TITLE 54.1. PROFESSIONS AND OCCUPATIONS.

§ 54.1-111 amended.
Department of Professional and Occupational Regulation and the Department of Health Professions; authority to recover civil penalties for certain violations. Authorizes the Departments of Professional and Occupational Regulation (DPOR) and the Department of Health Professions (DHP) to enforce the licensure and regulatory provisions of Title 54.1 through instituting proceeds in general district courts or circuit courts to recover civil penalties. The bill provides that the civil penalty must be at least $200 but no more than $1,000 per violation, with each unlawful act constituting a separate violation; but in no event can the civil penalties against any one person, partnership, corporation or other entity exceed $10,000 per year. HB 2142; CH. 544.

§§ 54.1-202, 54.1-300, 54.1-4400 through 54.1-4422, and 54.1-2000 through 54.1-2008. See § 2.1-1.5; SB 1080.

§§ 2.1-1.6, 2.1-20.4, 9-6.25:2, 54.1-300, 54.1-500, 54.1-500.1, 54.1-501, and 54.1-516 amended; §§ 54.1-517.1 and 54.1-517.2 added.
Department of Professional and Occupational Regulation; residential home inspectors. Provides for the voluntary certification of residential home inspectors by the Department of Professional and Occupational Regulation through the Board for Asbestos, Lead and Home Inspectors. Under the bill, no person may provide a certified home inspection or hold himself out as a, or use the title of, "certified home inspector," unless certified by the Board. HB 2174; CH. 723.

§ 54.1-2003 amended.
Board of Accountancy; educational requirements for CPA certificate. Corrects the name of the National Business College of Virginia to the National College of Business and Technology. HB 2757; CH. 339.
§ 54.1-2100. See § 13.1-1002; HB 2235.

§§ 54.1-2700 and 54.1-2706 amended; §§ 54.1-2709.1 through 54.1-2709.4 added.
Practice of dentistry. Defines "dentistry," according to current ADA definitions, as the evaluation, diagnosis, prevention, and treatment, through surgical, nonsurgical, or related procedures, of diseases, disorders, and conditions of the oral cavity and the maxillofacial, adjacent and associated structures, and their impact on the human body. The Board of Dentistry, with the assistance and advice of an advisory committee comprised of three members selected by the Medical Society of Virginia and three members selected by the Virginia Society of Oral and Maxillofacial Surgeons, is directed to promulgate regulations establishing criteria for certification of oral and maxillofacial surgeons to perform certain procedures within the definition of dentistry that are not for the prevention and treatment of disorders, diseases, lesions and malpositions of the human teeth, alveolar process, maxilla, mandible, or adjacent tissues, or any necessary related procedures or are not provided incident to a head or facial trauma sustained by the patient. The Board's regulations must address patient safety; identification and categorization of approved procedures; and application process for certification to perform such procedures; and the minimum education, training, and experience for such certification. The Board is directed to take due consideration of the education, training, and experience requirements adopted by the American Dental Association Council on Dental Education or the Commission on Dental Accreditation and to require review of all complaints arising out of performance of the defined procedures jointly by a physician and an oral and maxillofacial surgeon. Receipt of reports of complaints by the Board of Dentistry against oral and maxillofacial surgeons shall be shared with the Board of Medicine which shall maintain the confidentiality of such complaint. The bill also adds to the criteria for disciplinary actions, practicing outside the scope of the dentist's or dental hygienist's education, training and experience and the performance of a procedure that is subject to certification without such certification. Oral and maxillofacial surgeons must also register annually with the Board of Dentistry and submit certain information, similar to that required of physicians, that is subject to consumer review. Enactment clauses delay the effective date of the certification until 60 days after the effective date of the board's regulations to implement these requirements and such regulations will be promulgated to be effective within 280 days of enactment. SB 806; CH. 662 (effective-see bill).

§§ 54.1-2900 and 54.1-2901 amended.
Medicine and healing arts; auricular acupuncture. Clarifies that acupuncture detoxification specialists who are certified by the National Acupuncture Detoxification Association or an equivalent certifying body, and who are currently exempt from licensure when they are supervised by a National Acupuncture Detoxification Association certified licensed physician acupuncturist or licensed acupuncturist, may perform auricular acupuncture in the context of a chemical dependency treatment program for patients eligible for federal, state or local public funds. HB 1588; CH. 533.

