| 7 | | - | respectively, so as to authorize advanced practice registered nurses and physician assistants3 |
|---|
| 8 | | - | to order home healthcare services to patients of home health agencies; to provide for4 |
|---|
| 9 | | - | definitions; to provide for the approval of continuing education regarding death certificates;5 |
|---|
| 10 | | - | to provide for authorizing job descriptions; to provide for tax credits for qualified caregiving6 |
|---|
| 11 | | - | expenses to include advanced practice registered nurses and physician assistants; to provide7 |
|---|
| 12 | | - | for related matters; to repeal conflicting laws; and for other purposes.8 |
|---|
| 13 | | - | BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:9 |
|---|
| 14 | | - | SECTION 1.10 |
|---|
| 15 | | - | Title 16 of the Official Code of Georgia Annotated, relating to crimes and offenses, is11 |
|---|
| 16 | | - | amended by revising paragraph (4.2) of Code Section 16-13-72, relating to the sale,12 |
|---|
| 17 | | - | distribution, or possession of dangerous drugs, as follows:13 |
|---|
| 18 | | - | "(4.2) A registered professional nurse licensed under Article 1 of Chapter 26 of Title 4314 |
|---|
| 19 | | - | who is employed or engaged by a licensed home health agency may possess sterile saline,15 |
|---|
| 20 | | - | sterile water, and diluted heparin for use as intravenous maintenance for use in a home16 |
|---|
| 21 | | - | health setting, and such nurse may administer such items to patients of the home health17 |
|---|
| 22 | | - | - 1 - 25 HB 54/SCSFA |
|---|
| 23 | | - | agency upon the order of a licensed physician, an advanced practice registered nurse18 |
|---|
| 24 | | - | acting pursuant to the authority of Code Section 43-34-25, or a physician assistant19 |
|---|
| 25 | | - | provided that the individual ordering the home health services does not have an20 |
|---|
| 26 | | - | ownership interest in an entity to which they are referring. acting pursuant to the authority21 |
|---|
| 27 | | - | of Code Section 43-34-103. The State Board of Pharmacy shall be authorized to adopt22 |
|---|
| 28 | | - | regulations governing the storage, quantity, use, and administration of such items;23 |
|---|
| 29 | | - | provided, however, that nothing in this paragraph or in such regulations shall be24 |
|---|
| 30 | | - | construed to restrict any authority of nurses existing under other provisions of law;"25 |
|---|
| 31 | | - | SECTION 2.26 |
|---|
| 32 | | - | Title 31 of the Official Code of Georgia Annotated, relating to health, is amended by revising27 |
|---|
| 33 | | - | paragraph (20) of Code Section 31-6-2, relating to definitions relative to state health planning28 |
|---|
| 34 | | - | and development, as follows:29 |
|---|
| 35 | | - | "(20) 'Home health agency' means a public agency or private organization, or a30 |
|---|
| 36 | | - | subdivision of such an agency or organization, which is primarily engaged in providing31 |
|---|
| 37 | | - | to individuals who are under a written plan of care of a physician treatment ordered by32 |
|---|
| 38 | | - | a physician, an advanced practice registered nurse acting pursuant to the authority of33 |
|---|
| 39 | | - | Code Section 43-34-25, or a physician assistant provided that the individual ordering the34 |
|---|
| 40 | | - | home health services does not have an ownership interest in an entity to which they are35 |
|---|
| 41 | | - | referring. acting pursuant to the authority of Code Section 43-34-103, on a visiting basis36 |
|---|
| 42 | | - | in the places of residence used as such individuals' homes, part-time or intermittent37 |
|---|
| 43 | | - | nursing care provided by or under the supervision of a registered professional nurse, and38 |
|---|
| 44 | | - | one or more of the following services:39 |
|---|
| 45 | | - | (A) Physical therapy;40 |
|---|
| 46 | | - | (B) Occupational therapy;41 |
|---|
| 47 | | - | (C) Speech therapy;42 |
|---|
| 48 | | - | (D) Respiratory therapy;43 |
|---|
| 49 | | - | - 2 - 25 HB 54/SCSFA |
|---|
| 50 | | - | (E) Skilled nursing care;44 |
|---|
| 51 | | - | (D)(F) Medical social services under the direction of a physician, an advanced practice45 |
|---|
| 52 | | - | registered nurse acting pursuant to the authority of Code Section 43-34-25, or a46 |
|---|
| 53 | | - | physician assistant provided that the individual ordering the home health services does47 |
|---|
| 54 | | - | not have an ownership interest in an entity to which they are referring. acting pursuant48 |
|---|
| 55 | | - | to the authority of Code Section 43-34-103; or49 |
|---|
