2023 Senate Bill 175 - SD Legislature modify practice criteria for physician assistants.

An Act to modify practice criteria for physician assistants.

Be it enacted by the Legislature of the State of South Dakota:

Section 1. That   36-4A-1 be AMENDED:

36-4A-1. Terms as used in this chapter mean:

(1) "Board," the State Board of Medical and Osteopathic Examiners;

(2) "Collaboration," the communication of pertinent information to a physician or other licensed health care provider, together with a consultation, during which each provider contributes the provider's expertise to optimize the overall care delivered to a patient; and

(3) "Physician assistant," a health professional care provider who meets the qualifications defined set forth in this chapter and is licensed by the board;

(3) "Supervising physician," a doctor of medicine or doctor of osteopathy licensed by the board who supervises a physician assistant;

(4) "Supervision," the act of overseeing the activities of, and accepting responsibility for, the medical services rendered by a physician assistant.

Section 2. That   36-4A-1.1 be AMENDED:

36-4A-1.1. The term, practice collaborative agreement, as used in this chapter, means a written agreement authored and that:

(1) Is signed by the a physician assistant and the supervising physician. The practice agreement shall prescribe the delegated activities which the physician assistant may perform, consistent with    36-4A-26.1 and contain such other information as required by the board to describe the physician assistant's level of competence and the supervision provided by the physician who has not completed two thousand eighty practice hours and:

(a) A physician licensed in accordance with chapter 36-4; or

(b) A physician assistant who has completed four thousand practice hours;

(2) Contains the terms and conditions governing the collaboration of the providers; and

(3) Contains any other information required by the board, in accordance   36-4A-42.

A physician assistant for whom a collaborative agreement has been signed shall keep a copy of the practice agreement shall be kept on file at the physician assistant's primary practice site and be filed with and approved by the board prior to beginning practice. No physician assistant may practice without an approved practice agreementshall provide a copy to the board, upon request.

Section 3. That chapter 36-4A be amended with a NEW SECTION:

If a physician assistant has completed two thousand eighty practice hours, a collaborative agreement is no longer required in order for the physician assistant to practice:

(1) In the primary care areas of:

(a) Acute care;

(b) Family medicine;

(c) General internal medicine;

(d) General pediatrics; and

(e) Geriatrics; or

(2) In the emergency department of a rural health care facility.

Section 4. That chapter 36-4A be amended with a NEW SECTION:

Before a physician assistant may engage in any area of practice other than those listed in section 3 of this Act, the physician assistant shall, for each additional area, acquire two thousand eighty practice hours, under the terms of a collaborative agreement with the employing health care facility.

The agreement must also set forth the scope and manner of practice, as governed by the facility's credentialling and privileging requirements.

The facility shall keep a copy of the collaborative agreement on file and provide a copy to the board, upon request.

Section 5. That   36-4A-4 be AMENDED:

36-4A-4. Except as provided in      36-4A-5 and 36-4A-6, any person who practices as a physician assistant in this state, without a license issued by the board and a practice collaborative agreement approved by the board, if required by this chapter, is guilty of a Class 1 misdemeanor. Each violation shall be consideredis a separate offense.

Section 6. That chapter 36-4A be amended with a NEW SECTION:

A person who is not licensed under this chapter, but meets the qualifications for licensure under this chapter, may use the title of physician assistant, but may not practice as a physician assistant.

Section 7. That   36-4A-8 be AMENDED:

36-4A-8. The board may grant a license to an applicant who:

(1) Is of good moral character;

(2) Has successfully completed an educational program for physician assistants accredited by the Accreditation Review Commission on Education for the Physician Assistant or its successor agency, or, prior to 2001, either by the Committee on Allied Health Education and Accreditation or the Commission on Accreditation of Allied Health Education Program Programs;

(3) Has passed the Physician Assistant National Certification Certifying Examination administered by the National Committee on Education for Commission on Certification of Physician Assistants; and

(4) Has submitted verification that the physician assistant applicant is not subject to any disciplinary proceeding or pending complaint before any medical or other licensing board unless the board considers such proceedings or complaint and agrees to licensure; and

(5) Has completed a minimum of two thousand eighty practice hours or entered into a collaborative agreement, as provided for in this chapter.

Section 8. That   36-4A-8.1 be AMENDED:

36-4A-8.1. The board may issue a temporary license to an applicant who has successfully completed an approved program and has submitted evidence to the board that the applicant is a candidate accepted to write the examination required by    36-4A-8 or is awaiting the results of the first examination for which the applicant is eligible after graduation from an approved physician assistant program.

A temporary license may be issued only once and, except as otherwise provided in this section, is effective for a term of not moreperiod no longer than one hundred twenty days. A temporary license expires on the occurrence of the followingupon:

(1) Issuance of a regular license; or

(2) Failure to pass the licensing examination; or

(3) Expiration of the term for which the temporary license was issued.

The period of effectiveness set forth in this section for a temporary license does not apply to an applicant who has passed the licensing examination, has a collaborative agreement, and has an application for licensure pending before the board.

The period of effectiveness set forth in this section for a temporary license and the requirement for evidence of acceptance to write the examination required by   36-4A-8, upon graduation from an approved program, do not apply to an otherwise eligible applicant, if the examination is delayed or cancelled due to a natural disaster or gubernatorially declared emergency.

Section 9. That chapter 36-4A be amended with a NEW SECTION:

Upon application and payment of the fee established by the board in accordance with   36-4A-42, the board may issue a license to practice, as a physician assistant, to a person licensed under the laws of another state, territory, or country, if the requirements for licensure of that other state, territory, or country meet the requirements of this state and if the person is not otherwise disqualified under   36-4A-8.

Upon application and payment of the fee established by the board in accordance with   36-4A-42, the board may issue a temporary license to a person awaiting licensure by endorsement under this section. A temporary license issued under this section must state the period during which the license is effective. The period may not exceed one hundred twenty days, except in the case of a natural disaster or gubernatorially declared emergency.

Section 10. That   36-4A-20.1 be AMENDED:

36-4A-20.1. The board may not approve any practice agreement that includes abortion as a permitted procedureNothing in this chapter authorizes a physician assistant to effectuate an abortion.

Section 11. That   36-4A-26.1 be AMENDED:

36-4A-26.1. A physician assistant shall be considered an agent of the supervising physician in the performance of all practice-related activities. A physician assistant may provide those medical services that are delegated by the supervising physician pursuant to    36-4A-1.1 if the service is within the physician assistant's skills, forms a component of the physician's scope of practice, and is provided with supervisionmay provide any medical service for which the physician assistant has been prepared by education, training, and experience, including:

(1) Initial medical diagnosis and institution of a plan of therapy or referral;

(2) Prescribing and provision of drug samples or a limited supply of labeled medications, including controlled substances listed on Schedule II in chapter 34-20B for one period of not more than thirty days, for treatment of causative factors and symptoms. Medications or sample drugs provided to patients shall must be accompanied with written administration instructions and appropriate documentation shall must be entered in the patient's record. Physician assistants may request, receive, and sign for professional samples of drugs provided by the manufacturer;

(3) Responding to emergencies and the institution of emergency treatment measures, including the writing of a chemical or physical restraint order when if the patient may do personal harm or harm others;

(4) Completing and signing