DEPARTMENT OF TRANSPORTATION [67 PA. CODE CHS. 71, 75 AND 83] Licensing [27 Pa.B. 4439] The Department of Transportation (Department), Bureau of Driver Licensing, under the authority contained in 75 Pa.C.S. §§ 1508, 1508.1, 1509 and 6103, proposes to amend Chapters 71, 75 and 83 (relating to school bus drivers; drivers license examination; and physical and mental criteria, including vision standards relating to the licensing of drivers) to read as set forth in Annex A.
Purpose of these Chapters
The purpose of Chapter 71 is to provide rules regarding the course of instruction and physical examination for school bus drivers as required by 75 Pa.C.S. 1509 (relating to qualifications for school bus driver endorsement).
The purpose of Chapter 75 (relating to Driver's License Examination) is to provide standards and procedures for the issuance, renewal and replacement of photographic driver's licenses under 75 Pa.C.S. 1510(a) (relating to issuance and content of driver's license).
The purpose of Chapter 83 is to provide rules regarding the physical and mental criteria used by physicians in conducting physical examinations of applicants for learner's permits and driver's licenses and by physicians and other persons authorized to diagnose and treat disorders and disabilities delineated in this chapter in determining whether a person examined by the provider should be reported to the Department as having a disorder affecting the ability of the person to drive safely.
Purpose of these Proposed Amendments
The purpose of these amendments is to amend Chapters 71, 75 and 83, consistent with the provisions of 75 Pa.C.S. § 1508.1 (relating to physical examinations), to permit physician assistants and certified registered nurse practitioners to conduct the physical examinations required for the issuance of a driver's license and a school bus driver endorsement. Under 75 Pa.C.S. 1508(a) (relating to examination of applicant for driver's license), every applicant for a driver license shall be examined for the type or class of vehicles that the applicant desires to operate. The examination includes a physical examination, a screening test of the applicant's eyesight and a test of the applicant's ability to read and understand official traffic-control devices, knowledge of safe driving practices and the traffic laws of the Commonwealth. Further, the applicant must provide an actual demonstration of the applicant's ability to exercise ordinary and reasonable control in the operation of a motor vehicle of the type or class for which the applicant desires to drive.
Historically, in this Commonwealth, licensed physicians conducted the physical examinations of applicants for a driver's license and the school bus endorsement. However, health care systems have evolved and with the cost reducing methods of managed care, schools now have certified registered nurse practitioners (CRNP) rather than physicians and many doctors' offices now maintain only one physician and several physician assistants.
A CRNP is a registered nurse licensed in this Commonwealth by both the State Board of Nursing and the State Board of Medicine. Further, CRNPs are licensed in a particular clinical specialty area and perform acts of medical diagnosis or prescription of medical, therapeutic or corrective measures in collaboration with, and under the direction of, a physician licensed to practice medicine.
A physician assistant is a person certified by the State Board of Medicine to assist a physician or group of physicians in the provision of medical care and services and under the supervision and direction of the physician or group of physicians.
CRNPs and physician assistants have been performing physical examinations for several years, and under the authority contained in 49 CFR 390.5 and 391.43(a)(1), may perform the commercial driver physical examinations.
The following represents a summary of the significant amendments:
(1) Sections 71.2, 75.2 and 83.2 (all relating to definitions) are proposed to be amended to provide a definition for the terms ''certified registered nurse practitioner'' and ''physician assistants.'' These health care provider definitions were developed by the State Board of Medicine.
(2) Sections 71.3, 75.6 and 83.1 (relating to physical examinations; physical examination; and purpose) are proposed to be amended, consistent with 75 Pa.C.S. § 1508.1, to permit CRNPs and physician assistants to perform the physical examination of applicants as prescribed in these chapters.
(3) Section 71.3(c), certificate of school transportation physician, has been restyled as ''physical examination certificate'' since the certificate issued for the successful completion of the annual physical examination of a school bus driver may now be administered by a CRNP or a physician assistant, and thus issuance of the certificate is not limited to a school transportation physician.
(4) Section 75.6 is proposed to be amended by deleting the reference to other applicants or drivers who may not be physically or mentally qualified to be licensed to drive and thus are required to submit to a physical examination. The intent of this legislation and the regulatory amendments is to allow CRNPs and physician assistants to perform the preliminary physical examination required for initial licensing. The deleted phrase refers to individuals who are already licensed and that the Department has reason to believe are medically incompetent. Examination of these drivers is covered under Chapter 83 and must still be performed by a physician. These examinations are not related to the application for initial licensure and their inclusion here is confusing.
Persons and Entities Affected
These proposed amendments affect physicians, CRNPs and physician assistants who give the physical examination to applicants as prescribed in these chapters. Persons applying for their learner's permit or school bus endorsement are also affected.
Fiscal Impact
These proposed amendments will not impose any increased costs on private persons, State or local governments. These proposed amendments will not require any additional reports or other paperwork requirements.
Regulatory Review
Under section 5(a) of the Regulatory Review Act (71 P. S. 745.5(a)), on August 20, 1997, the Department submitted, a copy of the proposed amendments to the Independent Regulatory Review Commission (IRRC) and to the Chairpersons of the House and Senate Committees on Transportation. In addition to submitting these proposed amendments, the Department has provided IRRC and the Committees with a copy of a detailed Regulatory Analysis Form prepared by the Department in compliance with Executive Order 1996-1. A copy of this material is available to the public upon request. If IRRC has objections to any portions of the proposed amendments, it will notify the Department within 10 days of the close of the Committees' 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 regulations, by the Department, the General Assembly and the Governor of objections raised.
