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State lawmakers reintroduce physician’s assistant legislation

Three people surround a podium with a sign that reads 'patient-led care.' There are other people behind them against a blue curtain.
(Left to Right): Rep. Donovan McKinney (D-Detroit), Rep. Carrie Rheingans (D-Ann Arbor), Rep. Curt VanderWall (R-Ludington) speak at a press conference in Lansing on Thursday, October 6.

Michigan lawmakers are renewing an effort to give physician’s assistants (PAs) more authority.

Newly filed bills in the Michigan House would change PAs’ titles to physician associate, giving them power to supervise medical assistants while counting them as mental health professionals.

The package would also enter Michigan in a multi-state compact to recognize licenses from out of state.

“Since we know patients deserve the highest quality of care from professionals who are trained to provide it, we’re here trying to address this gap," said
Representative Carrie Rheingans (D-Ann Arbor), one of the co-sponsors the legislation.

"Sometimes outdated laws on the books get in the way of people trying to provide that care and address our mental health crisis right now in our state."

Federal numbers show Michigan has 526 facilities and 77 geographic areas designated as Health Provider Shortage Areas. That means they’re dealing with a “shortage of primary, dental, or mental health care providers.”

The bill to identify PAs as mental health professionals came up last legislative session as well, sponsored by then-Senator Curt VanderWall (R-Ludington).

Though the legislation passed the Senate unanimously, it stalled before the Michigan House.

While in Senate committee, it faced pushback from various organizations, including the Michigan Psychiatric Society.

The group shared concerns over giving PAs and nurse practitioners the authority to make decisions regarding hospitalization, seclusion and restraint.

“[I]nstead of curtailing the use of restraint and seclusion, a goal for everyone in the mental health community, SB 191 simply adds a host of new people, some of whom won’t be qualified, to the list of those who can do authorizations, exams and orders,” wrote Mark Reinstein, a representative for the medical group, in testimony to the committee.

Likewise, the most recent legislation is getting pushback from the Michigan State Medical Society, which said the bills are confusing the patient-physician dynamic.

“Quality patient care is rooted in the trusted relationship between patients, their loved ones, and the physicians who lead the health care teams providing care and counsel. The legislation introduced in the State House today undermines that care by creating confusion and clouding the medical transparency that patients rely on,” wrote CEO Tom George in a statement.

Supporters of the legislation argue PAs have gone through extensive schooling and training and have earned the right to make medical decisions.

Ashley Malliett is president of the Michigan Academy of Physician Assistants, though she used the term “Physician Associates” during a press conference Thursday morning. She pointed out what she described as troubling observations about calling PAs “physician’s assistants."

“We are not owned by another profession. We serve our patients. If anyone owns us, it’s our patients,” Malliett said.

Malliett said the bills are on behalf of Michigan patients.

“It’s their pain that we see when laws prevent them from being able to live healthier lifestyles and they are the ones that suffer when we cannot function as our education, training, and board certification allow us to,” Malliett said.

It’s unclear how soon the legislation could move. With VanderWall, now a Representative, joining as a co-sponsor, the package has at least some bipartisan support.

But Rheingans acknowledged there’s only a little time before the end of the calendar year. She called the package “a great election year thing if nothing else.”

In 2020, Governor Gretchen Whitmer vetoed legislation to join Michigan into a similar agreement for nurses and psychology workers.

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