PROPOSED RULEMAKING
STATE BOARD OF MEDICINE
[49 PA. CODE CH. 16]
Volunteer License
[27 Pa.B. 2947] The State Board of Medicine (Board) proposes to amend § 16.11 (relating to licenses, certificates and registrations) and add § 16.18 (relating to volunteer license) to read as set forth in Annex A.
A. Effective Date
The proposed amendments will be effective upon publication of final-form regulations in the Pennsylvania Bulletin.
B. Statutory Authority
The Board is required to promulgate regulations governing the volunteer license category by section 5 of the Volunteer Health Services Act (act) (35 P. S. § 449.5) which became effective February 3, 1997. Section 5 of the act mandates regulations governing: (1) qualifications for placing an active license on volunteer status; (2) criteria under which a retired licensee who has allowed a license to become inactive may obtain a volunteer license; and (3) procedures under which a volunteer license holder may return to active status. The Board is authorized to adopt regulations necessary to the administration of its enabling statute under section 8 of the Medical Practice Act of 1985 (63 P. S. § 422.8).
C. Background and Purpose
The purpose of the proposal is to implement the act. The act is intended to increase the availability of primary health services by establishing a procedure for physicians and other health care practitioners who have retired from active practice to provide professional services as volunteers in approved clinics. Primary health services are defined in the act as including services such as regular checkups, immunizations, school physicals, health education, prenatal and obstetrical care, early periodic screening and diagnostic testing, and health education.
An approved clinic is defined in the act as an organized community-based clinic which offers services to: (1) individuals and families who cannot pay for their care; (2) Medical Assistance clients; or (3) residents of medically underserved or health professionals shortage areas. Examples of these clinics include Federal or State qualified and approved health centers or nonprofit community based clinics.
The act permits persons who have been issued a license by the State Boards of Medicine, Osteopathic Medicine, Dentistry, Podiatry, Nursing, Optometry and Chiropractic to practice a component of the healing arts to apply for volunteer status. A volunteer license will be issued to a retired individual who documents to the satisfaction of the Board that the individual will practice without remuneration in approved clinics.
The act exempts holders of a volunteer license from biennial renewal fees and, if applicable, professional liability coverage mandated by the Health Care Services Malpractice Act (40 P. S. § 1301.701) and section 6 of the Medical Practice Act (63 P. S. § 422.6). However, volunteer licenses will be subject to biennial renewal conditioned upon completion of any continuing education which the Board requires for biennial renewal generally.
D. Description of Amendments
The volunteer license category would be added to the licenses, certificates and registrations issued by the Board in § 16.11. Section 16.18 would provide the statutory references to the act, as well as the statutory basis for the volunteer license category. The Board has interpreted the act as permitting a volunteer license holder to practice exclusively in an organized community-based clinic without remuneration.
Under section 3 of the act (35 P. S. § 449.43), an active licensee must possess a current, active, unrestricted license to qualify for a volunteer license. Section 4 of the act permits a licensee to apply who retired with a license in good standing. The Board has interpreted this qualification to mean a license which at the time of the application is not subject to an outstanding disciplinary action such as revocation or suspension. The act's definition of an ''approved clinic'' is included in subsection (b)(3). The criteria for obtaining a volunteer license are set forth in § 16.18(b). Both active licensees and retired licensees, registrants and certificateholders with inactive licenses may receive a volunteer license in order to practice as a volunteer without remuneration in an approved clinic.
Procedures to apply for a volunteer license are set forth in § 16.18(b). Applicants would be requested to provide basic license information. In addition, the applicant would be requested to execute a verification that the applicant intends to practice exclusively within the scope of a volunteer license. Also, in order to provide proper enforcement of the limitation of the act, applicants will be required to file with the Board a letter of agreement from the clinic that the applicant will work in the clinic. Section 16.18(c) would make this notification a continuing obligation during the biennial period of the license.
Biennial renewal of the volunteer license would be provided for under § 16.18(e). A volunteer license is subject to biennial renewal. However, under the act, the applicant for biennial renewal is exempt from payment of the biennial renewal fee in § 16.13 (relating to license, certification, examination and registration fees) and professional liability insurance coverage under § 16.31 (relating to notification).
Section 16.18(f) provides for return to active, remunerative practice. A volunteer would be required to apply to the Board and meet the general reactivation requirements of § 16.15 (relating to biennial registration; inactive status and unregistered status).
Section 16.18(g) notifies the volunteer license holder that he continues to be subject to the disciplinary provisions of the Medical Practice Act of 1985 (63 P. S. §§ 422.1--422.45). In addition, § 16.18(g) proposes that a violation of the act or the regulations adopted thereunder may constitute independent grounds for discipline.
E. Compliance with Executive Order 1996-1
In accordance with the requirements of Executive Order 1996-1, in drafting and promulgating the proposed amendments the Board solicited input and suggestions from the regulated community by providing drafts to organizations and entities which represent the professionals and to nonprofit organizations who represent qualified providers of volunteer services.
F. Fiscal Impact and Paperwork Requirements
1. Commonwealth--The proposed amendments will create a new license for which no fee will be charged. As such, the expenses of the program will be borne as a part of the Board's overall operating expenses which are financed through biennial renewals of active licensees. Therefore, the administration and enforcement of a new license category may have a fiscal impact on overall Board costs. The net effect, however, is estimated to be minimal owing to the relatively small number of licensee population who will seek a volunteer license compared with the number of active licensees. Additional paperwork will be incurred by the Board and the private sector to generate and file application forms.
2. Political subdivisions--There will be no adverse fiscal impact or paperwork requirements imposed.
3. Private sector--The proposed amendments will have a positive fiscal impact on individual licensees who restrict their professional activities to volunteer work since these individuals are exempt from maintaining professional liability insurance required under the Health Care Services Malpractice Act (40 P. S. §§ 1301.101--1301.1006) and the biennial renewal fee for licensure. The proposed amendments should impose no additional fiscal or paperwork requirements.
