The month’s Legislation Update includes the signing of a new law to help support advanced practice clinicians‘ mental health and prevent burnout during the COVID-19 pandemic, malpractice damage cap to protect PAs, and work by the Colorado Academy of PAs to change the term used to describe the PA-physician relationship.
New Law Promotes Mental Health Awareness in Health Care Workers
On March 18, 2022, President Joseph Biden signed the Dr Lorna Breen Health Care Provider Protection Act (H.R. 1667). The legislation will establish grants for programs that offer behavioral health services for health care workers such as nurse practitioners (NPs) and PAs.
The Department of Health and Human Services (HHS) will award grants relevant to mental health training to students, residents, or professionals to hospitals, medical professionals associations, and other health care entities. Additionally, HHS must conduct a campaign to encourage health care providers to seek support and treatment for mental and behavioral health concerns, and disseminate best practices to prevent suicide and improve mental health and resiliency among health care providers.
HHS must also study and develop policy recommendations on:
- Improving mental and behavioral health among health care providers,
- Removing barriers to accessing care and treatment, and
- Identifying strategies to promote resiliency
“While helping their patients fight for their lives, many health care professionals are coping with their own trauma of losing patients and colleagues and fear for their own health and safety,” according to the website of the Dr Lorna Breen Foundation, which was established after Dr Breen, an ER physicians, took her own life during the COVID-19 pandemic.
“This bill helps promote mental and behavioral health among those working on the frontlines of the pandemic. It also supports suicide and burnout prevention training in health professional training programs and increases awareness and education about suicide and mental health concerns among health care professionals,” said the foundation.
The American Association of Nurse Practitioners (AANP) also supports the signing of the bill. “The ongoing global health crisis, now entering its third year, has pushed many front-line nurse practitioners and other health care providers to their emotional breaking point,” said April N. Kapu, DNP, APRN, ACNP-BC, FAANP, FCCM, FAAN, president of AANP. “The Dr. Lorna Breen Act, now a law, will provide urgently needed mental health services and support to the health care providers who have been working tirelessly throughout the pandemic, continuously prioritizing patient care above all else.”
The law and the funding to support mental health are “a welcome relief and give hope for the well-being of our essential health care workforce. AANP applauds Congress and President Biden for passing and enacting this important bipartisan law,” said Dr. Kapu.
Malpractice Damage Cap Protects PAs
The California Supreme Court ruled that the $250,000 malpractice cap on noneconomic damages in medical malpractice lawsuits now applies to PAs even if they are not supervised by a licensed physician.
This decision came about after the high court rejected a plaintiff’s claim that the cap did not apply to her because the PAs were not acting within the scope of practice allowed by state law and health care professionals that practice outside their scope of practice are exempt from protections by the Medical Injury Compensation Reform Act (MICRA). The Supreme Court ruled that the accused PA was protected by MICRA because he had a valid delegation of service agreements in place.
“A physician assistant who practices autonomously is 1) practicing medicine without a license, and 2) is guilty of a crime,” said attorney Stuart Esner in oral arguments before the Supreme Court. “The legislature has determined that physician assistants do not have the training or qualifications to safely treat and examine patients absent physician supervision.”
The California Supreme Court stated, however, “We hold that a physician assistant practices within the scope of his or her license for purposes of MICRA’s cap on noneconomic damages when the physician assistant acts as the agent of a licensed physician, performs the type of services authorized by that agency relationship, and does not engage in an area of practice prohibited by the PAPA. (Bus. & Prof. Code, former § 3502, subd. (d).)”
The California Supreme Court concluded: “We hold that a physician assistant does not render services “within [a] restriction imposed by the licensing agency” (§ 3333.2, subd. (c)(2)) simply by engaging in unprofessional conduct, such as the noncompliance with supervisory regulations at issue in this case.”
Persistence Pays Off for Colorado Academy of PAs
The Colorado Academy of PAs (CAPA) has successfully passed its priority legislation, HB22-1095, after over 3 hours of testimony. This legislation updates the term used to describe the relationship a PA has with a physician from “supervision” to “collaboration.”
“Over the course of the last 2 years, the pandemic has demonstrated the need to have an efficient set of laws and regulations that allow qualified health care providers to respond to patient needs. AAPA urges your support of HB 1095, which will reduce barriers to high-quality care in Colorado,” said Jennifer M. Orozco, MMS, PA-C, DFAAPA AAPA president.
Several PAs testified stating that current practice laws for PAs reduce patient access to care. There were also 2 physicians who testified in support of the bill reinforcing how necessary PAs are to health care.
1. American Association of Nurse Practitioners. AANP applauds signing of law to support health care workers suffering from burnout. March 23, 2022. Accessed March 22, 2022. https://www.aanp.org/news-feed/aanp-applauds-signing-of-law-to-support-health-care-workers-suffering-from-burnout
2. Claims Journal. Calif. Supreme: malpractice damage cap protects unsupervised physician assistants. February 28, 2022. Accessed March 23, 2022. https://www.claimsjournal.com/news/west/2022/02/28/308912.htm
3. American Academy of PAs. Colorado Academy of PAs’ persistence pays off with bill passage through key committee. February 27, 2022. Accessed March 23, 2022. https://www.aapa.org/news-central/2022/02/colorado-academy-of-pas-persistence-pays-off-with-bill-passage-through-key-committee/?utm_source=facebook&utm_medium=aapa_post&utm_campaign=news_central