SB 116 revises Kentucky’s physician assistant licensure and practice framework. The bill replaces the older supervising-physician model with a collaboration-based model, defining “collaboration agreement” and “collaborating physician,” and removing statutory references to supervision in multiple sections. It directs the Kentucky Board of Medical Licensure to regulate physician assistants through administrative rules, creates a nine-member Physician Assistant Advisory Committee, and sets licensure, renewal, endorsement, continuing education, emergency permitting, and disciplinary standards for physician assistants.
The bill also expands and clarifies the scope of practice for physician assistants. It authorizes physician assistants to perform a broad range of medical services, initiate emergency treatment, prescribe nonscheduled legend drugs, and, under specified conditions, prescribe controlled substances including Schedules II through V. It establishes limits on controlled-substance prescribing, requires DEA registration and use of Kentucky’s controlled-substance monitoring system, and sets continuing education requirements on pediatric abusive head trauma, dementia/Alzheimer’s, and controlled-substance topics. The bill further allows physician assistants to serve as qualified mental health professionals under certain training and experience thresholds, and to perform hospital admission histories and physicals and certain restraint/seclusion review functions.
Beyond physician-assistant licensure, SB 116 makes conforming changes to several other statutes. It updates mental health, juvenile, hospital, controlled-substance monitoring, and driver vision-testing laws to recognize physician assistants in roles previously tied to supervising physicians or other providers. It also amends Kentucky’s prescription monitoring and medicinal cannabis tracking provisions to include physician-assistant-related access, reporting, and disciplinary references, and it authorizes physician assistants credentialed by the cabinet to perform vision testing for driver licensing. The bill repeals three statutes governing supervising physicians and separate-location practice, reflecting the move away from that framework.
The overall sentiment reflected in the voting history is strongly supportive. The bill passed the Senate 32-2, later passed the House overwhelmingly on veto override 90-1, and then passed the Senate again 35-0. That pattern suggests broad bipartisan agreement that the bill modernizes physician assistant practice and expands access to care, especially in settings such as primary care, hospitals, mental health, and controlled-substance treatment oversight.
The main point of contention appears to be the degree of autonomy granted to physician assistants and the elimination of the supervising-physician structure. The bill preserves collaboration requirements and some limits, such as a maximum of four physician assistants per collaborating physician and restrictions on controlled-substance prescribing, but it still significantly broadens practice authority. Any concerns likely centered on patient safety, oversight, and the appropriate balance between access to care and physician control, though the recorded votes indicate those concerns did not prevent passage.
SB 116 substantially amends Kentucky’s physician assistant statutes in KRS Chapter 311 by replacing supervision-based language with collaboration-based practice rules, creating a new collaboration agreement requirement, establishing a Physician Assistant Advisory Committee, and repealing the statutes that governed supervising physicians and separate-location practice. It also amends related provisions in mental health, juvenile, hospital, controlled-substance monitoring, and driver licensing law to recognize physician assistants in additional clinical and administrative roles. The bill expands physician assistant authority to include broader medical services, controlled-substance prescribing under conditions, and certain mental-health and vision-testing functions, while adding continuing education, reporting, and disciplinary requirements.
The bill appears to have enjoyed broad and largely bipartisan support. It passed both chambers by wide margins, including a near-unanimous House veto override and unanimous final Senate passage. The voting pattern suggests lawmakers generally viewed the bill as a modernization of physician assistant practice and a way to improve access to care and administrative flexibility. No committee transcript was provided, so there is no recorded committee debate to indicate substantial opposition beyond the narrow dissent reflected in the votes.
The central policy issue is the shift from a supervising-physician model to a collaboration model for physician assistants. Supporters likely favored greater practice flexibility, expanded access to care, and updated terminology that better reflects current practice, while potential critics may have worried about reduced physician oversight, especially for controlled substances, mental-health evaluations, and independent clinical judgment. The bill addresses some of those concerns by requiring collaboration agreements, limiting the number of physician assistants per collaborating physician, and retaining board oversight and prescribing restrictions. The narrow vote margins in the Senate’s initial passage indicate some lingering concern, but the final votes show those objections were limited.