§ 54.1-2901 amended.
Health professions; medical assistants. Revises the authority of licensed or certified practitioners of the healing arts to delegate to supervised employees those nondiscretionary activities and functions that do not require the exercise of professional judgment for their performance and are usually or customarily delegated to other persons by practitioners of the healing arts, if the relevant practitioner of the healing arts is authorized to perform the delegated duties and assumes responsibility for such activities or functions. This bill removes the requirement that the unregulated person be employed by a professional licensed or certified by the Board of Medicine; the requirement that the unregulated person be supervised by the responsible licensed or certified professional remains. HB 1694; CH. 237/SB 849; CH. 235.

§ 54.1-2910.1 amended.
Health professions; data required. Requires physicians of medicine or osteopathy and all podiatrists to report any convictions for felonies to the Board of Medicine for inclusion in the health care data available to consumers upon request. The data required currently includes any disciplinary action by the Board against the practitioner as well as any paid claims or settlements. All practitioners of medicine, osteopathy and all podiatrists are required to report. HB 2153; CH. 199.

§§ 54.1-2911 and 54.1-3605 amended; §§ 54.1-2940 and 54.1-3608 repealed.
Health professions; regulation of clinical psychologists. Clarifies that the Board of Psychology has the power to set licensure standards for clinical psychologists and removes the clinical psychologist from the Board of Medicine. Formerly, clinical psychologists were regulated by the Board of Medicine. The physician members of the Board of Medicine are appointed from each congressional district; the Board also includes one osteopathic physician, one podiatrist, one chiropractor, and two citizen members. This bill also increases the Board's membership by two citizen members and notes that no two citizen members can reside in the same congressional district. HB 2139; CH. 198.

§§ 54.1-2911 and 54.1-3605 amended; §§ 54.1-2940 and 54.1-3608 repealed.
Health professions; regulation of clinical psychologists. Clarifies that the Board of Psychology has the power to set licensure standards for clinical psychologists and removes the clinical psychologist from the Board of Medicine. Formerly, clinical psychologists were regulated by the Board of Medicine after being licensed by the Board of Psychology. The physician members of the Board of Medicine are appointed from each congressional district; the Board also includes one osteopathic physician, one podiatrist, one chiropractor, and two citizen members. This bill also increases the Board's membership by two citizen members and notes that no two citizen members can reside in the same congressional district. SB 1059; CH. 186.

§ 54.1-2914 amended.
Health Professions; unprofessional conduct. Removes from the Board of Medicine the vestiges of control of unprofessional conduct of physical therapists and physical therapy assistants. When the Board of Physical Therapy was constituted in the 2000 Session, this language was transferred to the new Board but inadvertently left in the provisions of the Board of Medicine. HB 1689; CH. 268.

§§ 54.1-2914, 54.1-3473, 54.1-3474, 54.1-3480, 54.1-3482, and 54.1-3483 amended.
Physical therapy. Provides limited direct access to physical therapy. This bill authorizes physical therapists who have actively practiced upon the referral and direction of a licensed doctor of medicine, osteopathy, chiropractic, podiatry or dental surgery for three years, to treat a patient for 14 days without referral if the patient has previously been referred for physical therapy within two years, the physical therapy is being provided for the same injury, disease or condition as indicated in the referral, and the physical therapist notifies the practitioner identified by the patient no later than three days after treatment begins. Treatment for more than 14 days will require a referral. Other limited exceptions are provided for a one-time evaluation of a patient who has not been referred, services provided to student athletes during a game or other athletic activity, employees for evaluation and consultation related to workplace ergonomics, special education students whose individualized education plans indicate a need for physical therapy, the public for wellness, fitness, and health screenings, the public for the purpose of health promotion and education, and the public for the purpose of prevention of impairments, functional limitations, and disabilities. This bill also clarifies the definition of "practice of physical therapy" and notes that this practice does not include medical diagnosis of disease or injury. Invasive procedures are authorized when performed under the direction and referral of a licensed doctor of medicine, podiatry, or dental surgery. The physical therapist is also required to immediately refer any patient whose medical condition is determined to be beyond the physical therapist's scope of practice. Technical amendments are made to the Board of Medicine's and the Board of Physical Therapy's statutes to correct some inadvertent errors made when the Board of Physical Therapy was established last year. In addition, the Board is required to establish requirements to ensure continuing competency and to promulgate, pursuant to a second enactment clause, emergency regulations. SB 1367; CH. 858.

