New Law Changes Practice Relationships for PAs in Vermont

Posted By American Med Spa Association, Friday, June 19, 2020

A new bill in Vermont seeks to provide physician assistants (PAs) the ability to practice in collaboration with a physician. The bill is sponsored by Senator Debbie Ingram and is known as Senate Bill 128 (S 128). You can review the text of S 128 in full here; it has already passed  both the house and senate and awaits signature by Governor Phil Scott.
Currently, PAs in Vermont must practice under the supervision and delegation of a physician. PAs operate as the agent of the physician and may only perform services that are approved by the physician in a delegation agreement. S 128 would change the nature of this relationship to be one of collaboration between the PA and physicians.
Under S 128, PAs would enter written practice agreements with a physician or physicians who share their area of specialty. These agreements would contain a process for physician communication and periodic joint evaluation. The PA’s scope of practice would be limited to medical care that is within their education, training and experience, though the physician may list specific restrictions. The physician would not need to be physically present while the PA is practicing, but they must be available for communication at all times. PAs would be permitted to practice for 30 days without a practice agreement if their supervising physician retires or is no longer available. Additionally, in times of emergency, the PA may act without an agreement. S 128 would make PAs responsible for the care they provide. The agreements themselves are not required to be in their original form, but a version must be filed with the medical board.
The national trend has been moving toward allowing PAs to practice with reduced physician oversight and in collaboration with other health professionals rather than under the supervision of physicians. And while S 128 would still retain some physician oversight, it is still in line with this trend. Given that S 128 has already been passed both the house and senate, it is likely it will become law very soon.