Missouri PAs Celebrate Legislative Successes

Bills Increase Access for Patients and Reduce Administrative Barriers

July 18, 2018

Missouri PAs are celebrating the recent enactment of two important bills: S.B. 660 and S.B. 718. The new laws will increase access for patients in need of psychiatric care and treatment for opioid use disorder (OUD), and reduce administrative barriers faced by PAs serving rural and underserved populations.

S.B. 660 amends the definition of “mental health professional” to include psychiatric PAs, defined as licensed PAs with at least two years of experience practicing in psychiatry or PAs who have completed a postgraduate residency or fellowship for PAs in psychiatry. The new definition will apply to provisions of law covering alcohol and drug treatment as well as comprehensive psychiatric services. S.B. 660 was signed on June 1 and becomes effective on August 28.

S.B. 718, which was signed on July 6 and became effective immediately, makes changes related to PA supervision and practice, including:

• Changing the physician to PA ratio from three PAs per physician to up to six combined PAs, NPs, and assistant physicians (APs);
• Eliminating the statutory requirement that a PA practice within 50 miles of a supervising physician, instead allowing the Board of Registration for the Healing Arts to determine the geographic proximity requirement;
• Adding certified community behavioral clinics and federally-qualified health centers to a current exemption provided to rural health clinics which allows PAs practicing in these facilities to be subject to only the minimum federal supervision requirements;
• Expanding prescriptive authority for PAs who have the federal waiver to prescribe buprenorphine for medication-assisted treatment of OUD by allowing them to prescribe this medication for up to 30 days at a time (formerly limited to a 5-day supply); and,
• Creating a new program for physicians, PAs, NPs, and APs who treat OUD (the Improved Access to Treatment for Opioid Addictions, or IATOA program) which is meant to increase the number of clinicians who receive the federal buprenorphine waiver and increase patient access to medication-assisted treatment. PAs participating in the IATOA program would be subject to fewer supervision requirements and be empowered to engage in community and law enforcement functions as appropriate.

The Missouri Academy of PAs (MOAPA) was active in drafting and lobbying for both S.B. 660 and S.B. 718, and AAPA assisted MOAPA with research and grassroots e-mail alerts.

For more information on the new laws, or on PA practice in Missouri, contact Erika Miller, director, constituent organization outreach and advocacy.