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Reports of Success from Tallahassee to Bismarck
Although it is only May, 2009 has already been memorable in so many ways. State legislatures across the country are making 2009 a banner year by enacting improvements in laws that govern PA practice. Read on!
Legislation to repeal a chart co-signature requirement passed the Florida state legislature on April 28 without a single dissenting vote. Governor Crist is expected to sign the measure into law. An amendment to remove a chart co-signature requirement from Wisconsin regulations is nearing the final steps in the process.
Legislation to authorize controlled medication prescribing (Schedules III-V) has been passed by the state legislatures of Alabama and Missouri. The Alabama bill was signed on May 13; the Missouri bill also contains upgrades to the state's supervision requirements. Once the Missouri bill is signed, 48 states will authorize controlled medication prescriptive authority for PAs. (Florida and Kentucky do not yet authorize PAs to prescribe controlled drugs.)
Legislation to authorize Schedule II prescribing for Illinois PAs passed the legislature this week. North Dakota passed a Schedule II bill in March. Once the Illinois bill is signed by the state's new and improved governor (Governor Pat Quinn (D) - worse hair, better ethics) 37 states will include Schedule II medications in PA prescriptive authority. Earlier this session the Illinois General Assembly passed legislation adding the AAPA model disaster language to Illinois code.
Last summer AAPA state government staff reviewed laws in Hawaii that needed to be amended to add "physician assistant" to the definition of health care provider. Hawaii Academy leaders got busy, and report passage of SB 1142 on May 5. The bill includes PAs in the definition of "health care provider" in numerous sections of Hawaii law and also authorizes PAs to practice absent supervision in disasters and to order PT and OT.
In Indiana, lawmakers approved House Bill 1573, which made changes to streamline the licensing process for PAs. A new law in Georgia removes the dreaded "'s" from the title of the physician assistant profession and authorizes a PA to receive a license prior to establishing a relationship with a supervising physician.
And 30 state legislatures are still in session!
Federation of State Medical Boards Update
The Federation of State Medical Boards (FSMB) held its 97th (as in 97th!) annual meeting in Washington, D.C., at the end of April. Attendees learned about health care reform, maintenance of licensure (should continued board certification be required for physician license renewal?), regulation of medi-spas, appropriate treatment of pain, and assorted other topics.
Eight PAs were among the attendees; Noel Genova, PA-C, from Maine was a speaker.
Angst about PA regulation voiced at previous Federation meetings was notably absent this year. AAPA staff provided comments on a draft revision of the Federation's Essentials of Modern Medical Practice Act that contained archaic provisions in its PA section. The reference committee that heard the comments took the Academy's advice and referred the section of the Essentials that deals with PAs for further revision.
A Seat at the Table
Texas PA leaders are working on a bill to streamline prescribing and supervision requirements. As part of the process they have been improving their communication with the medical society. For the first time in over a decade a PA was invited to attend a meeting of the medical society Council on Legislation. After her presentation on PA philosophy and the ideal relationship between physicians and PAs, she was invited to attend the medical society House of Delegates and was introduced by the Speaker; a first for PAs in Texas.
From the "No-Nonsense" State
Nebraska PAs are nearing success with a bill that will repeal archaic supervision requirements and simplify the licensure process. Among the revisions is removal of a requirement that licensed physicians send paperwork to the state when they decide to supervise a PA.
Some questioned this part of the bill - but not for long. The Department of Health and Human Services (DHHS) opined that the Department already has authority to discipline both physicians and PAs for practicing outside the standard of care or the law and additional credentialing of a licensed doctor was just not necessary. DHHS has the ability to limit specific physicians from supervising a PA through disciplinary action. Eliminating the step of credentialing physicians beyond an active unrestricted license is a cost and manpower savings issue for DHHS and facilitates the ability of a physician or hospital to add a PA to the staff. The Board of Medical Examiners has only restricted a physician's use of a PA twice in the last ten years. Both times this restriction could have been placed on the physician's license when the doctor was initially disciplined.
Seems like sound reasoning to us!
Quick Reminder: Conference is Nearly Here
There are many wonderful sessions and events at the AAPA Annual Conference. Here are dates, locations, and times for sessions of special interest to LW readers:
State Legislative Coordinators Meeting
Tuesday, May 26, 8:00 - 10:00 AM
San Diego Convention Center, Room 23C
New Development: California Assemblyman Nathan Fletcher will attend the session to discuss the state legislator's perspective and new issues in health legislation. Assemblyman Fletcher is Vice Chair of the Assembly Health Committee and author of California PA legislation.
Consortium of PA Representatives to State Regulatory Agencies Meeting
Tuesday, May 26, 10:00 AM- 12:00 Noon
San Diego Convention Center, Room 23C
Mapping Your Career - What the PA Who Takes a Break from Clinical Practice Needs to Know
Tuesday, May 26, 3:00 - 3:45 PM
San Diego Convention Center, Room 32AB
PA in Trouble - How to Avoid a Letter from the State Medical Board
Tuesday, May 26, 4:00 - 4:45 PM
San Diego Convention Center, Room 32AB
Puerto Rico Summit
Wednesday, May 27, 2:00 - 4:00 PM
San Diego Marriott Hotel & Marina, Cardiff room
PAs and Practice Ownership - The Good, the Bad, and the Details
Wednesday, May 27, 4:00 - 4:45 PM
San Diego Convention Center, Room 30A-E
Hope to see you in San Diego!
Legislative Watch is a monthly state government newsletter written for PA leaders, regulators, and educators. Newsletter editors may reprint items from LW if they credit the source as "The American Academy of Physician Assistants' Legislative Watch." LW is written by Ann Davis, PA-C, AAPA director of state government advocacy and outreach ( This e-mail address is being protected from spambots. You need JavaScript enabled to view it ; 703-836-2272 ext 3201), who wants you to know two things about going to San Diego: even though it is in Southern California, it is chillier than you might think. Pack a sweater. And, don't worry as you are landing. There really is an airport in the middle of those tall buildings!