| 56 | | - | (E)(G) Part-time or intermittent services of a home health aide."50 |
|---|
| 57 | | - | SECTION 3.51 |
|---|
| 58 | | - | Said title is further amended by revising Code Section 31-7-150, relating to definitions, as52 |
|---|
| 59 | | - | follows:53 |
|---|
| 60 | | - | "31-7-150.54 |
|---|
| 61 | | - | As used in this article, the term:55 |
|---|
| 62 | | - | (.5) 'Advanced practice registered nurse' has the same meaning as set forth in Code56 |
|---|
| 63 | | - | Section 43-26-3.57 |
|---|
| 64 | | - | (1) 'Branch office' means a location or site, identified in the application or endorsement58 |
|---|
| 65 | | - | thereto, from which a home health agency provides services within a portion of the total59 |
|---|
| 66 | | - | geographic area served by the parent agency and which is part of the home health agency60 |
|---|
| 67 | | - | and is located sufficiently close to share administration, supervision, and services in a61 |
|---|
| 68 | | - | manner that renders it unnecessary for the branch independently to meet the requirements62 |
|---|
| 69 | | - | of this article.63 |
|---|
| 70 | | - | (1.1)(2) 'Department' means the Department of Community Health.64 |
|---|
| 71 | | - | (2)(3) 'Home health agency' means a public, nonprofit, or proprietary organization,65 |
|---|
| 72 | | - | whether owned or operated by one or more persons or legal entities, which is engaged in66 |
|---|
| 73 | | - | furnishing home health healthcare services.67 |
|---|
| 74 | | - | (3)(4) 'Home health healthcare services' means those items and services furnished to an68 |
|---|
| 75 | | - | individual according to a written plan of treatment signed by the patient's physician, an69 |
|---|
| 76 | | - | - 3 - 25 HB 54/SCSFA |
|---|
| 77 | | - | advanced practice registered nurse acting pursuant to the authority of Code Section70 |
|---|
| 78 | | - | 43-34-25, or a physician assistant acting pursuant to the authority of Code Section71 |
|---|
| 79 | | - | 43-34-103, by a home health agency, or by others under arrangement with the home72 |
|---|
| 80 | | - | health agency on a visit or hourly basis, in a place of temporary or permanent residence73 |
|---|
| 81 | | - | used as the individual's home, as follows:74 |
|---|
| 82 | | - | (A) Part-time or intermittent skilled nursing care as ordered by a physician, an75 |
|---|
| 83 | | - | advanced practice registered nurse acting pursuant to the authority of Code Section76 |
|---|
| 84 | | - | 43-34-25, or a physician assistant provided that the individual ordering the home health77 |
|---|
| 85 | | - | services does not have an ownership interest in an entity to which they are referring.78 |
|---|
| 86 | | - | acting pursuant to the authority of Code Section 43-34-103 and provided by or under79 |
|---|
| 87 | | - | the supervision of a registered nurse and at least one other service listed in80 |
|---|
| 88 | | - | subparagraphs (B) through (D) of this paragraph;81 |
|---|
| 89 | | - | (B) Physical, occupational, or speech therapy;82 |
|---|
| 90 | | - | (C) Medical social services; and83 |
|---|
| 91 | | - | (D) Home health aide services.84 |
|---|
| 92 | | - | (4)(5) 'License' means a license issued by the department.85 |
|---|
| 93 | | - | (5)(6) 'Licensee' means the individual, corporation, or public entity with whom rests the86 |
|---|
| 94 | | - | ultimate responsibility for maintaining approved standards for the home health agency.87 |
|---|
| 95 | | - | (6)(7) 'Parent home health agency' means the agency that develops and maintains88 |
|---|
| 96 | | - | administrative controls of subunits or branch offices.89 |
|---|
| 97 | | - | (7)(8) 'Physician' means an individual currently licensed or authorized to practice90 |
|---|
| 98 | | - | medicine, surgery, or osteopathy in this state.91 |
|---|
| 99 | | - | (9) 'Physician assistant' means an individual licensed pursuant to Article 4 of Chapter 3492 |
|---|
| 100 | | - | of Title 43 and acting pursuant to the authority of Code Section 43-34-103.93 |
|---|
| 101 | | - | (8)(10) 'Plan of treatment' means a plan written, signed, and reviewed at least every two94 |
|---|
| 102 | | - | months by the patient's physician, an advanced practice registered nurse acting pursuant95 |
|---|
| 103 | | - | to the authority of Code Section 43-34-25, or a physician assistant provided that the96 |
|---|
| 104 | | - | - 4 - 25 HB 54/SCSFA |
|---|
| 105 | | - | individual ordering the home health services does not have an ownership interest in an97 |
|---|
| 106 | | - | entity to which they are referring. acting pursuant to the authority of Code Section98 |
|---|
