The Physicians Assistants bill package: Scope of Practice, Interstate Compact, mental health practice
Michigan Radio covers the PA scope of practice issues well, but fails to provide bill numbers. This is more difficult to find with Mackinac Center reducing its bill tracking services. The bills will pop eventually, assuming the current legislature moves them and follows procedure by publishing accurate agendas before committee hearings.
My thoughts below.
House lawmakers reintroduce physician’s assistant legislation
Newly filed bills in the Michigan House would change PAs’ titles to physician associate, give them power to supervise medical assistants, and count them as mental health professionals.
The package would also enter Michigan in a multi-state compact to recognize licenses from out of state.
Representative Carrie Rheingans (D-Ann Arbor) co-sponsors the legislation.
“Since we know patients deserve the highest quality of care from professionals who are trained to provide it, we’re here trying to address this gap. Sometimes outdated laws on the books get in the way of people trying to provide that care and address our mental health crisis right now in our state,” Rheingans said during a press conference Thursday morning.
Federal numbers show Michigan has 526 facilities and 77 geographic areas designated as Health Provider Shortage Areas. That means they’re dealing with a “shortage of primary, dental, or mental health care providers.”
The bill to identify PAs as mental health professionals came up last legislative session as well, sponsored by then-Senator Curt VanderWall (R-Ludington).
Though the legislation passed the Senate unanimously, it stalled before the Michigan House.
While in Senate committee, it faced pushback from various organizations, including the Michigan Psychiatric Society.
The group shared concerns over giving PAs and nurse practitioners the authority to make decisions regarding hospitalization, seclusion, and restraint.
“[I]nstead of curtailing the use of restraint and seclusion, a goal for everyone in the mental health community, SB 191 simply adds a host of new people, some of whom won’t be qualified, to the list of those who can do authorizations, exams and orders,” written testimony to the committee from the group read.
Likewise, the most recent legislation is also getting pushback from the Michigan State Medical Society, which said the bills are confusing the patient-physician dynamic.
“Quality patient care is rooted in the trusted relationship between patients, their loved ones, and the physicians who lead the health care teams providing care and counsel. The legislation introduced in the State House today undermines that care by creating confusion and clouding the medical transparency that patients rely on,” a written statement from CEO Tom George read.
Supporters of the legislation argue PAs have gone through extensive schooling and training and have earned the right to make medical decisions.
Ashley Malliett is president of the Michigan Academy of Physician Assistants, though she used the term “Physician Associates” during a press conference Thursday morning.
She pointed out what she described as troubling observations about calling PAs “physician’s assistants."
“We are not owned by another profession. We serve our patients. If anyone owns us, it’s our patients,” Malliett said.
Malliett said the bills are on behalf of Michigan patients.
“It’s their pain that we see when laws prevent them from being able to live healthier lifestyles and they are the ones that suffer when we cannot function as our education, training, and board certification allow us to,” Malliett said.
It’s unclear how soon the legislation could move. With VanderWall, now a Representative, joining as a co-sponsor, the package has at least some bipartisan support.
But Rheingans acknowledged there’s only a little time before the end of the calendar year. She called the package “a great election year thing if nothing else.”
As always, but particularly in a shortage environment, every clinician should be able to practice to their full scope of education and training.
State boundaries are a minor player in healthcare job mobility and shortages. However, the fix is simple: state reciprocity. All it takes is political will to buck the educational establishment, which perpetuates the myth that Michigan licenses are higher quality than those of other states.
This is the third interstate license compact this fall. The Occupational and Physical Therapy compact bills were heard this week in the House Health Policy Committee.
It cannot be over-emphasized that Compacts are overkill for the stated problem. The hidden but real benefit is to corporate globalists. (I'm serious - look up who's behind it.) For the rest of us, they eliminate the people's representation in state licensing and facilitate centralized power over bedside care. There is also an added cost to states in time and fees.
The PA Compact Bill is HB 5117. Link: http://legislature.mi.gov/doc.aspx?2023-HB-5117
The PA name change to allow Physician Associate is HB 5116.
PA scope of practice bills are HB 5114 and HB 5115.
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