Support HB 2134
Arizona House Health & Human Services Committee Hearing

Dear Colleagues,

The Arizona State Association of Physician Assistants (ASAPA) is pleased to announce that our bill, HB 2134, will be heard in the Arizona State House Health and Human Services Committee on Monday, February 10th, at 2:00 p.m.

This bill serves two key purposes:

1. Clarifying Collaboration Language – We aim to amend last year’s bill by removing the term “oversight” from the description of collaboration. This adjustment will eliminate confusion among PAs, employers, the Arizona Regulatory Board of Physician Assistants (ARBoPA), and the Governor’s Regulatory Review Council. The revised language will clearly differentiate collaboration from supervision, facilitating a smoother transition to collaboration status for experienced PAs and ultimately improving access to care for Arizonans.
2. Ensuring Licensure Standards – HB 2134 will codify the requirements for obtaining an Arizona PA license, ensuring that all PAs, including those applying through the Universal Recognition pathway, meet the same rigorous standards. This change will prevent individuals who have been licensed in other states or U.S. territories without completing PA school or passing the Physician Assistant National Certifying Exam (PANCE) from obtaining an Arizona license.

Action Needed: Make Your Voice Heard

We strongly encourage you to contact your legislators to express your support for HB 2134. Legislators need to hear from constituents—not just ASAPA—on the importance of this bill.

You can find your legislators and their contact information by visiting: https://www.azleg.gov/findmylegislator/.

Your advocacy is essential to ensuring the success of this bill and strengthening the PA profession in Arizona.

Thank you for your support!

Best regards,
Carlos Gutierrez EdD, MMS, PA-C
President, ASAPA

My name is Carlos Gutierrez, and I proudly serve as the President of the Arizona State Association of Physician Assistants (ASAPA). Over the past year, ASAPA has been deeply involved in addressing significant issues related to the implementation of the Rules initially established by the regulatory body (the Board) to enforce HB2043. This legislation, co-authored with input from ASAPA, was designed to reduce administrative burdens associated with PA practice in Arizona. Our primary concern centered on the requirement for a signed agreement between a collaborative PA and a collaborating physician or entity for a PA to practice collaboratively after completing 8,000 hours of clinical practice. These Rules effectively mandated a supervision agreement, which we believe misaligned with the legislative intent of HB2043.

In response, ASAPA formally petitioned the Arizona Governor's Regulatory Review Council (GRRC) to void Rules R4-17-402(B-G). On July 30, 2024, the GRRC ruled in our favor, determining that the Rules exceeded the agency’s statutory authority and did not adhere to the requirements of HB2043. Consequently, R4-17-402(B-G) was declared void. Following this ruling, ASAPA promptly notified the Board of our intent to collaborate in crafting Rules that faithfully reflect the legislative intent of HB2043 as a co-author of the bill.

ASAPA is grateful for the Board’s willingness to engage in meaningful dialogue during this post-GRRC rulemaking process. After meeting with the Board in good faith, I submitted the Association’s final endorsed and edited Draft Proposal to the Board’s Executive Director on October 15, 2024. We were pleased to receive confirmation from the Board that they “endorse” the amendments and plan to present the proposal at the Board’s December 4, 2024 meeting with the intention of acceptance.

ASAPA thanks the Board for their cooperation throughout this process. We anticipate the Board will approve the amended Draft Proposal as collaboratively developed, ensuring alignment with the statutory language of HB2043. Details regarding the agenda and location for the December 4, 2024, meeting can be found at AZPA.gov. As the sole advocacy organization for Arizona PAs, ASAPA will have representatives present at the meeting in assuring PAs in Arizona can optimally practice in teams through collaboration.
Thank you for your continued support of Arizona’s PAs and for working together to uphold the integrity of our profession and the legislative process.

Carlos Gutierrez EdD, MMS, PA-C
President
Arizona State Association of Physician Assistants

Join ASAPA today and become a vital part of Arizona's advocacy for PAs! Together, we can strengthen our profession and make a lasting impact. Click here to learn more and sign up.

Google Meet - Video Link: https://meet.google.com/wzc-wype-kck

Google Meet - Live Stream (For those who cannot join the above Video Link): https://stream.meet.google.com/stream/683cb01d-f228-4613-9e12-01dd2e6536a9

Kevin Kupferer, PA-C, DHSC
President, ASAPA

• HB2043 Final Bill
• Board interpretation of amendments
• FAQs from the Board 
• Notice of final rulemaking

ASAPA feels strongly that these rules go against the law passed and the legislative intent of HB 2043, these rules will not allow PA practice to move forward as intended.  HB 2043 and the rules are scheduled to go into effect on December 31, 2023.  ASAPA has worked tirelessly during the rulemaking process to ensure that the rules were acceptable for PAs in Arizona and will continue to do so.  With that, ASAPA is pursuing every avenue possible, including potential legal action, to stop these rules from going into effect. 
 
