Rep. Steve Sheldon, R-Bowling Green, sponsored legislation last week that would allow physician assistants to prescribe Schedules II through V controlled substances.
“Kentucky is the only state in the nation that does not allow PAs to prescribe some level of controlled substances,” said Sheldon, also a pharmacist in Bowling Green. “It is important to note that no state that has granted PAs prescriptive authority has ever revoked or lessened PA prescriptive authority.”
Sheldon said that with the majority of physician assistants acting as primary providers, being able to prescribe directly helps the health care system.
“There are approximately 1,800 licensed PAs in Kentucky,” Sheldon said. “Kentucky has 202 health professional shortage areas with a population of 1,348,604 residents.”
Sheldon added that 27.6 percent of physician assistants serve rural areas.
“PAs, on average, complete more clinical and classroom hours than nurse practitioners,” Sheldon said. “Nurse practitioners in Kentucky, who receive comparable schooling and physician oversight, were granted full prescriptive authority of Schedule II-V drugs including opioids … and have been allowed to prescribe controlled substances since 2006.”
The regulation includes a temporary licensing, professional standards for prescribing and dispensing controlled substances and professional standards for prescribing or dispensing buprenorphine-mono products or buprenorphine combined with naloxone.
The controlled substance prescription would still have some regulation.
According to Sheldon, Schedule II substances are limited to a three-day supply with no refills, Schedule II and II non-narcotic substances are limited to a 30-day supply with no refill and Schedules IV and V are limited to the original prescription and refills are not to exceed a six-month supply.
Prescriptions for diazepam, clonazepam, lorazepam, alprazolam and carisoprodol are limited to a 30-day supply without any refills, according to Sheldon.
“As a result of feedback from the Kentucky Board of Medical Licensure, updates have been made to PA disciplinary statutes to make them more consistent with other providers,” Sheldon said.
A board also would be formed should this bill be passed. The board would consist of nine members serving four-year terms and the licenses would be valid for two years. During that two years, five hours of continuing education in best prescription practices of controlled substances training must be completed in order to prescribe controlled substances.
“Kentucky is the last state in the nation that does not allow a degree of prescriptions authority for physician assistants. Rep. Sheldon’s proposal would actually allow physician assistant’s some collaborative prescription authority along with their supervising physician,” said Adam Haley, executive director of the Kentucky Academy of Physician’s Assistants.
“It is a team-based model in that we work very closely with a supervising physician. In rural areas, especially, that supervising physician doesn’t necessarily have to be physically at the same location as the PA all the time. So what may happen is if the PA needs to write a prescription for a patient, and that supervising physician is not there, they may have to send them somewhere else, oftentimes to an emergency room or another care facility just to get a prescription filled.”
As of Friday, the bill is headed to the Licensing, Occupations and Administrative Regulations Committee.