G. Sunset Date
The Board continuously monitors its regulations. Therefore, no sunset date has been assigned.
H. Regulatory Review
Under section 5(a) of the Regulatory Review Act (71 P. S. § 745.5(a)), on June 6, 1997, the Board submitted a copy of these proposed amendments to the Independent Regulatory Review Commission (IRRC) and the Chairpersons of the House Professional Licensure Committee and the Senate Consumer Protection and Professional Licensure Committee. In addition to submitting the proposed amendments, the Board has provided IRRC and the Committees with a copy of a detailed Regulatory Analysis Form prepared by the Board in compliance with Executive Order 1996-1, ''Regulatory Review and Promulgation.'' A copy of this material is available to the public upon request.
If IRRC has objections to any portion of the proposed amendments, it will notify the Board within 30 days of the close of the public comment period. The notification shall specify the regulatory review criteria which have not been met by that portion. The Regulatory Review Act specifies detailed procedures for review, prior to final publication of the amendments, by the Board, the General Assembly and the Governor of objections raised.
I. Public Comment
Interested persons are invited to submit written comments, suggestions or objections regarding the proposed amendments to Gerald S. Smith, Board Counsel, State Board of Medicine, P. O. Box 2649, 116 Pine Street, Harrisburg, PA 17105-2649, within 30 days of publicationof this proposed rulemaking. Please reference No. 16A-494 (Volunteer License), when submitting comments.
DANIEL B. KIMBALL, Jr. M.D.,
ChairpersonFiscal Note: 16A-494. No fiscal impact; (8) recommends adoption.
Annex A
TITLE 49. PROFESSIONAL AND VOCATIONAL STANDARDS
PART I. DEPARTMENT OF STATE
Subpart A. PROFESSIONAL AND OCCUPATIONAL AFFAIRS
CHAPTER 16. STATE BOARD OF MEDICINE--GENERAL PROVISIONS
Subchapter B. GENERAL LICENSE, CERTIFICATION AND REGISTRATION PROVISIONS § 16.11. Licenses, certificates and registrations.
* * * * * (d) The Board will issue a volunteer license to qualified licensees, certificateholders and registrants.
§ 16.18. Volunteer license.
(a) Purpose and scope. The following subsections implement the Volunteer Health Services Act (35 P. S. §§ 449.41--449.50) and provide for the issuance of a volunteer license to a qualified Board-regulated practitioner as defined in section 2 of the act (63 P. S. § 422.2), who retires from active practice and seeks to provide professional services as a volunteer. A volunteer license authorizes the holder to practice only in an organized community-based clinic and without remuneration.
(b) License. A volunteer license may be issued to a Board-regulated practitioner of the Board who meets one of the following:
(1) Holds a currently renewed, active, unrestricted license, registration or certificate in this Commonwealth and retires from active practice at the time the applicant applies for a volunteer license.
(2) Retires from active practice in this Commonwealth in possession of an unrestricted license which was allowed to lapse by not renewing it. A retired licensee, registrant or certificateholder shall meet the requirements of the act or the regulations pertaining to continued education or continued competency to be eligible for renewal. As used in this section, an ''unrestricted license, certification or registration'' is a license which is not restricted or limited by order of the Board under its disciplinary power.
(3) Documents to the satisfaction of the Board that the applicant will practice without personal remuneration in approved clinics. As used in this section, an ''approved clinic'' is an organized community-based clinic offering primary health care services to individuals and families who cannot pay for their care, to Medical Assistance clients, or to residents of medically underserved areas or health professionals shortage areas. The term may include a State health center, nonprofit community-based clinic and Federally qualified health center, as designated by Federal rulemaking or as approved by the Department of Health or the Department of Public Welfare.
(c) Applications. An applicant for a volunteer license shall complete an application obtained from the Board. In addition to providing information requested by the Board, the applicant shall provide:
(1) An executed verification on forms provided by the Board certifying that the applicant intends to practice exclusively as follows:
(i) Without personal remuneration for professional services.
(ii) In an organized community-based clinic offering primary health care services to one or more of the following:
(A) Individuals and families who cannot pay for their care.
(B) Medical assistance clients.
(C) Residents of medically underserved areas or health professional shortage areas.
(2) A letter signed by the director or chief operating officer of the community-based clinic that the applicant has been authorized to provide volunteer services in the named clinic by the governing body or responsible officer of the clinic.
(d) Validity of license. A volunteer license shall be valid for the biennial period for which it is issued, subject to biennial renewal. During each biennial renewal period, the volunteer license holder shall notify the Board of any change in clinic or volunteer status within 30 days of the date of a change, or at the time of renewal, whichever occurs first.
(e) Renewal of license. A volunteer license shall be renewed biennially on forms provided by the Board. The applicant shall be exempt from payment of the biennial renewal fee of § 16.13 (relating to licensure, certification, examination and registration fees), and shall be exempt from the requirements with regard to the maintenance of liability insurance coverage under section 701 of the Health Care Services Malpractice Act (40 P. S. § 1301.701) and § 16.31 (relating to notification).
(f) Return to active practice. A volunteer license holder who desires to return to active practice shall notify the Board and apply for biennial registration on forms provided by the Board.
(g) Disciplinary provisions. A volunteer license holder shall be subject to the disciplinary provisions of the act and this chapter. Failure of the licensee to comply with the Volunteer Health Services Act (35 P. S. §§ 449.41--449.50) or this section may also constitute grounds for disciplinary action.
[Pa.B. Doc. No. 97-978. Filed for public inspection June 20, 1997, 9:00 a.m.]
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