If you want to reach out to the board regarding these rules, you are encouraged to do so before the end of the year.  The board’s contact information is provided below.
 

• Phone: (480) 551-2700
• Email: questions-noreply@azmd.gov

 
We wanted to send an update regarding sending emails to the board as several people have experienced a bounce back message using the email address listed above.  If your email doesn’t go through to the above address, please re-send your email to patricia.mcsorley@azmd.gov.
 
ASAPA appreciates your help and support as we continue to strive to improve PA practice in Arizona.  Thank you! 
 
Sincerely,
Amanda Shelley, MPAS, PA-C
Legislative Chair, ASAPA

ASAPA has been engaged in the ongoing rulemaking process for the implementation of HB 2043, our PA practice modernization bill, that was passed in the 2023 legislative session.  As you may be aware, part of the success of passing HB 2043 is that it removes the requirement for a practice agreement between physicians and PAs with more than 8,000 hours.  As the Arizona Regulatory Board of Physician Assistants (Board) has developed rules for the implementation of this bill, they have finalized regulations that still require ‘written policies’ regarding collaboration for PAs with more than 8,000 hours.  The detailed requirements that go into these written policies essentially mimic the requirement for a practice agreement, which defeats the progress made with passing HB 2043, thus making the new system more burdensome for PAs and employers. The Board has provided the following information on their website regarding these proposed regulations.

• HB2043 Final Bill
• Board interpretation of amendments
• FAQs from the Board 
• Notice of final rulemaking

ASAPA feels strongly that these rules go against the law passed and the legislative intent of HB 2043, these rules will not allow PA practice to move forward as intended.  HB 2043 and the rules are scheduled to go into effect on December 31, 2023.  ASAPA has worked tirelessly during the rulemaking process to ensure that the rules were acceptable for PAs in Arizona and will continue to do so.  With that, ASAPA is pursuing every avenue possible, including potential legal action, to stop these rules from going into effect. 
 
If you want to reach out to the board regarding these rules, you are encouraged to do so before the end of the year.  The board’s contact information is provided below.

• Phone: (480) 551-2700
• Email: questions-noreply@azmd.gov

ASAPA appreciates your help and support as we continue to strive to improve PA practice in Arizona.  Thank you! 

 
Sincerely,
Amanda Shelley, MPAS, PA-C
Legislative Chair, ASAPA

This email is being sent to update you and provide you with information regarding some important changes to the Physician Assistant Practice Act after the enactment of HB 2043 and effective December 31,2023. HB 2043, (link attached).

The new legislation allows for collaborative practice for licensed Arizona physician assistants who have worked at least 8,000 clinical hours, and who are certified by the Board to work without supervision. The anticipated requirements for certification for collaborative practice are set forth in the attached links, which also includes a link for frequently asked questions (FAQs) and the recently adopted rules for collaborative practice.

The application will be available on the ARBoPA website later in December.

In addition, the new legislation changes the requirements needed in Supervision Agreements between the physician assistant and the supervising physician or the physician's employer. Previously, the law mandated a physician assistant could only perform the health care tasks delegated by a supervising physician, the new legislation allows for a physician assistant to provide “any legal medical service for which the physician assistant has been prepared by education, training and experience and that the physician assistant is competent to perform” including the tasks previously identified in the statute. Health care tasks are no longer required to be specifically delegated by a supervising physician. A Supervision Agreement that describes the physician assistant’s scope of practice and prescribing authority is nonetheless required prior to performing health care tasks.

Please take the time to familiarize yourself with the changes that will become effective on December 31, 2023. If you have any questions for regarding HB 2043, please send an email to:

questions-noreply@azmd.gov and Board Staff will respond.

Patricia McSorley
Executive Director

Arizona Medical Board

Arizona Regulatory Board of Physician Assistants

With the signing of H.B. 2043, PAs in the Grand Canyon State are now empowered to expand patient care through more modernized, team-based healthcare. In addition to removing the supervision agreement for those PAs with 8,000 or more hours, the legislation will also update who is responsible for the care provided by the PA, allow the Arizona Board of Physician Assistants to determine appropriate regulations for changes in specialty, and allows for direct payment to PAs. The new law will take effect at the end of the calendar year.

