As communities continue to recover from hurricanes, the aftermath of these storms serves as an important reminder about PA ability to lawfully practice during a disaster or an emergency. Although PAs have the medical proficiency and desire to care for those affected by natural and man-made disasters, state laws and regulations often prevent PAs from caring for those in need in these situations.
The first barrier to PAs rendering aid in a disaster or emergency is licensure. This problem typically occurs when a disaster or emergency occurs in one state, but a PA licensed in another state is called upon or wants to respond. This is typical when a disaster overwhelms a state’s health care resources or when a PA is traveling and happens upon an emergency.
The second impediment to PA-rendered assistance results from the fact that PAs must have an agreement with a physician to practice in every state. The physician with whom a PA collaborates or who supervises a PA in their home state may not be willing or able to do so when a PA is called upon to provide emergency field response or health care during a disaster.
While many state and territorial governments will normally declare a state of emergency to solve out-of-state licensure issues, additional attention to laws and regulations is needed to address collaboration/supervision requirements with a physician. Although many jurisdictions have Good Samaritan laws that offer legal protection to people who assist a person who is injured or in danger (the laws protect the “Good Samaritan” from liability if unintended consequences result from their assistance), these provisions are not enough to shield PAs from potential disciplinary action for failing to abide by collaboration/supervision requirements. This will no longer be an issue in states that pass Optimal Team Practice (OTP) legislation, authorizing PAs to practice without an agreement with a specific physician. However, until states achieve OTP, constituent organizations should revise their current state laws and rules to address this issue as soon as possible. Sample language is provided below (consistent with AAPA policy “collaboration” appears throughout; “supervision” language appears for states still using that term as applied to PA practice:
A PA licensed in this state or licensed or authorized to practice in any other U.S. jurisdiction or who is credentialed as a PA by a federal employer who is responding to a need for medical care created by an emergency or a state or local disaster (not to be defined as an emergency situation that occurs in the place of one’s employment) may render such care that they are able to provide without collaboration [ supervision], as it is defined in this section of law or with such collaboration [supervision] as is available.
Any physician who collaborates with a PA [supervises a PA] providing medical care in response to such an emergency or state or local disaster shall not be required to meet the requirements set forth in this section of law for a collaborating [supervising] physician.
No PA licensed in this state or licensed or authorized to practice in other states of the United States who voluntarily and gratuitously, and other than in the ordinary course of employment or practice, renders emergency medical assistance shall be liable for civil damages for any personal injuries that result from acts or omissions by those persons in rendering emergency care, which may constitute ordinary negligence. The immunity granted by this section shall not apply to acts or omissions constituting gross, willful or wanton negligence, or when the medical assistance is rendered at any hospital, physician’s office or other healthcare delivery entity where those services are normally rendered. No physician who collaborates with a PA [supervises a PA] voluntarily and gratuitously providing emergency care as described in this subsection shall be liable for civil damages for any personal injuries that result from acts or omissions by the PA rendering emergency care.
For assistance in addressing disaster provisions in your state contact your constituent organization outreach and advocacy team member.