New Bill Calls for Supervision Standards for Physician Assistants in Colorado

Posted By American Med Spa Association, Friday, January 18, 2019

A new bill introduced in Colorado would require physician assistants (PA) to receive mandated supervision and review time at certain points in their career. The bill filed in the House of Representatives by Representative Cutter and Landgraf and Senator Fields has been initially assigned to Health & Insurance for further discussion. You can review the text of House Bill 1095 (HB 1095) in full here
HB 1095 would require that PAs receive certain levels of supervision based on how long they have been practicing. PAs that have been licensed less than three years must practice at the same location as their supervising physician for their first 160 hours. The supervising physician must supervise the PA for a minimum of 40 hours during that period and can designate an alternate supervisor for the remaining time. At the conclusion of the PAs first 160 hours, the PA no longer needs to practice at the same site as the physician, but the physician must be available to the PA the whole time they are practicing via telecommunication. Furthermore, within a month after completing 160 hours of practice the physician must complete a performance assessment and a supervisory plan for the PA going forward. Once a PA has been practicing for more than three years their level of supervision is determined by their practice agreement with the supervising physician. 
The practice agreement can set conditions and restrictions on certain specific duties, procedures, and medication. The practice agreement must also contain: 1) a process for communication and decision making between the PA and physician, 2) provision for an alternate supervising physician if the primary physician isn’t available, 3) signatures of both the PA and supervising physician, 4) a provision for either person to terminate the agreement with at least 30 days’ notice. When the terms and conditions of the agreement change both parties must re-sign the updated agreement. If the parties decide to terminate the current agreement they would have 45 days to enter into a new agreement. 
For PA who already been practicing for three years and want to make a substantial change in their scope of practice or area must complete an additional period of required supervision: They must have on-site supervision for the first 80 hours with the supervising physician needing to provide 20 of those hours. After the initial 80 hours, the physician can be available via telecommunication and the PA must receive a performance assessment at 6 and 12 months. 
Finally, HB 1095 would also add two additional seats to the medical board to be filled by PAs and PAs with three years of practice would be liable for their own professional negligence. HB 1095 bucks the current national trend on PA supervision but is forward-looking by adding PA representation on the board. Most other states have been moving toward greater practice autonomy for PAs; in some states, PAs may practice without a written agreement and in many places where physician oversight is needed it is left up to the physician and PA to determine the appropriate levels of oversight and review. In that sense, HB 1095 is behind the general trend. 
We will be monitoring HB 1095 as it works its way through Colorado’s legislative process this year. If you would like to contact HB 1095’s sponsors, they can be reached via the legislature’s website.