Sunset Date
The Department is not establishing a sunset date for these proposed amendments, since these proposed amendments are needed to administer provisions required under the 75 Pa.C.S. (relating to Vehicle Code). The Department will, however, continue to closely monitor these amendments for their effectiveness.
Public Comments
Interested persons are invited to submit written comments, suggestions or objections regarding the proposed amendments to Rebecca L. Bickley, Director, Bureau of Driver Licensing, Riverfront Office Center, 1101 South Front Street, 4th Floor, Harrisburg, PA 17104, within 30 days of publication of this notice in the Pennsylvania Bulletin.
Contact Person
The contact person is Lawrence Jones, Manager, Bureau of Driver Licensing, Department of Transportation, Riverfront Office Center, 1101 South Front Street, 4th Floor, Harrisburg, PA 17104, (717) 787-7740.
BRADLEY L. MALLORY,
SecretaryFiscal Note: 18-342. No fiscal impact; (8) recommends adoption.
Annex A TITLE 67. TRANSPORTATION PART I. DEPARTMENT OF TRANSPORTATION Subpart A. VEHICLE CODE PROVISIONS ARTICLE IV. LICENSING CHAPTER 71. SCHOOL BUS DRIVERS § 71.2. Definitions.
The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise:
CRNP--Certified registered nurse practitioner--A registered nurse licensed in this Commonwealth who is certified, by both the State Board of Nursing and the State Board of Medicine, in a particular clinical specialty area and who, while functioning in the expanded role as a professional nurse, performs acts of medical diagnosis or prescription of medical therapeutic or corrective measures in collaboration with and under the direction of a physician licensed to practice medicine in this Commonwealth.
* * * * * Physician assistant--A person certified by the State Board of Medicine to assist a physician or group of physicians in the provision of medical care and services and under the supervision and direction of the physician or group of physicians.
* * * * * § 71.3. Physical examination.
(a) General rule. A physical examination shall be given by a school transportation physician, a CRNP or a physician assistant:
* * * * * (c) [Certificate of school transportation physician] Physical examination certificate. The examining school transportation physician, CRNP or physician assistant shall issue a certificate, valid for the ensuing year, to every driver who passes a physical examination.
* * * * * CHAPTER 75. DRIVER'S LICENSE EXAMINATION Subchapter A. GENERAL PROVISIONS § 75.2. Definitions.
The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise:
* * * * * CRNP--Certified registered nurse practitioner--A registered nurse licensed in this Commonwealth who is certified, by both the State Board of Nursing and the State Board of Medicine, in a particular clinical specialty area and who, while functioning in the expanded role as a professional nurse, performs acts of medical diagnosis or prescription of medical therapeutic or corrective measures in collaboration with and under the direction of a physician licensed to practice medicine in this Commonwealth.
* * * * * Physician assistant--A person certified by the State Board of Medicine to assist a physician or group of physicians in the provision of medical care and services and under the supervision and direction of the physician or group of physicians.
* * * * * § 75.6. Physical examination.
An applicant for a driver's license, who has never been issued a driver's license in this Commonwealth or another state, [and every other applicant or driver the Department has reason to believe may not be physically or mentally qualified to be licensed to drive a motor vehicle] shall submit to a physical examination by a licensed physician, [who] or CRNP or a physician assistant. The licensed physician, or CRNP or physician assistant performing the examination shall report the findings of the physical examination to the Department on a physical examination certificate or form provided by the Department. The Department may request that the report be submitted on a special certificate relating to the alleged mental or physical disability of the applicant or licensee.
CHAPTER 83. PHYSICAL AND MENTAL CRITERIA, INCLUDING VISION STANDARDS RELATING TO THE LICENSING OF DRIVERS § 83.1. Purpose.
Section 1517(b) of the act (relating to medical advisory board) authorizes the Department to adopt physical and mental criteria, including vision standards, for licensing of drivers under Chapter 15 of the act (relating to licensing of drivers). These physical and mental criteria have been formulated by the Medical Advisory Board under the authority of sections 1517 and 1518 of the act (relating to medical advisory board; and reports on mental or physical disabilities or disorders). In addition to their use by the Department in connection with its responsibilities under Chapter 15 of the act, these physical and mental criteria shall be used by physicians, CRNPs and physician assistants in conducting physical examinations of applicants for learner's permits and driver's licenses and by physicians and other persons authorized to diagnose and treat disorders and disabilities covered in this chapter in determining whether a person examined by the provider should be reported to the Department as having a disorder affecting the ability of the person to drive safely.
§ 83.2. Definitions.
The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise:
* * * * * CRNP--Certified registered nurse practitioner--A registered nurse licensed in this Commonwealth who is certified, by both the State Board of Nursing and the State Board of Medicine, in a particular clinical specialty area and who, while functioning in the expanded role as a professional nurse, performs acts of medical diagnosis or prescription of medical therapeutic or corrective measures in collaboration with and under the direction of a physician licensed to practice medicine in this Commonwealth.
* * * * * Physician assistant--A person certified by the State Board of Medicine to assist a physician or group of physicians in the provision of medical care and services and under the supervision and direction of the physician or group of physicians.
* * * * * [Pa.B. Doc. No. 97-1393. Filed for public inspection August 29, 1997, 9:00 a.m.]