| 107 | | - | 43-34-103 prescribing items and services for the patient's condition.99 |
|---|
| 108 | | - | (9)(11) 'Registered nurse' means an individual who is currently licensed as a registered100 |
|---|
| 109 | | - | professional nurse in this state.101 |
|---|
| 110 | | - | (10)(12) 'Subunit' means a semiautonomous organization which serves patients in a102 |
|---|
| 111 | | - | geographic area different from that of the parent agency and which, by virtue of the103 |
|---|
| 112 | | - | distance between it and the parent agency, is judged incapable of sharing administration,104 |
|---|
| 113 | | - | supervision, and services on a daily basis with the parent agency and must shall,105 |
|---|
| 114 | | - | therefore, independently meet the licensing requirements for a home health agency and106 |
|---|
| 115 | | - | shall be separately licensed."107 |
|---|
| 116 | | - | SECTION 4.108 |
|---|
| 117 | | - | Said title is further amended by revising Code Section 31-7-153, relating to standards for109 |
|---|
| 118 | | - | patient care and agency operation, regulations as to issuance, denial, suspension, or110 |
|---|
| 119 | | - | revocation of licenses, and hearings, as follows:111 |
|---|
| 120 | | - | "31-7-153.112 |
|---|
| 121 | | - | The department shall promulgate regulations which define standards for the care, treatment,113 |
|---|
| 122 | | - | health, safety, welfare, and comfort of patients served by home health agencies and for the114 |
|---|
| 123 | | - | maintenance and operation of home health agencies which will promote safe and adequate115 |
|---|
| 124 | | - | care and treatment of the patients. These regulations shall be no less stringent than those116 |
|---|
| 125 | | - | required for participation of home health agencies in the Title XVIII medicare Medicare117 |
|---|
| 126 | | - | program and shall include, but not be limited to, a provision requiring the agency to have118 |
|---|
| 127 | | - | policies established by a professional group which includes at least one physician and one119 |
|---|
| 128 | | - | registered nurse and appropriate representation from other professional disciplines;120 |
|---|
| 129 | | - | provisions governing the services the agency provides; provisions for the supervision of121 |
|---|
| 130 | | - | services by a physician, advanced practice registered nurse, physician assistant, or122 |
|---|
| 131 | | - | - 5 - 25 HB 54/SCSFA |
|---|
| 132 | | - | registered nurse, as appropriate, and maintenance of clinical records on all patients,123 |
|---|
| 133 | | - | including a plan of treatment prescribed by a physician. The department is authorized to124 |
|---|
| 134 | | - | issue, deny, suspend, or revoke licenses in accordance with regulations promulgated125 |
|---|
| 135 | | - | pursuant to this Code section. Such regulations shall also include hearing procedures126 |
|---|
| 136 | | - | related to denial, suspension, or revocation of licenses."127 |
|---|
| 137 | | - | SECTION 5.128 |
|---|
| 138 | | - | Said title is further amended by revising Code Section 31-7-154, relating to inspections, as129 |
|---|
| 139 | | - | follows:130 |
|---|
| 140 | | - | "31-7-154.131 |
|---|
| 141 | | - | Each home health agency for which a license has been issued shall be periodically132 |
|---|
| 142 | | - | inspected by an authorized representative of the department. Such inspections shall be for133 |
|---|
| 143 | | - | the purpose of ensuring that this article is being followed. The department is directed to134 |
|---|
| 144 | | - | ensure by inspection that the licensee is providing quality care to its patients in accordance135 |
|---|
| 145 | | - | with the orders of the patient's physician, an advanced practice registered nurse, or a136 |
|---|
| 146 | | - | physician assistant; provided, however, that an agency shall be exempt from an additional137 |
|---|
| 147 | | - | on-site licensure inspection if certified in a federal program for reimbursement of medicare138 |
|---|
| 148 | | - | Medicare or Medicaid services."139 |
|---|
| 149 | | - | SECTION 6.140 |
|---|
| 150 | | - | Title 43 of the Official Code of Georgia Annotated, relating to professions and businesses,141 |
|---|
| 151 | | - | is amended by revising paragraph (1) of subsection (b) of Code Section 43-34-23, relating142 |
|---|
| 152 | | - | to the delegation of authority to nurse or physician assistant, and by adding a new paragraph143 |
|---|
| 153 | | - | to read as follows:144 |
|---|
| 154 | | - | "(b)(1)(A) A physician may delegate the authority contained in subparagraph (B) of145 |
|---|
| 155 | | - | this paragraph to:146 |
|---|
