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Hospitals told committee S1163 would let hospitals set PA/APRN inpatient roles; liability, training debated
Summary
At the hearing on S1163, the Vermont Association of Hospitals and Health Systems said hospitals should retain discretion over physician assistant (PA) and advanced practice registered nurse (APRN) inpatient privileges, arguing similar training hours in hospital settings; lawmakers asked about liability and the ability of hospitals to set more restrictive rules.
Devon Green of the Vermont Association of Hospitals and Health Systems told the House Health Care committee on April 7 that S1163 should allow hospitals to decide how physician assistants and APRNs practice in inpatient settings.
Green summarized training and residency-hour requirements for APRNs and PAs drawn from Medical Board guidance and said that within hospitals the two roles function similarly; he argued that hospitals are the appropriate place to set local supervision and privilege policies rather than a one-size-fits-all statutory rule.
“If hospitals want to make it more restrictive they can say ‘no, you need to be supervised by a physician,’ ” Green said, explaining that the bill would give hospitals flexibility to align inpatient privileges with current practice and local safety needs.
Committee members sought clarity about liability and admitting/discharging responsibility. Witnesses said hospital policies and hospital-held liability insurance remain central; where a hospital names a clinician as the admitting provider, the hospital’s insurance and policies typically govern risk and coverage. Members noted small differences could change which license bears admitting or discharge liability and asked whether that shift would affect physician exposure; witnesses said hospitals could continue to restrict scope if they chose.
Members asked whether hospitals had opposed the change; Green said he had not heard opposition broadly and that hospitals could choose to be more restrictive if concerned. The committee did not take a vote; members indicated they wanted additional detail and possible edits to ensure hospitals retain discretion while clarifying liability and supervision expectations.
The committee recessed for a short break after the discussion.
