BOSTON (SHNS) - As a thin primary care pipeline restricts health care access and the stressors of the COVID-19 pandemic and Steward Health Care crisis are still being felt, physician associates say PAs are an answer to industry cries for help.  Bill supporters say an increasing number of lawma kers agree with them on both a professional and personal level. At a State House lobby day Tuesday, several lawmakers referenced their own struggles within the squeezed primary care industry and amidst a shortage of health care workers available in Massachusetts. A trio of bills this session related to PA caregiving boundaries present physician assistants as a collective puzzle piece that could fit into the state's health care agenda this session. Sen. Cindy Friedman, the Senate's health care point-person, deemed PAs necessary players in the field. "We need all of the advanced practitioners we can get. All of the PAs here today are part of the solution to addressing the Commonwealth's crisis in health care," Friedman said. In March, Friedman was among lawmakers who said the state's health care system is "falling apart." Health and Human Services Undersecretary Dr. Kiame Mahaniah, a senior voice in the Healey administration's team, echoed that crisis sentiment. "There is no getting out of the health care crisis without physician assistants," Mahaniah told more than 200 PA students. Physician associates, often referred to as physician assistants, are licensed health care workers who collaborate with physicians and can diagnose, treat, prescribe, order imaging and perform procedures.  Massachusetts Association for Physician Associates President-elect Duncan Daviau said he's experiencing the crisis on the ground as he watches primary care physicians leave his practice to retire or depart medicine altogether.  "I work at Mercy Medical Center in Springfield. We've just had a mass exodus of our physicians — I'm losing my supervising physician, as are my ten-to-fifteen other PA colleagues, and we don't have a new one right now," Daviau said. Under state regulations, PAs are required to file a supervising physician with the state in order to practice. If a PA loses their supervising physician, like Daviau and his colleagues have, the PA has just 30 days under state regulation to locate a new one.  "This is compounding an access issue in our local area emergency department," Daviau said, pointing to a bill filed (H 2371, S 1502) by Sen. Julian Cyr and Rep. Christine Barber that would remove that regulation, which critics say is a barrier to caregiving. Lawmakers suggest not just reducing barriers, but extending PA reach in the struggling landscape of mental and behavioral health care, where assistants could add more hands to a diminishing workforce. Recalling time spent navigating the mental health system, Rep. Kate Donaghue said PAs provided her son, who passed away seven years ago from an overdose, with the help he needed when he was struggling with his mental health. A bill she filed this session (H 2206, S 1387) would enable PAs to authorize psychiatric holds, which Donaghue said would reduce emergency department boarding, minimize the chances of people walking away from getting help due to backlogs, and save the state money.  While some argue that the scope of practice for PAs doesn't include being able to initiate Section 12 holds, Massachusetts College of Pharmacy and Health Sciences student Paige Fairbanks said PAs are trained to handle patients with severe mental health issues in the classroom and in clinicals. "I think about how police officers are able to put people on psychiatric holds or take them off of them, but they have no psychiatry background," Fairbanks said. "We do clinical rotations and learn a ton of it in the classroom."  An interstate prong also plays a role in attempts to stabilize health care with PAs — a "PA interstate compact" (H 2531, S 1608) would enable health care professionals from out-of-state to practice in Massachusetts, and vice versa.  "We want people to be able to come into Massachusetts and work here who have had training in other places, and this interstate compact will allow us to facilitate that process and make it a little easier," said Rep. Lindsay Sabadosa of Northampton, whose constituents sometimes travel to New York, Vermont and Connecticut to access health care. "People go where it's most accessible, affordable and where they can get an appointment. And so it's really important that we recognize that when we're looking at health care professionals too," Sabadosa said. The Legislature included a nurse licensure compact its 2024 economic development law. ...read more read less