Passage of HB 1175

North Dakota PAs,

It is with great pleasure to announce that H.B. 1175 has been officially signed into law! After unanimously passing through both the N.D. House of Representatives and Senate, Governor Doug Burgum signed the bill on April 4th, 2019, finalizing our current efforts for Optimal Team Practice (OTP) in North Dakota.

The enactment of H.B. 1175 is a significant accomplishment for PAs in North Dakota and sets a precedence for PA regulation nationwide. While a few states have made great progress towards OTP, H.B. 1175 is the most modernized and comprehensive PA practice bill to date. PAs in North Dakota were also the one of the first to accomplish the Six Key Elements for Modern PA Practice back in 2010. While we tend to be humble in our everyday lives and practices, we have a lot to be proud of both past and present.

The NDAPA Board of Directors would like to thank all our members for their hard work throughout the legislative process and for your dedication to our profession. We would also like to thank the N.D. Board of Medicine (NDBOM), Rep. Bill Devlin and our other bill sponsors, the American Academy of Physician Assistants, Dr. Gordon Leingang, and all the other individuals and organizations that provided testimony or letters of support. And last but certainly not least, very special thanks to Duane Houdek, our lobbyist, who volunteered his time just for this bill. Mr. Houdek used his vast experience in the legislative process and knowledge of our profession to educate legislators on the importance of this bill.

H.B. 1175 was drafted with much consideration for PAs in all practice settings. While the legislation itself is quite comprehensive on what PAs can do, there will need to be rules drafted and approved by the NDBOM that further define the licensing requirements. Rules cannot be more restrictive than law, however, the NDBOM must ensure that the licensure process is efficient and that PAs are practicing within their scope. The bill will officially go into effect on August 1, 2019. Please stay tuned as the NDAPA and NDBOM work together in this process and we will communicate with you as those rules are determined.

H.B. 1175 makes significant changes to PA practice including:

• Removing the requirement that PAs have a written agreement with a physician if they practice at licensed facilities (e.g., hospitals and nursing homes), facilities with a credentialing and privileging process (clinics), or physician-owned practices;
• Allowing PAs to own their own practice with approval of the North Dakota Board of Medicine;
  • PA practice owners with less than 4,000 hours of experience must have a collaborating physician;
• Defining PAs scope of practice as determined by their education and training;
• Removing references to physician responsibility for care provided by PAs; and
• Clarifying that PAs are responsible for the care they provide to patients.

As noted, H.B. 1175 advances our practices in multiple ways that will enhance our ability to provide health care to the citizens of North Dakota. By far the most substantial change in the bill is that PAs will no longer be required to have a state-mandated supervisory agreement with a physician. While we all have great respect for our physician colleagues, the supervisory agreement requirement has created significant barriers for our ability to practice where we are needed but many times not considered because of it. The NDAPA firmly believes that H.B. 1175 will not affect our relationships with our physician colleagues and our current level of collaboration will continue despite any changes to our regulation.

The NDAPA will continue to keep you up to date in the coming months. If you haven’t already, please register for our 41st Annual Spring Primary Care Conference in May. We will have further discussions at that time and are planning a celebration of the passage of H.B. 1175.

 If you have any question about H.B. 1175, please email NDAPAboard@gmail.com.

Sincerely,

Jay Metzger, PA-C

President, N.D. Academy of Physician Assistants