COMMUNITY PARAMEDICS:

The act establishes a certification process for community paramedics. To be certified an individual must already be certified as a paramedic, finish a community paramedic certification program, and complete an application form provided by the Department of Health and Senior Services. An ambulance service must enter into a contract to provide community paramedic services. The act also defines "emergency medical technician-community paramedic," "community paramedic," and "EMT-CP" as used in statutory provisions relating to emergency services (190.098, 190.100).

These provisions are identical to HCS/SB 24 (2013), CCS/SS/SCS/HB 307 (2013), HCS/HB 335 (2013), CCS/SS/HB 336 (2013), and SCS/HCS/HB 653.

COLLABORATIVE PRACTICE ARRANGEMENTS:

Currently, a collaborative practice arrangement must include provisions providing how the collaborating physician and the advanced practice registered nurse will maintain geographic proximity. This act adds that an arrangement may allow for the waiver of the proximity requirement for no more than twenty-eight days per year in order for the advanced practice registered nurse to provide care at a rural health clinic that is located more than fifty miles from the hospital sponsor (334.104).

This provision is similar to provisions contained in SCS/HB 625 (2013) and CCS 2/HCS/SB 330 (2013).

PHYSICIAN ASSISTANCE:

This act modifies the scope of practice for physician assistants. The act changes the definition of the term "supervision" by repealing the requirement that a physician assistant must work in the same facility of a supervising physician sixty-six percent of the time that the physician assistant provides care. The act states that the physician assistant is to only practice where the supervising physician routinely provides care. Supervising physicians and physician assistants also shall sign an attestation which states that the physician assistant will not practice beyond the physician assistant's training and experience. In addition, the definition of supervision provides that the physician assistant and the supervising physician shall work in the same facility for at least four hours every fourteen days of patient care.

The requirement that a physician assistant must only practice at locations within thirty miles of the supervising physician is repealed. The act provides that under a supervision agreement a physician assistant may practice at locations which are fifty miles from the supervising physician.

In the case of physician-physician assistant teams, no supervision requirements beyond federal law requirements are necessary for the teams to practice in a rural health clinic.

Under current law physician assistants are prohibited from performing abortions. The act includes that physician assistants shall also not prescribe abortions.

The act modifies the definition of "physician assistant supervision agreement" by adding that the agreement must contain certain elements defined in the act including complete contact information of both the supervising physician and physician assistant, a list of locations where the physician assistant is authorized to practice, and the manner of supervision provided (334.735).

These provisions are identical to HCS/SCS/SB 126 (2013), HCS/SB 330 (2013), HCS/HB 685 (2013), SS/HCS/HB 315 (2013), and similar to SB 219 (2013).

JESSICA BAKER