| 156 | | - | (i) A physician assistant in accordance with a job description; or147 |
|---|
| 157 | | - | - 6 - 25 HB 54/SCSFA |
|---|
| 158 | | - | (ii) A nurse recognized by the Georgia Board of Nursing as a certified nurse midwife,148 |
|---|
| 159 | | - | certified registered nurse anesthetist, certified nurse practitioner, or clinical nurse149 |
|---|
| 160 | | - | specialist in psychiatric/mental health in accordance with a nurse protocol.150 |
|---|
| 161 | | - | (B) A physician may delegate to those healthcare professionals identified in151 |
|---|
| 162 | | - | subparagraph (A) of this paragraph:152 |
|---|
| 163 | | - | (i) The authority to order controlled substances selected from a formulary of such153 |
|---|
| 164 | | - | drugs established by the board and the authority to order dangerous drugs, medical154 |
|---|
| 165 | | - | treatments, and diagnostic studies;155 |
|---|
| 166 | | - | (ii) The authority to request, receive, and sign for professional samples and to156 |
|---|
| 167 | | - | distribute professional samples to patients. The office or facility at which the157 |
|---|
| 168 | | - | healthcare professional identified in subparagraph (A) of this paragraph is working158 |
|---|
| 169 | | - | shall maintain a general list of the professional samples approved by the delegating159 |
|---|
| 170 | | - | physician for request, receipt, and distribution by the healthcare professional160 |
|---|
| 171 | | - | identified in subparagraph (A) of this paragraph as well as a complete list of the161 |
|---|
| 172 | | - | specific number and dosage of each professional sample and medication voucher162 |
|---|
| 173 | | - | received. Professional samples that are distributed by a healthcare professional163 |
|---|
| 174 | | - | identified in subparagraph (A) of this paragraph shall be so noted in the patient's164 |
|---|
| 175 | | - | medical record. In addition to the requirements of this Code section, all professional165 |
|---|
| 176 | | - | samples shall be maintained as required by applicable state and federal laws and166 |
|---|
| 177 | | - | regulations; and167 |
|---|
| 178 | | - | (iii) The authority to sign, certify, and endorse all documents relating to healthcare168 |
|---|
| 179 | | - | provided to a patient within his or her scope of authorized practice, including, but not169 |
|---|
| 180 | | - | limited to, documents relating to physical examination forms of all state agencies and170 |
|---|
| 181 | | - | verification and evaluation forms of the Department of Human Services, the State171 |
|---|
| 182 | | - | Board of Education, local boards of education, the Department of Community Health,172 |
|---|
| 183 | | - | and the Department of Corrections; provided, however, that a healthcare professional173 |
|---|
| 184 | | - | - 7 - 25 HB 54/SCSFA |
|---|
| 185 | | - | identified in subparagraph (A) of this paragraph shall not have the authority to assign174 |
|---|
| 186 | | - | a percentage of a disability rating.175 |
|---|
| 187 | | - | (1.1) Healthcare professionals identified in subparagraph (A) of this paragraph must176 |
|---|
| 188 | | - | paragraph (1) of this subsection shall complete biennial continuing education regarding177 |
|---|
| 189 | | - | the recognition and documentation of the causes of death and appropriate execution of178 |
|---|
| 190 | | - | death certificates, as approved by the board for a physician assistant as identified in179 |
|---|
| 191 | | - | division (b)(1)(A)(i) of this Code section or by the Board of Nursing for a healthcare180 |
|---|
| 192 | | - | professional identified in division (b)(1)(A)(ii) of this Code section."181 |
|---|
| 193 | | - | SECTION 7.182 |
|---|
| 194 | | - | Said title is further amended in Code Section 43-34-103, relating to application for licensure183 |
|---|
| 195 | | - | as a physician assistant, authorized delegated authority, and prohibited acts, by adding a new184 |
|---|
| 196 | | - | subsection to read as follows:185 |
|---|
| 197 | | - | "(m) In addition to and without limiting the authority granted by Code Section 43-34-23,186 |
|---|
| 198 | | - | a physician may delegate to a physician assistant, in accordance with a job description, the187 |
|---|
| 199 | | - | authority to order home healthcare services to a patient."188 |
|---|
| 200 | | - | SECTION 8.189 |
|---|
| 201 | | - | Title 48 of the Official Code of Georgia Annotated, relating to revenue and taxation, is190 |
|---|
| 202 | | - | amended by revising paragraph (1) of subsection (a) of Code Section 48-7-29.2, relating to191 |
|---|
| 203 | | - | tax credits for qualified caregiving expenses, as follows:192 |
|---|
