SOUTH DAKOTA Bill Provides for Physician Assistant Independence

Posted By American Med Spa Association, Thursday, February 10, 2022

Bill Name: Senate Bill 134 (SB 134) 

Primary Sponsor: Senators Chris Johnson and Erin Tobin

Status: 2/22/22 Failed Senate Vote

AmSpa’s Take: Reducing practice oversight requirements and allowing independence for physician assistants (PAs) is a growing national trend. Many states have already done this for nurse practitioners with positive results. South Dakota could be among the first few states to provide this to PAs.

Outlook: This bill is in the first steps of the process and, based on the sponsor’s past records and party, it is more likely to pass. The bill is currently sponsored by 17 total senators, one of whom is also the chair of the Committee on Health and Human Services, so this could indicate strong support, at least through the first committee stage.

Analysis: Currently, physician assistants (PAs) in South Dakota must practice under the supervision of a physician. Their scope of practice and prescriptive authority are defined by this supervisory relationship as outlined in a written practice agreement. SB 134 would change this to require an initial period of practice under a collaboration agreement. PAs would need to practice in collaboration for their first 1,040 hours of practice; after this period, they would be independent and not need to have any formal supervision. Under SB 134, PAs could collaborate with physicians and may also collaborate with other PAs. For a PA to qualify as the “senior” collaborator, they must have at least 4,000 hours of practice in their specialty. 
PAs would then be able to provide services that they have the training, education and skill to provide. PAs wishing to switch specialties would need to undertake another period of collaboration until they had at least 1,040 hours in that new specialty.     
This would be a major change to how PAs practice and could allow independent practices without any physician involvement, instead relying on more senior PAs for collaboration. SB 134 does not explicitly state that PAs with more than 1,040 hours can practice independently but does strongly imply that. However, one section lists locations where PAs may practice as licensed health care facilities, facilities with credentialing and privileging systems, physician-owned facilities or other practices allowed under the chapter. So, it is not immediately clear if PA-owned practices would be permissible under this bill. If so, this would make South Dakota among the first few states to allow PAs to practice on their own without physician oversight. This has been a long-running trend in practice requirements for advanced practitioners such as PAs and advanced practice registered nurses (APRNs). The majority of states have already provided APRNs with the ability to practice independently and, slowly, states are heading in that same direction for PAs. If you would like additional information, to read the bill or to contact the sponsors, you can find this information through this link