March 15, 2006

 

 

 

Today, Governor Mark Sanford signed into law a modification to the Physician Assistant Practice Act that has been long overdue. The changes to the law will allow PAs to prescribe category III – V controlled substances, be issued a “permanent” license to practice as a PA in SC, and allow licenses to be issued before the interview process has occurred. These changes were advanced in the interest of patient care and helping patients receive the healthcare they need, when they need it.

 

Three years ago in July 2003, Tom Gocke, PA-C Orthopedic PA who had recently moved from North Carolina to SC was dismayed that he could not write for controlled substances in SC. Pain management is a major component of orthopedics and not having this privilege limited his ability to adequately treat his patients. Therefore, he approached the BME about allowing PAs to write controlled substances and was referred to the PA Advisory Committee to the BME. Tom pursued this avenue and made a presentation to the PA Advisory Committee advocating that PAs should be allowed to prescribe controlled substances. After hearing Tom’s presentation the Advisory Committee began the work of drafting language that would modify the PA practice act as it relates to prescribing. SCAPA President, CJ Parris, PA-C contacted me to help Tom develop the language for inclusion in the law. Tom’s approach was to model the language after North Carolina’s law for which he was familiar. We started there and began the long road to changing the law.

 

Many of the modifications to the law were a direct result of deliberations by the members of the PA Advisory Committee. They suggested the change in the interview schedule and they wanted the license that is issued to the PA to be permanent and not expire when a PA severed his/her relationship with a supervising physician. Another change that is important is clarification that the supervising physician must be available seventy-five percent of the time per month. This language was previously nonspecific about the time frame.

 

Why does it take three years? The language was bounced back and forth from the BME and the Advisory Board and each board meets every three months. As language was negotiated between the Advisory Board, the BME and SCAPA, the bill was being masterfully drafted by Rick Wilson, Esq., employee of LLR and legal advisor to the BME. A nearly final version was ready for introduction to the State Assembly in winter 2005, however it was sent by LLR to the Governor’s Office since he likes to review bills that are generated by agencies of his administration. Many calls to the Governor’s Office were not returned and the bill sat there for endless weeks. Finally in March, we were able to get the bill sponsored and introduced in the House by Representative Brian White. The bill was introduced late in the first session of the General Assembly with no hope of getting passed in 2005. We would have to wait for the General Assembly to reconvene in January 2006. If the bill did not pass during the 2006 session then it would have to be redrafted and reintroduced the subsequent year.

While our bill sat in a pile of other legislative bills from July till January during the General Assembly’s adjournment, the SCAPA Board of Directors and Legislative Committee were at work developing a plan to make certain the bill did not languish during the 2006 General Assembly Session. A request for proposals (RFP) was developed and sent to a select number of registered lobbyists with the desire to find someone to represent your interests in Columbia. Eleven companies responded, however the requested fees were far beyond the financial capabilities of SCAPA. The SCAPA board reviewed the budget and determined what we could afford with some help from the American Academy of Physician Assistants (AAPA) and the membership. We discussed our financial constraints with a small group of companies who responded to the RFP and selected four to interview. Ted Riley, Esquire of Riley, Pope and Laney was the finalist from this involved process. SCAPA contracted with him in September 2005 to develop our strategy for getting the bill passed.

 

With the leadership of Ted Riley we began meeting with influential medical organizations in SC. We met with the South Carolina Medical Association (SCMA) Interspecialty Council (IC) which serves as their legislative committee. SCMA IC voted to support our bill without the expanded prescriptive privileges.

 

Reamer Bushardt and I met with Dr. William Hueston of the SC Academy of Family Physicians (SCAFP) and the Board of SCAFP asked that we make some minor wording changes to the bill. These changes did not modify our intent of the law and were readily adopted. In response to our collegial dialogue, the Board of Directors of SCAFP voted to support the PA Practice Act Modifications. Testimony by Sally Rogers from the SCAFP was instrumental in achieving today’s success.

 

Mr. Riley arranged for a meeting between SCAPA and the SC Nursing Association. Reamer Bushardt and I, along with Ted Riley and Janet Jordan, met with four representatives from SCNA to discuss the bill. We provided clarifications and they offered suggestions and the meeting was amicable. SCNA did express concerns about the educational requirements for PAs in SC and they raised this issue again during deliberations before the House subcommittee. PAs are proud of the educational process for our profession in this country and believe that graduates from every accredited program who are NCCPA certified should be eligible for licensure in South Carolina. SCAPA developed a detailed explanation of the expansive education provided to PAs and the issue was dropped by SCNA.

 

The AAPA provided exceptional support for our legislative endeavors. The AAPA Board of Directors allocated ten thousand dollars ($10,000) to SCAPA to help finance our legislative initiative. In addition, Ann Davis and Ramon Gardenhire sent out legislative alerts to the PAs in South Carolina. Through the Legislative Action Center they were able to target email PAs by legislative districts. As the bill was in subcommittee an alert was sent to the PAs living in the districts of those House and/or Senate members of the subcommittee. The same email process was done as the bill moved to full committee and then another alert sent when the bill was forwarded to the full body.

 

Many individuals were involved in the passage of this bill. It began with Tom Gocke and includes the PA members of the PA Advisory Committee; Lisa Sands, Arnold E. Metz, and Buck Harvey. SCAPA President CJ Parris attended many of the Advisory and the BME committee meetings to oversee the issues and contribute to the advocacy of this bill. Janet Jordan, Executive Director for SCAPA was the person that held this project together as she helped with development of the RFP, interviewing lobbyists, and sending out legislative alerts. Reamer Bushardt provided his pharmacotherapeutic and pharmacology expertise as well as his enthusiasm to many of the meetings. In addition, Reamer designed the curriculum which convinced the BME that PAs could and should be allowed to prescribe controlled substances. Reamer, Buck Harvey, Steward Darby, CJ Parris and I all provided testimony in Columbia to convince the legislators that this bill is about providing the best possible healthcare to the people of South Carolina.  

 

In addition to these, many SCAPA members contributed funds above and beyond their annual dues, which allowed us to hire a lobbyist and secure a legislative grant from AAPA. Special thanks to the following contributors:

American Academy of Physician Assistants

CJ Parris

 

Reamer Bushardt

Bryan Walker

 

Larry Dillard

Wanda Hancock

Paul Jacques

Tim Stuart

 

Roberta Alsworth

Cecilia Cannon

Lisa Castles

Wanda Copeland

Stewart Darby

Doyce Emmert

Gary Evans

Terry Fuller

Larry Harris

Buck Harvey

Kirk Heinold

Jill Hinman

Thomas Hokanson

Dean Huiet

Steve Jackson

Marylee Jackson

Monty Kitchens

William Knoblach

Anonymous

Theresa Morris

Henry Ramirez

Ellie Rogers

April Ross

Susan Coker Ruth

Tara Sabatinos

Christopher Smith

Timothy Stich

Stephanie Thompson

 

Joe Bethle

Nancy Billings

Anjinetta Johnson

Judith Robertson

Robert Vaughn

 

The message was heard and today marks the collaborative success of the above mentioned individuals and the PAs who responded to the emails and advocated on their local level.

 

Congratulations and Well Done!