| 204 | | - | "(1) 'Qualified caregiving expenses' means payments by the taxpayer for home health193 |
|---|
| 205 | | - | agency services, personal care services, personal care attendant services, homemaker194 |
|---|
| 206 | | - | services, adult day care, respite care, or healthcare equipment and supplies which195 |
|---|
| 207 | | - | equipment and supplies have been determined to be medically necessary by a physician,196 |
|---|
| 208 | | - | an advanced practice registered nurse acting pursuant to the authority of Code Section197 |
|---|
| 209 | | - | 43-34-25, or a physician assistant provided that the individual ordering the home health198 |
|---|
| 210 | | - | - 8 - 25 HB 54/SCSFA |
|---|
| 211 | | - | services does not have an ownership interest in an entity to which they are referring. acting199 |
|---|
| 212 | | - | pursuant to the authority of Code Section 43-34-103, which services, care, or equipment200 |
|---|
| 213 | | - | and supplies are:201 |
|---|
| 214 | | - | (A) Provided to the qualifying family member; and202 |
|---|
| 215 | | - | (B) Purchased or obtained from an organization or individual not related to the203 |
|---|
| 216 | | - | taxpayer or the qualifying family member."204 |
|---|
| 217 | | - | SECTION 9.205 |
|---|
| 218 | | - | All laws and parts of laws in conflict with this Act are repealed.206 |
|---|
| 219 | | - | - 9 - |
|---|
| 8 | + | respectively, so as to authorize physician assistants to order home healthcare services to3 |
|---|
| 9 | + | patients of home health agencies; to provide for definitions; to provide for the approval of4 |
|---|
| 10 | + | continuing education regarding death certificates; to provide for authorizing job descriptions;5 |
|---|
| 11 | + | to provide for tax credits for qualified caregiving expenses to include physician assistants;6 |
|---|
| 12 | + | to provide for related matters; to repeal conflicting laws; and for other purposes.7 |
|---|
| 13 | + | BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:8 |
|---|
| 14 | + | SECTION 1.9 |
|---|
| 15 | + | Title 16 of the Official Code of Georgia Annotated, relating to crimes and offenses, is10 |
|---|
| 16 | + | amended by revising paragraph (4.2) of Code Section 16-13-72, relating to the sale,11 |
|---|
| 17 | + | distribution, or possession of dangerous drugs, as follows:12 |
|---|
| 18 | + | "(4.2) A registered professional nurse licensed under Article 1 of Chapter 26 of Title 4313 |
|---|
| 19 | + | who is employed or engaged by a licensed home health agency may possess sterile saline,14 |
|---|
| 20 | + | sterile water, and diluted heparin for use as intravenous maintenance for use in a home15 |
|---|
| 21 | + | health setting, and such nurse may administer such items to patients of the home health16 |
|---|
| 22 | + | - 1 - 25 LC 52 0844S |
|---|
| 23 | + | agency upon the order of a licensed physician or a physician assistant acting pursuant to17 |
|---|
| 24 | + | the authority of Code Section 43-34-103. The State Board of Pharmacy shall be18 |
|---|
| 25 | + | authorized to adopt regulations governing the storage, quantity, use, and administration19 |
|---|
| 26 | + | of such items; provided, however, that nothing in this paragraph or in such regulations20 |
|---|
| 27 | + | shall be construed to restrict any authority of nurses existing under other provisions of21 |
|---|
| 28 | + | law;"22 |
|---|
| 29 | + | SECTION 2.23 |
|---|
| 30 | + | Title 31 of the Official Code of Georgia Annotated, relating to health, is amended by revising24 |
|---|
| 31 | + | paragraph (20) of Code Section 31-6-2, relating to definitions relative to state health planning25 |
|---|
| 32 | + | and development, as follows:26 |
|---|
| 33 | + | "(20) 'Home health agency' means a public agency or private organization, or a27 |
|---|
| 34 | + | subdivision of such an agency or organization, which is primarily engaged in providing28 |
|---|
| 35 | + | to individuals who are under a written plan of care of a physician treatment ordered by29 |
|---|
| 36 | + | a physician or a physician assistant acting pursuant to the authority of Code30 |
|---|
| 37 | + | Section 43-34-103, on a visiting basis in the places of residence used as such individuals'31 |
|---|
| 38 | + | homes, part-time or intermittent nursing care provided by or under the supervision of a32 |
|---|
| 39 | + | registered professional nurse, and one or more of the following services:33 |
|---|
| 40 | + | (A) Physical therapy;34 |
|---|
| 41 | + | (B) Occupational therapy;35 |
|---|
| 42 | + | (C) Speech therapy;36 |
|---|
| 43 | + | (D) Respiratory therapy;37 |
|---|
| 44 | + | (E) Skilled nursing care;38 |
