Updated S.C. law paves way for physician assistants to expand care

Updated S.C. law paves way for physician assistants to expand care

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Physician assistants

The PA profession is one of the fastest growing in the country. Currently, there are more than 131,500 PAs practicing in all 50 states, D.C., and U.S. territories. There are more than 1,600 PAs in South Carolina.

LEXINGTON – New legislation in South Carolina will allow physicians assistants to increase care for patients through modernization of the regulation of PA practice.

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Senate Bill 132 was signed by Gov. Henry McMaster on May 13 and will go into effect Aug. 11.

"We are excited that the General Assembly continues to show their commitment to improving access to health care for all South Carolinians. When providers are able to work collaboratively at the top of their skill sets, patients win," said Thornton Kirby, president and CEO, South Carolina Hospital Association.

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The new law will expedite PA entry into the health care workforce by streamlining licensure processes and removing requirements that serve no public protection role. For example, prior to the enactment of Senate Bill 132, South Carolina was one of 10 states that required PAs to pass a jurisprudence exam as part of the licensure process.

“I applaud South Carolina legislators for putting patients above politics.  After evaluating the medical evidence, key outcome data, and best practices legislators are even more committed to removing barriers in the form of restrictive scope of practice laws,” S.C. Academy of Physician Assistants Legislative Co-Chair Kevin Harmon said.

PAs are medical providers who diagnose illness, develop and manage treatment plans, prescribe medications and often serve as a principal health care provider. With thousands of hours of medical training, PAs are versatile and collaborative. PAs practice in every medical setting and specialty, improving healthcare access and quality.

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“Admission to PA school is highly competitive with many student applicants coming in with a concentration in premedicine. PA students have diverse patient care backgrounds that include roles such as paramedics, registered dieticians, researchers and nurses,” SCAPA Legislative Co-Chair Megan Fulton said.

States are increasingly removing barriers in an effort to expand access to care that PAs provide. A June 2018 study conducted by the Hamilton Project, an economic research group and think tank within the Brookings Institution, concludes that removing barriers to PA care would alleviate health care shortages and would improve efficiency and productivity in the delivery of healthcare — all with no adverse effects on patient outcomes.

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“PAs are playing a critical role in addressing health care shortages throughout the country. We want to extend our gratitude to Gov. McMaster and the legislature for their efforts to ensure patients in South Carolina continue to benefit from the high-quality care PAs provide,” SCAPA President Jen Marshall said.

“Many people in South Carolina lack adequate access to quality health care, especially in rural areas – partly because South Carolina ranks 40th among the states with just 77.5 physicians per 100,000 residents. Nationally, the number is 90.1 per 100,000.  This problem is compounded by a strong bias in the distribution of those physicians to urban or suburban areas. S. 132 eases this access problem by empowering physician assistants to provide health care services that are commensurate with their increased level of education and training,” Sen. Tom Davis, R-Beaufort, said.

The PA profession is one of the fastest growing in the country. The U.S. Bureau of Labor Statistics projects that the profession will increase 37 percent from 2016 to 2026, significantly faster than the average for all occupations. Currently, there are more than 131,500 PAs practicing in all 50 states, D.C., and U.S. territories. Today, there are more than 1,600 PAs in South Carolina.

“It is clear that the future of South Carolina’s health care can only be met with an increased number of highly qualified physician assistants being an integral part of the process, particularly in rural South Carolina.  This bill was needed to ensure that South Carolina residents’ health care needs can be met,” Sen. Brad Hutto, D-Orangeburg.

Additionally the updated law allows for:

• Full prescriptive authority including increased prescriptive authority for Schedule 2 narcotic medications.

• Revision of onsite practice requirement: A PA with less than 2 years of continuous practice or switching specialties must practice with the supervising physician for at least 60 before being allowed to practice at an offsite location, with a limited exception for retail medical clinics. The 60-day requirement may be waived in writing by the supervising physician.

• 1:6 Ratio (Supervising/Collaborating Physician: PA/APRN (can be up to 6 total APPs combined).

• Chart co-signature requirements determined at the practice level.

• PAs can start practice 10 business days (or earlier if approved) after their scope of practice guidelines are submitted to the board of medical examiners.

• A PA may sign specified documents on behalf of the supervising physician or alternate supervising physician.

• End-of-life care: pronounce death, certify the manner and cause of death, sign death certificates, issue an order for a patient to receive appropriate services from a licensed hospice, execute a do not resuscitate order.

• Authorization for PAs to delegate a limited list of functions to unlicensed personnel (CMAs).

• Certify that a student is unable to attend school but may benefit from receiving instruction given in his home or hospital.


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