§§ 9-6.14:4.1, 54.1-2952.1, 54.1-3301, 54.1-3303, and 54.1-3422 amended.
Prescriptive authority of physician assistants. Expands the prescriptive authority of physician assistants as follows: Schedules V and VI controlled substances on and after July 1, 2001; and Schedules IV through VI on and after January 1, 2003. Currently, physician assistants' prescriptive authority is limited to Schedule VI drugs. The bill also removes the Board of Medicine's responsibility for developing a formulary for the specific drugs that physician assistants are allowed to prescribe and requires the supervising physician or podiatrist to develop a written agreement with each physician assistant under his supervision listing the controlled substances the physician assistant is or is not authorized to prescribe. In addition to the requirement for periodic site visits by physicians or podiatrists who supervise physician assistants that is currently in the law, the regulations of the Board of Medicine will include requirements for continued physician assistant competency, e.g., continuing education, testing, and any other requirement. The regulations must also address the need to promote ethical practice, an appropriate standard of care, patient safety, the use of new pharmaceuticals, and appropriate communication with patients. A second enactment clause requires the Joint Commission on Health Care, with the full cooperation of the Medical Society of Virginia, the Old Dominion Medical Society, the Board of Medicine, the Board of Pharmacy, and physician assistant associations, to study physician assistant prescriptive authority as provided in this act to determine the impact of the authority to prescribe Schedules IV through VI controlled substances and devices on patient care, provider relationships, third-party reimbursement, physician practices, and patient satisfaction with physician assistant treatment. A preliminary report will be submitted to the Senate Committee on Education and Health and the House Committee on Health, Welfare and Institutions by July 1, 2004, and a final report will be provided to the Governor and the 2005 General Assembly. HB 2318; CH. 465.

§§ 54.1-2957.5 and 54.1-2957.6 amended.
Department of Health Professions; athletic trainers. Clarifies the qualifications for membership on the Advisory Board on Athletic Training and the exceptions from certification as an athletic trainer. HB 2516; CH. 61.

§ 54.1-3001 amended.
Practice of nursing. Exempts, for no more than 90 days from the date of approval of an application submitted to the Board, any nurse who is a graduate of a foreign nursing school and has met the credential, language, and academic testing requirements of the Commission on Graduates of Foreign Nursing Schools when such nurse is working as a nonsupervisory staff nurse in a licensed nursing home or certified nursing facility. During such 90 day period, such nurse must take and pass the licensing examination to remain eligible to practice nursing in Virginia; no exemption granted under this subdivision can be extended. A second enactment requires the Board of Nursing to promulgate emergency regulations. HB 2245; CH. 244 (effective 3/14/01)/SB 892; CH. 251 (effective 3/15/01).

§ 54.1-3011.2. See § 32.1-122.6; SB 1139.

§ 54.1-3025.1 added.
Health professions; certified nurse aides. Requires the Board of Nursing to develop and promulgate regulations to establish a career advancement certification for certified nurse aides that will indicate enhanced competence in patient care tasks and enable certified nurse aides to expand the scope of the responsibilities and duties delegated to them. Upon successful completion of required educational and training standards, an advanced certificate will be awarded. The programs will have to be approved by the Board. An advanced certificate must be renewed biennially upon payment of the specified fee and submission of proof of compliance with the Board's requirements. HB 1778; CH. 448.

§ 54.1-3101 amended.
Board of Nursing Home Administrators. Revises the membership of the seven-member Board of Nursing Home Administrators by increasing the number of nursing home administrators from three to four, reducing the number of members who are from professions and institutions concerned with the care and treatment of chronically ill and elderly patients from four to two, and adding one member who is a resident of a nursing home or a family member of a resident of a nursing home. Appointments to the Board are made by the Governor for four-year terms. HB 2430; CH. 554.

§ 54.1-3101 amended.
Board of Nursing Home Administrators. Revises the membership of the Board to include one resident of a nursing home or a family member of a resident of a nursing home by reducing the number of members who are from professions and institutions concerned with the care and treatment of chronically ill and elderly patients from four to two and also increasing to four those members who are licensed nursing home administrators. Appointments to the Board are made by the Governor for four-year terms. SB 1290; CH. 527.