|---|
| 45 | + | (D)(F) Medical social services under the direction of a physician or a physician39 |
|---|
| 46 | + | assistant acting pursuant to the authority of Code Section 43-34-103; or40 |
|---|
| 47 | + | (E)(G) Part-time or intermittent services of a home health aide."41 |
|---|
| 48 | + | - 2 - 25 LC 52 0844S |
|---|
| 49 | + | SECTION 3.42 |
|---|
| 50 | + | Said title is further amended by revising Code Section 31-7-150, relating to definitions, as43 |
|---|
| 51 | + | follows:44 |
|---|
| 52 | + | "31-7-150.45 |
|---|
| 53 | + | As used in this article, the term:46 |
|---|
| 54 | + | (1) 'Branch office' means a location or site, identified in the application or endorsement47 |
|---|
| 55 | + | thereto, from which a home health agency provides services within a portion of the total48 |
|---|
| 56 | + | geographic area served by the parent agency and which is part of the home health agency49 |
|---|
| 57 | + | and is located sufficiently close to share administration, supervision, and services in a50 |
|---|
| 58 | + | manner that renders it unnecessary for the branch independently to meet the requirements51 |
|---|
| 59 | + | of this article.52 |
|---|
| 60 | + | (1.1)(2) 'Department' means the Department of Community Health.53 |
|---|
| 61 | + | (2)(3) 'Home health agency' means a public, nonprofit, or proprietary organization,54 |
|---|
| 62 | + | whether owned or operated by one or more persons or legal entities, which is engaged in55 |
|---|
| 63 | + | furnishing home health healthcare services.56 |
|---|
| 64 | + | (3)(4) 'Home health healthcare services' means those items and services furnished to an57 |
|---|
| 65 | + | individual according to a written plan of treatment signed by the patient's physician, or58 |
|---|
| 66 | + | a physician assistant acting pursuant to the authority of Code Section 43-34-103; by a59 |
|---|
| 67 | + | home health agency,; or by others under arrangement with the home health agency, on60 |
|---|
| 68 | + | a visit or hourly basis, in a place of temporary or permanent residence used as the61 |
|---|
| 69 | + | individual's home, as follows:62 |
|---|
| 70 | + | (A) Part-time or intermittent skilled nursing care as ordered by a physician or a63 |
|---|
| 71 | + | physician assistant acting pursuant to the authority of Code Section 43-34-103 and64 |
|---|
| 72 | + | provided by or under the supervision of a registered nurse and at least one other service65 |
|---|
| 73 | + | listed in subparagraphs (B) through (D) of this paragraph;66 |
|---|
| 74 | + | (B) Physical, occupational, or speech therapy;67 |
|---|
| 75 | + | (C) Medical social services; and68 |
|---|
| 76 | + | - 3 - 25 LC 52 0844S |
|---|
| 77 | + | (D) Home health aide services.69 |
|---|
| 78 | + | (4)(5) 'License' means a license issued by the department.70 |
|---|
| 79 | + | (5)(6) 'Licensee' means the individual, corporation, or public entity with whom rests the71 |
|---|
| 80 | + | ultimate responsibility for maintaining approved standards for the home health agency.72 |
|---|
| 81 | + | (6)(7) 'Parent home health agency' means the agency that develops and maintains73 |
|---|
| 82 | + | administrative controls of subunits or branch offices.74 |
|---|
| 83 | + | (7)(8) 'Physician' means an individual currently licensed or authorized to practice75 |
|---|
| 84 | + | medicine, surgery, or osteopathy in this state.76 |
|---|
| 85 | + | (9) 'Physician assistant' means an individual licensed pursuant to Article 4 of Chapter 3477 |
|---|
| 86 | + | of Title 43 and acting pursuant to the authority of Code Section 43-34-103.78 |
|---|
| 87 | + | (8)(10) 'Plan of treatment' means a plan written, signed, and reviewed at least every two79 |
|---|
| 88 | + | months by the patient's physician or a physician assistant acting pursuant to the authority80 |
|---|
| 89 | + | of Code Section 43-34-103 prescribing items and services for the patient's condition.81 |
|---|
| 90 | + | (9)(11) 'Registered nurse' means an individual who is currently licensed as a registered82 |
|---|
| 91 | + | professional nurse in this state.83 |
|---|
| 92 | + | (10)(12) 'Subunit' means a semiautonomous organization which serves patients in a84 |
|---|
| 93 | + | geographic area different from that of the parent agency and which, by virtue of the85 |
|---|
| 94 | + | distance between it and the parent agency, is judged incapable of sharing administration,86 |
|---|
| 95 | + | supervision, and services on a daily basis with the parent agency and must shall,87 |
|---|
| 96 | + | therefore, independently meet the licensing requirements for a home health agency and88 |
