(1) As used in this section, unless the context otherwise requires: (a) "Collaboration" means, as indicated by the patient's condition, community standards of care, and a physician assistant's education, training, and experience: (I) Consultation between the physician assistant and a physician or physician group; or (II) Referral by the physician assistant to a physician or, if the referral is to a physician practicing in a different practice area than the physician assistant, a physician's practice group. (b) "Collaborative agreement" means a written agreement that describes the manner in which a physician assistant collaborates with a physician or a physician group. (c) "Performance evaluation" means a document that includes domains of competency relevant to the practice of a physician assistant, uses more than one modality of assessment to evaluate the domains, and includes consideration of the physician assistant's education, training, experience, competency, and knowledge of the practice area in which the physician assistant is engaged. (d) "Physician" means a physician licensed in good standing pursuant to this article 240 or article 290 of this title 12, including a physician in a physician group. (2) (a) A physician assistant licensed pursuant to this article 240 shall enter into a collaborative agreement with a physician or a physician group. The physician entering into a collaborative agreement must be actively practicing in Colorado with a regular and reliable physical presence in Colorado. The collaborative agreement must include: (I) The physician assistant's name, license number, and primary location of practice; (II) The signature of the physician assistant and the physician or physician group with whom the physician assistant has entered into the collaborative agreement; (III) A description of the physician assistant's process for collaboration, the degree of which must be based on the physician assistant's primary location and area of practice and may include: (A) Decisions made by the physician or physician group with whom the physician assistant has entered into a collaborative agreement; and (B) The credentialing or privileging requirements of the physician assistant's primary location of practice; (IV) A description of the performance evaluation process, which may be completed by the physician assistant's employer in accordance with a performance evaluation and review process established by the employer; and (V) Any additional requirements specific to the physician assistant's practice required by the physician entering into the collaborative agreement, including additional levels of oversight, limitations on autonomous judgment, and the designation of a primary contact for collaboration. (b) (I) Except as provided in subsection (2)(b)(IV) of this section, for a physician assistant with fewer than five thousand practice hours, or a physician assistant changing practice areas with fewer than three thousand practice hours in the new practice area, the collaborative agreement is a supervisory agreement that must include the provisions described in subsections (2)(a)(III)(A), (2)(a)(III)(B), (2)(a)(IV), and (2)(a)(V) of this section and must also: (A) Require that collaboration during the first one hundred sixty practice hours be completed in person or through technology, as permitted by the physician or physician group with whom the physician assistant has entered into the collaborative agreement; (B) Incorporate elements defining the expected nature of collaboration, including: The physician assistant's expected area of practice; expectations regarding support and consultation from the physician or physician group with whom the physician assistant has entered into a collaborative agreement; methods and modes of communication and collaboration; and any other pertinent elements of collaborative, team-based practice applicable to the physician assistant's practice or established by the employer; and (C) Require a performance evaluation and discussion of the performance evaluation with the physician assistant after the physician assistant has worked with the employer for six months, again after the physician assistant has worked with the employer for twelve months, and additional evaluation thereafter as determined by the physician or physician group with whom the physician assistant has entered into the collaborative agreement. (II) The performance evaluation may be completed by the physician assistant's employer in accordance with the performance evaluation and review process established by the employer; except that the performance evaluation must be completed with at least the minimum frequency required in subsection (2)(b)(I)(C) of this section. (III) Except as provided in subsection (2)(b)(IV) of this section, after a physician assistant has completed the number of practice hours required pursuant to this subsection (2), the additional collaborative agreement requirements described in this subsection (2)(b) no longer apply. (IV) Notwithstanding the provisions of this subsection (2): (A) For a physician assistant entering into a collaborative agreement with a physician or physician group in the emergency department of a hospital with a level I or level II trauma center, the collaborative agreement remains a supervisory agreement and continues indefinitely. (B) For a physician assistant changing practice areas to practice in an emergency department of a hospital that is not a level I or level II trauma center, the supervising physician or physician group may increase the number of hours for which the collaborative agreement is a supervisory agreement pursuant to this subsection (2)(b). (3) A physician assistant may provide the board with a signed affidavit outlining practice experience for the purposes of meeting the requirements described in subsection (2)(b) of this section, as applicable, if the physician assistant: (a) Held an unencumbered license in another state or territory of the United States before becoming licensed in this state pursuant to section 12-240-113; or (b) Was initially licensed in this state prior to August 7, 2023.
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