Committee forwards four bill drafts to legislative management, including pharmacist scope and physician assistant compact

The Rural Health Transformation Committee voted to forward four bill drafts to legislative management for further consideration and possible introduction in a future session. The committee also approved a separate motion endorsing the department’s rural health transformation application (see separate article).

What the drafts cover - LC 25.1383: Adds a requirement that students participate in the presidential physical fitness test as part of required school physical education curriculum. Liz Fordall of Legislative Council described the draft as "a fairly simple bill" amending curricular requirements. (LC number from the bill draft cover sheet.) - LC 25.1384: Requires the physician‑licensing board to require a minimum of one hour of continuing education on nutrition and metabolic health each licensing renewal period and includes legislative intent that other health‑occupation boards consider similar nutrition education requirements. - LC 25.1385: Establishes a physician assistant licensure compact. Beth Dittis of Legislative Counsel walked the committee through the compact’s structure: it would create a multi‑state commission, enable a compact privilege to practice in remote states, and require participating states to share disciplinary and criminal background information through a data system. - LC 25.1386: Expands pharmacist authority by creating an independent prescriptive authority pathway and a therapeutic‑substitution framework; the draft lists specific, limited drug categories, CLIA‑waived test conditions (influenza, strep, COVID) tied to pharmacist testing, emergency short‑term supplies and procedures for notifying prescribers when substitutions are made. Dittis said the pharmacy board and board of medicine collaborated during drafting.

Committee action and process notes Representative Sid Nelson moved to forward all four bill drafts to legislative management; the motion was seconded and carried on a roll call vote.

Committee leaders and staff reminded members that forwarding a draft to legislative management does not finalize language. The chair and Legislative Counsel explained that bills forwarded to legislative management will still follow normal legislative procedures — committee hearings, public testimony and amendment processes — if legislative management advances them and a special session or regular session takes up the measures.

Committee discussion highlights Members asked technical and policy questions during the bill presentations. On the pharmacist draft, several legislators voiced concern about the draft’s breadth and signaled they want further debate on prescriptive authority before any final statutory change. Beth Dittis said the draft was a starting point and could be narrowed or changed prior to session. Representative Fralick asked whether additional conditions (for example, statin or corticosteroid access for acute conditions) could be added; Dittis said the committee could embed items in statute or give the Board of Pharmacy rulemaking authority to expand or limit clinical areas.

The physician assistant compact drew a detailed staff presentation explaining the compact commission, reporting obligations, how the compact privilege works, and adverse‑action procedures. Staff said North Dakota’s participation would mean physician assistants practice under a compact privilege (not a North Dakota license) and that the state would retain disciplinary authority over licensees physically licensed in North Dakota.

Next steps If legislative management advances any of the drafts, the bills will proceed through the normal committee and floor process; any appropriation of funds to implement policy changes would require a separate legislative appropriation. Committee leadership asked members to be prepared for additional meetings, including a tentative Dec. 4 briefing from DHHS on the submitted CMS application.