|---|
| 97 | + | shall be separately licensed."89 |
|---|
| 98 | + | SECTION 4.90 |
|---|
| 99 | + | Said title is further amended by revising Code Section 31-7-153, relating to standards for91 |
|---|
| 100 | + | patient care and agency operation, regulations as to issuance, denial, suspension, or92 |
|---|
| 101 | + | revocation of licenses, and hearings, as follows:93 |
|---|
| 102 | + | - 4 - 25 LC 52 0844S |
|---|
| 103 | + | "31-7-153.94 |
|---|
| 104 | + | The department shall promulgate regulations which define standards for the care, treatment,95 |
|---|
| 105 | + | health, safety, welfare, and comfort of patients served by home health agencies and for the96 |
|---|
| 106 | + | maintenance and operation of home health agencies which will promote safe and adequate97 |
|---|
| 107 | + | care and treatment of the patients. These regulations shall be no less stringent than those98 |
|---|
| 108 | + | required for participation of home health agencies in the Title XVIII medicare Medicare99 |
|---|
| 109 | + | program and shall include, but not be limited to, a provision requiring the agency to have100 |
|---|
| 110 | + | policies established by a professional group which includes at least one physician and one101 |
|---|
| 111 | + | registered nurse and appropriate representation from other professional disciplines;102 |
|---|
| 112 | + | provisions governing the services the agency provides; provisions for the supervision of103 |
|---|
| 113 | + | services by a physician, a physician assistant, or a registered nurse, as appropriate, and104 |
|---|
| 114 | + | maintenance of clinical records on all patients, including a plan of treatment prescribed by105 |
|---|
| 115 | + | a physician. The department is authorized to issue, deny, suspend, or revoke licenses in106 |
|---|
| 116 | + | accordance with regulations promulgated pursuant to this Code section. Such regulations107 |
|---|
| 117 | + | shall also include hearing procedures related to denial, suspension, or revocation of108 |
|---|
| 118 | + | licenses."109 |
|---|
| 119 | + | SECTION 5.110 |
|---|
| 120 | + | Said title is further amended by revising Code Section 31-7-154, relating to inspections, as111 |
|---|
| 121 | + | follows:112 |
|---|
| 122 | + | "31-7-154.113 |
|---|
| 123 | + | Each home health agency for which a license has been issued shall be periodically114 |
|---|
| 124 | + | inspected by an authorized representative of the department. Such inspections shall be for115 |
|---|
| 125 | + | the purpose of ensuring that this article is being followed. The department is directed to116 |
|---|
| 126 | + | ensure by inspection that the licensee is providing quality care to its patients in accordance117 |
|---|
| 127 | + | with the orders of the patient's physician or a physician assistant; provided, however, that118 |
|---|
| 128 | + | - 5 - 25 LC 52 0844S |
|---|
| 129 | + | an agency shall be exempt from an additional on-site licensure inspection if certified in a119 |
|---|
| 130 | + | federal program for reimbursement of medicare Medicare or Medicaid services."120 |
|---|
| 131 | + | SECTION 6.121 |
|---|
| 132 | + | Title 43 of the Official Code of Georgia Annotated, relating to professions and businesses,122 |
|---|
| 133 | + | is amended by revising paragraph (1) of subsection (b) of Code Section 43-34-23, relating123 |
|---|
| 134 | + | to the delegation of authority to nurse or physician assistant, and by adding a new paragraph124 |
|---|
| 135 | + | to read as follows:125 |
|---|
| 136 | + | "(b)(1)(A) A physician may delegate the authority contained in subparagraph (B) of126 |
|---|
| 137 | + | this paragraph to:127 |
|---|
| 138 | + | (i) A physician assistant in accordance with a job description; or128 |
|---|
| 139 | + | (ii) A nurse recognized by the Georgia Board of Nursing as a certified nurse midwife,129 |
|---|
| 140 | + | certified registered nurse anesthetist, certified nurse practitioner, or clinical nurse130 |
|---|
| 141 | + | specialist in psychiatric/mental health in accordance with a nurse protocol.131 |
|---|
| 142 | + | (B) A physician may delegate to those healthcare professionals identified in132 |
|---|
| 143 | + | subparagraph (A) of this paragraph:133 |
|---|
| 144 | + | (i) The authority to order controlled substances selected from a formulary of such134 |
|---|
| 145 | + | drugs established by the board and the authority to order dangerous drugs, medical135 |
|---|
| 146 | + | treatments, and diagnostic studies;136 |
|---|
| 147 | + | (ii) The authority to request, receive, and sign for professional samples and to137 |