“Our bill sponsors, Representative Selina Bliss, Representative John Gillette, and Senator Eva Burch, were instrumental in getting our bill heard and passed through to the governor. I wish to thank past and present legislative advocates Amanda Shelley PA-C, Sarah Bolander PA-C, Jennifer Feirstein PA-C,  Jacob Gubler PA-C, and our entire Legislative Affairs Committee for setting the stage for a successful legislative year.  Additionally, I can honestly say that we could not have passed this bill without the grassroots efforts of our membership. Our team worked tirelessly to ensure lawmakers understand how updated PA practice laws help to address our state's growing needs for access to quality healthcare, especially in rural and underserved communities." ASAPA President Melinda Rawcliffe, MPAS, DMSc, PA-C, said. 

Disclaimer: The Arizona Regulatory Board of PAs is the governing body of the law. ASAPA will not be able to legally advise individuals or companies on the application of the new law.  

When reaching out to your senator please let them know you are a constituent, what you do, etc. Also, please point out that you, (or your employer on your behalf), carry the same level of malpractice coverage as our physician colleagues.

Two ways to reach out: 

1. If you have very limited time, follow this link to be part of our email campaign that will automatically send a letter to your senator. This will take less than a minute but please be sure to personalize the message whenever possible.

2. If you have already sent a letter, or if you can spend a few minutes more, contact your senator by phone. If you're not sure who your senator is, go to the 'Find My Legislator' tool on the Arizona State Legislature website here.

Talking points:

HB 2043 WILL:

• Modernize PA practice laws and improve patient access to care.
• Strengthen the health care team, expand access to care, and reduce health care costs by removing burdensome administrative constraints - while ensuring access to safe, quality patient care. 
• Update the term used to describe the PA-physician relationship from 'supervision' to 'collaboration' for a PA with more than 8,000+ practice hours.
• Enable an experienced PA (8,000+ practice hours) to have more flexibility at the practice level.
• ASAPA has been working with the Arizona Medical Association (ArMA) and the Arizona Osteopathic Medical Association (AOMA) for consensus language and they have reached a neutral position on this bill with the amendments made in Committee.
• Those in opposition to this bill have created concern around liability – PAs and their employers have insurance coverage in the same amounts as physicians and other health professionals.

Please act today to help push our bill to the governor's desk!

ASAPA is pleased to announce that HB2043 passed out of the Senate committee with a 6-1 vote. There was bipartisan support for this historic bill. The next phase includes a full vote on the Senate floor in the coming weeks. 

Watch here for further updates!

PLEASE JOIN OUR GRASSROOTS MOVEMENT TO GET

HB2043 ACROSS THE FINISH LINE!

Our OTP bill, HB2043, has passed the House and is moving to the Senate HHS Committee later this month.  We need your help!

Action needed: Please contact your senator as well as senators on the HHS Committee, (listed below), to tell them how important this bill is for improving access for patients and decreasing administrative barriers to the care patients need.

How: You can reach out via our microsite or connect with them directly via phone or email. If you're not sure who your legislators are you can look them up here.

Senate HHS Committee Members:

Sen. T.J. Shope -chair; tshope@azleg.gov, District 16

Sen. Janae Shamp - vice chair; jshamp@azleg.gov, D29

Sen. Eva Burch - our bill sponsor in the Senate; eburch@azleg.gov, D9

Sen. Sonney Borrelli; sborrelli@azleg.gov, D30

Sen. Sally Ann Gonzales; sgonzales@azleg.gov, D20

Sen. Theresa Hatathlie; thatahile@azleg.gov, D6

HB 2043 WILL:

• Modernize PA practice laws and improve patient access to care.
• Strengthen the health care team, expand access to care, and reduce health care costs by removing burdensome administrative constraints - while ensuring access to safe, quality patient care. 
• Modernizes the relationship and updates the use of 'supervision' and 'collaboration' to describe the PA-physician relationship.
• Give individual practices the ability to require additional collaboration if appropriate for their practice.

HB 2043 is similar to laws recently enacted in North Dakota, Utah, and Wyoming.

Why do we need HB 2043?

• It will increase access to health care, particularly in rural areas, and decrease health care costs.
• Students are carefully following improvements to state laws as they consider where to begin practice upon graduation. Arizona PA students support increasing employment opportunities for PAs in the state so they can stay in Arizona and increase access to care.
• It will allow employers (private practices, health systems, hospitals, and others) - not government - to determine at the practice level what is best for the practice and its patients.
• It will increase job opportunities for PAs. Currently employers hire nurse practitioners because they do not require supervision agreements. Employers do not want to manage the burdensome paperwork and time it takes to supervise a PA under current PA practice laws.

Legislation by Nick YoungsonCC BY-SA 3.0Pix4free