Bill Name: Senate Bill 23-083 (SB 23-083)

Primary Sponsor: Senators Faith Winter and Cleave Simpson

Status: 2/11/2023 Passed Senate, Introduced In House - Assigned to Public & Behavioral Health & Human Services

AmSpa’s Take: Reducing the amount of regulation and paperwork with which advanced practitioners such as physician assistants (PAs) and nurse practitioners (NPs) need to comply to practice frees up time and resources that can be better spent seeing patients, improving skills and developing their practices.

Outlook: This bill is in the first steps of the process, but, based on the sponsor’s past records, it has a higher likelihood of passing. Some of the sponsors hold leadership positions on the committee where this bill was assigned.

Analysis: Currently, Colorado physician assistants (PAs) practice under the supervision of a physician. This supervising physician delegates the health care tasks that the PA may perform. The relationship is formalized using a written supervision agreement, which lays out what tasks and medications are authorized. Under SB 23-083, PAs would instead work in collaboration with a physician or employer.

This new collaborative relationship, like the supervisory one, requires a written agreement between the physician or employer and PA. The collaboration agreement must include:

1. The PA’s name, license number and primary practice location;
2. The signatures of both the PA and physician or employer representative;
3. A general description of the process for collaboration, which may include decisions made by the physician or employer and credentialing requirements for the practice location;
4. A description of the performance evaluation process; and
5. Any additional requirements placed by the physician or employer as to levels or oversight or limitations on PA autonomous judgement.

SB 23-083 also requires that PAs with fewer than 3,000 hours of clinical experiences would need to:

1. Collaborate in person or through technology for the first 160 hours;
2. Define the expected area of practice, elements of support and consultation from the physician, and modes of communication; and
3. A performance evaluation and discussion with the PA after the first six months and again after 12 months, with additional reviews as defined by the physician or employer’s policies.

Once the PA has completed 3,000 hours of practice these additional requirements no longer apply.

SB 23-083 loosely defines “collaboration,” which is characterized as involving interaction, consultation, or referral to a physician or other appropriate health care member as indicated by the patient’s condition. PAs must also certify financial responsibility as a condition of licensure.

The majority of states allow nurse practitioners to practice independently. More recently, many states have been giving more freedom and autonomy to PAs, as well. SB 23-083 is squarely within this trend. If you would like additional information, to read the language of the bill, or to contact the sponsors or committee, you can find the information you need through this link.