qualifications, permitted duties and supervision requirements.

Background

The AMB is tasked with protecting the public from unlawful, incompetent, unqualified, impaired or unprofessional practitioners of allopathic medicine through licensure, regulation and rehabilitation. The AMB's responsibilities include: 1) issuing licenses, permits and registrations; 2) investigating and resolving conflicts; 3) providing information to the public; and 4) administering the Physician Health Program (A.R.S. § 32-1403).

The ABOE licenses and regulates medical physicians who practice osteopathic medicine, a system of medical treatment that emphasizes the inter-relationship of the body’s muscles, bones and joints with other body systems as an adjunct to invasive or chemically-based treatment. The ABOE's responsibilities include: 1) issuing licenses; 2) conducting hearings; 3) placing physicians on probation; 4) entering stipulated orders; 5) issuing letters of concern and decrees of censure; and 6) adopting prescribing rules (A.R.S. §§ 32-1801 and 32-1803).

There is no anticipated fiscal impact to the state General Fund associated with this legislation.

Provisions

1. Requires the AMB and the ABOE, or the delegated Executive Directors, to grant a transitional training permit to a graduate of an allopathic school of medicine or an osteopathic school of medicine who is not otherwise eligible to apply for a license to practice or a specified training permit but who meets the following eligibility criteria:

a) has successfully completed steps one and two of the U.S. Medical Licensing Examination or equivalent exams; and

b) either:

i. within two years immediately preceding application for a training permit, has qualified for and submitted a valid application to an accredited internship or residency program, but denied a position; or

ii. has been selected for an internship or residency position but ended participation before completion for a reason not considered grounds for disciplinary action.

2. Allows the transitional training permit to be renewed for two additional one-year periods if the permittee submits a valid application to and is not selected for an accredited internship or residency program in the year preceding an application for renewal.

3. Prohibits a permittee from holding a permit for an aggregate time period of more than 36 months.

4. Requires a permittee to function only within the supervised setting of an entity that is either:

a) licensed as an assisted living facility, behavioral health facility, dialysis long-term care facility, nursing care institution, outpatient surgical center, recovery care center or residential care institution; or

b) a facility operated by or for any federally recognized American Indian tribe, the Indian Health Service, the U.S. Veterans Administration, a prison, a school or university, a community health center or a federally qualified health center.

5. Requires a supervising entity to:

a) provide the permittee ongoing clinical training related to the services that may be delegated to the permittee;

b) ensure that the permittee participates in at least 60 hours per one-year period of continuing medical education programs approved by the applicable board;

c) be responsible for all aspects of the performance of a permittee;

d) ensure that the health care tasks performed by a permittee have been properly delegated and are in within the scope of their training, experience and competence;

e) ensure that every clinical encounter is overseen or reviewed by a licensed physician and that such oversight is documented;

f) ensure that in clinical or other patient encounters the permittee is clearly identified as a medical graduate in training;

g) define the employment or contractual relationship with the permittee, including terms of compensation, benefits, billing, reimbursement and liability coverage; and

h) establish and document a process for evaluating the permittee's performance.

6. Allows a supervising entity to delegate to a permittee medical tasks that are of a nature typically delegated in an accredited internship or residency program, including telehealth services, if all other prescribed conditions are met.

7. Requires a supervising entity, prior to employing or contracting with a permittee, to file a document with the Department of Health Services outlining the types and extent of training the entity plans to provide permittees and the scope of tasks that the entity plans to delegate.

8. Requires an applicant for an initial or renewed transitional training permit to comply with applicable registration requirements and pay a fee that is the same as the fee prescribed for an approved internship program prior to the issuance of a permit.

9. Allows accredited internships or residency programs operating in Arizona at institutions that employ or contract permittees to develop a mechanism recognizing clinical experience gained by a permittee as satisfying relevant program requirements, if the permittee is subsequently placed in a program at the institution and the experience meets applicable standards.

10. Specifies that a supervising entity is not required to establish a transitional training permit program.

11. Subjects a permittee to applicable disciplinary regulations.

12. Becomes effective on signature of the Governor, if the emergency clause is enacted.

Amendments Adopted by Committee

1. Adopted the strike-everything amendment.

2. Makes a technical correction.

Senate Action

HHS 2/10/21 DPA/SE 6-2-0