§ 54.1-3300 amended; §§ 54.1-3320, 54.1-3321, and 54.1-3322 added.
Pharmacy. Sets forth the definitions, restrictions, and requirements for registration of pharmacy technicians. This bill distinguishes between pharmacy interns and pharmacy technicians and clarifies the duties that may be performed only by a pharmacist or a pharmacy intern while engaged in obtaining the practical experience required for licensure as a pharmacist. "Supervision" is defined as the direction and control by a pharmacist who is physically present in the pharmacy or in the facility in which the pharmacy is located and available for immediate oral communication regarding the activities of a pharmacy intern or a pharmacy technician. Pharmacists are authorized to determine the maximum number of pharmacy technicians to supervise; however, no pharmacist can supervise more than four pharmacy technicians at one time. A second enactment provides a modified grandfather clause by not requiring registration of pharmacy technicians until six months after the effective date of the Board of Pharmacy's final regulations. The Board must adopt final regulations for the registration of pharmacy technicians by July 1, 2003. HB 1826; CH. 317.

§ 54.1-3422 amended.
Drug Control Act; registration certificates. Adds optometrists and nurses to the list of practitioners who may have prescriptive authority and, thus, are not required to obtain a controlled substances registration certificate for the manufacture, distribution or dispensing of drugs. Persons such as medical researchers who may use controlled substances in their work and are not otherwise authorized to prescribe, manufacture, distribute, or dispense must still obtain controlled substances registration certificates. HB 2093; CH. 243.

§ 54.1-3480.1 added.
Health professions; continuing education for physical therapists. Requires, as a prerequisite to license renewal or reinstatement, that all licensed physical therapists complete biennial continuing education courses as approved by the Board. The Board must prescribe criteria for approving the courses and credit hour requirements. The Board is authorized to approve alternative courses upon timely application of any licensee. These education requirements must be certified to the Board and must be submitted by each physical therapist at the time he applies for renewal or reinstatement of the license. HB 1722; CH. 315.

§§ 8.01-581.13, 38.2-3412.1, 54.1-3500, 54.1-3505, and 54.1-3507 amended; §§ 54.1-3507.1, 54.1-3507.2, 54.1-3507.3, and 54.1-3509 added.
Health professions; substance abuse counseling assistants. Provides for an additional category of certification for substance abuse counseling assistants and delineates the difference in the scope of duties between a substance abuse counselor and a substance abuse counseling assistant. The bill also recognizes the name change of one of the nationally recognized associations from the National Association of Alcoholism and Drug Abuse Counselors to NAADAC: the Association for Addiction Professionals. The bill adds "certified substance abuse counseling assistant" to the list of individuals who may render services and receive reimbursement from insurance. The bill also provides for the continued certification of those persons who were certified prior to July 1, 2001, or who had registered their supervisory contracts or filed applications for certification with the Board prior to that date. Also, the bill provides that any application for certification filed after July 1, 2001, but before the effective date of the new regulations, for a person who meets the requirements in effect prior to July 1, 2001, shall be operative until the new regulations are in effect, when such person shall be deemed certified at the appropriate level under the new regulations. Additionally, this bill directs the Board to approve as a supervisor for individuals seeking certification as a counselor or assistant any person who has been approved prior to July 1, 2001. HB 2095; CH. 460.
§ 54.1-3510. See § 22.1-129; SB 1055.

§ 54.1-3910.1 added.
Enforcement, etc., of costs imposed by the Virginia State Bar Disciplinary Board. Allows orders of the Board regarding unpaid costs to be recorded, enforced, and satisfied as judgments. HB 2397; CH. 225.

§ 54.1-3932 amended.
Attorney's lien for fees. Provides that any person having or claiming a cause of action for annulment or divorce may contract with any attorney for legal services and that the attorney shall have a lien upon the cause of action as security for his fees for any services rendered in relation to the cause of action. The attorney's claim may not be exercised until the divorce judgment is final and the court may exclude spousal and child support from the lien. HB 1696; CH. 495.

§§ 54.1-4009 and 54.1-4010 amended.
Professions and occupations; pawnbrokers. Authorizes pawnbrokers to maintain required records electronically. Upon request by a law-enforcement official, pawnbrokers are required to make such electronic records available. The bill also allows a pawnbroker to charge a service fee for making daily electronic reports to law-enforcement officials and further provides that the fee shall not exceed five percent of the amount loaned or three dollars, whichever is less. Under the bill, violation of the service fee provisions shall constitute a Class 4 misdemeanor. The Department of State Police is directed to regulations for the uniform reporting of required information. HB 1591; CH. 401.

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