|---|
| 148 | + | distribute professional samples to patients. The office or facility at which the138 |
|---|
| 149 | + | healthcare professional identified in subparagraph (A) of this paragraph is working139 |
|---|
| 150 | + | shall maintain a general list of the professional samples approved by the delegating140 |
|---|
| 151 | + | physician for request, receipt, and distribution by the healthcare professional141 |
|---|
| 152 | + | identified in subparagraph (A) of this paragraph as well as a complete list of the142 |
|---|
| 153 | + | specific number and dosage of each professional sample and medication voucher143 |
|---|
| 154 | + | received. Professional samples that are distributed by a healthcare professional144 |
|---|
| 155 | + | - 6 - 25 LC 52 0844S |
|---|
| 156 | + | identified in subparagraph (A) of this paragraph shall be so noted in the patient's145 |
|---|
| 157 | + | medical record. In addition to the requirements of this Code section, all professional146 |
|---|
| 158 | + | samples shall be maintained as required by applicable state and federal laws and147 |
|---|
| 159 | + | regulations; and148 |
|---|
| 160 | + | (iii) The authority to sign, certify, and endorse all documents relating to healthcare149 |
|---|
| 161 | + | provided to a patient within his or her scope of authorized practice, including, but not150 |
|---|
| 162 | + | limited to, documents relating to physical examination forms of all state agencies and151 |
|---|
| 163 | + | verification and evaluation forms of the Department of Human Services, the State152 |
|---|
| 164 | + | Board of Education, local boards of education, the Department of Community Health,153 |
|---|
| 165 | + | and the Department of Corrections; provided, however, that a healthcare professional154 |
|---|
| 166 | + | identified in subparagraph (A) of this paragraph shall not have the authority to assign155 |
|---|
| 167 | + | a percentage of a disability rating.156 |
|---|
| 168 | + | (1.1) Healthcare professionals identified in subparagraph (A) of this paragraph must157 |
|---|
| 169 | + | paragraph (1) of this subsection shall complete biennial continuing education regarding158 |
|---|
| 170 | + | the recognition and documentation of the causes of death and appropriate execution of159 |
|---|
| 171 | + | death certificates, as approved by the board for a physician assistant as identified in160 |
|---|
| 172 | + | division (b)(1)(A)(i) of this Code section or by the Board of Nursing for a healthcare161 |
|---|
| 173 | + | professional identified in division (b)(1)(A)(ii) of this Code section."162 |
|---|
| 174 | + | SECTION 7.163 |
|---|
| 175 | + | Said title is further amended in Code Section 43-34-103, relating to application for licensure164 |
|---|
| 176 | + | as a physician assistant, authorized delegated authority, and prohibited acts, by adding a new165 |
|---|
| 177 | + | subsection to read as follows:166 |
|---|
| 178 | + | "(m) In addition to and without limiting the authority granted by Code Section 43-34-23,167 |
|---|
| 179 | + | a physician may delegate to a physician assistant, in accordance with a job description, the168 |
|---|
| 180 | + | authority to order home healthcare services to a patient."169 |
|---|
| 181 | + | - 7 - 25 LC 52 0844S |
|---|
| 182 | + | SECTION 8.170 |
|---|
| 183 | + | Title 48 of the Official Code of Georgia Annotated, relating to revenue and taxation, is171 |
|---|
| 184 | + | amended by revising paragraph (1) of subsection (a) of Code Section 48-7-29.2, relating to172 |
|---|
| 185 | + | tax credits for qualified caregiving expenses, as follows:173 |
|---|
| 186 | + | "(1) 'Qualified caregiving expenses' means payments by the taxpayer for home health174 |
|---|
| 187 | + | agency services, personal care services, personal care attendant services, homemaker175 |
|---|
| 188 | + | services, adult day care, respite care, or healthcare equipment and supplies which176 |
|---|
| 189 | + | equipment and supplies have been determined to be medically necessary by a physician177 |
|---|
| 190 | + | or a physician assistant acting pursuant to the authority of Code Section 43-34-103, which178 |
|---|
| 191 | + | services, care, or equipment and supplies are:179 |
|---|
| 192 | + | (A) Provided to the qualifying family member; and180 |
|---|
| 193 | + | (B) Purchased or obtained from an organization or individual not related to the181 |
|---|
| 194 | + | taxpayer or the qualifying family member."182 |
|---|
| 195 | + | SECTION 9.183 |
|---|
| 196 | + | All laws and parts of laws in conflict with this Act are repealed.184 |
|---|
| 197 | + | - 8 - |
|---|