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GOVERNMENTAL AFFAIRS NEWSLETTER ARTICLE

Scope of Practice Expansion wins Approval

Just before summer recess, the House and Senate approved our scope of practice expansion bills. It didn’t happen though without some political wrangling. We were cruising along just fine, having passed the house on a unanimous vote when suddenly we were picked up on the trial lawyers radar. Over the years we have managed to fly under that radar, but our luck ran out. Their group is powerful enough to cause a fair amount of havoc should they choose to do so. What caught their interest was the fact that we were asking for an expansion in our scope of practice, and that translates into increased risk. I did argue that what was being expanded hardly increased our risk of malpractice, but expansion of scope is expansion of scope in their eyes. They wrote to the respective legislative committees stating that they would block passage of our bills unless there was language placed in the legislation specifying minimal requirements on malpractice coverage for physician assistants.

All along, we have tried to keep this kind of language out of our legislative initiatives. But their request was supported as reasonable by the Medical Society and the Hospital Association. And as luck would have it, we had 48 hours to either accept minimal malpractice coverage limits or our bills would be dead in the water. This scenario takes me back to 1993 when we had to accept the “every third visit rule” or lose our proposed allopathic prescribing legislation.

The Governmental Affairs Committee and the PSPA board of directors contemplated the pros and cons of the minimal limits and in the end decided to accept the language in order to expand our scope of practice. The language calls for coverage in the minimum amount of one million dollars per occurrence or claims made. This was not a decision taken lightly by everyone involved. We understand that this may cause some hardship for certain individuals. Given the circumstances, the committee and the Board felt we had no choice other than to go forward. Since 2008 is a biennial license renewal year, the boards will require that we send proof of insurance at the minimum levels when we renew our licenses this fall.

One of the bigger headaches that our bills address is the ability to order physical/occupational and respiratory therapy. Their respective acts are being amended to allow them to accept our orders. The bills are included in this newsletter.

The Society hopes that our decision doesn’t create a great deal of hardship for our members. We act with the best interest of everyone in mind, but sometimes we are faced with tough decisions such as these. As our profession continues to grow and play an ever more important role in the delivery of health care in Pennsylvania, we are going to on the radar of an ever-increasing number of organizations.

HOSPITAL BASED PAS MATRIX RELEASED

HAP’s Advanced Practice Professionals Advisory Group has develped a guidebook entitled “Use of Physician Assistants, Certified Registered Nurse Practitioners, Certified Nurse Midwives, Certified Registered Nurse Anesthetists, and Clinical Nurse Specialists in the Hospital Setting in Pennsylvania.”  We are confident that this resource tool will provide guidance in understanding allowable practices in the hospital setting. Please distribute to your supervising physicians, PA co-workers and hospital administration.

STATE BOARD OF MEDICINE NEWS RELEASE

Board Approves Temporary Authorization for Physician Assistants to Practice Pending Board Approval of the “Application for Registration as a Supervising Physician”

At its meeting on March 21, 2013, the State Board of Medicine approved a temporary authorization for Physician Assistants to practice pending formal approval of the “Application for Registration as a Supervising Physician.”

Upon submission of the application, Board staff will review the application ONLY for completeness and issue a letter to the supervising physician providing the temporary authorization for the physician assistant to begin practice.

If the application is not “complete” (i.e., required signatures are not provided, information is missing, fee is not included, etc.), a temporary authorization for the physician assistant to begin practicing WILL NOT be issued.

The temporary authorization, when issued, will provide a period of 120 days during which the physician assistant may practice, under the terms of set forth in the written agreement as submitted to the Board. Within 120 days, the Board will notify the supervising physician of the final approval or disapproval of the application. If approved, a final approval of the written agreement will be issued to the Supervising Physician. If there are discrepancies that have not been corrected within the 120 day period, the temporary authorization to practice will expire.

Board Approves Reduction in Paperwork and Reporting Requirements
for Substitute Supervising Physicians of the Physician Assistants
The Board also approved a reduction in paperwork and reporting requirements for substitute supervising physicians. Effective immediately, the “Written Agreement Change Form” for Adding/Deleting a Substitute Supervisor will no longer be required to be filed with the Board office.
However, the “Written Agreement Change Form” is required and must be submitted to:

  • Delete a Physician Assistant;
  • Dissolve a Written Agreement;
  • Make Changes in Protocol, including: changing the job duties of the Physician Assistant;
  • Changing the Physician Assistant’s prescribing or dispensing privileges;
  • Changing the practice address (only if changing a hospital practice location)

Additional Amendments to Requirements for the Supervision of Physician Assistants
The Board will issue a Statement of Policy to make additional amendments to the “Application for Registration as a Supervising Physician” which will reduce the paperwork and reporting requirements. When the Statement of Policy has been published in the Pennsylvania Bulletin, additional amendments will be made to the application form(s).

Link to special notice on State Board of Medicine website:
Special Notice: 572039

Link to new forms:
State Board of Medicine Forms

KEEP YOUR LICENSE ACTIVE

If your license has been inactive for greater than four years, the medical board has now implemented steps that you must take in order to have your license reactivated. These steps include having an active NCCPA certificate and taking a pre-approved board review course. If your license has been inactive for less than four years and you have maintained your certification status, we urge you to contact the medical board to have your license reactivated. If you are considering a temporary move out of clinical practice, we strongly advise that you do not let your license lapse. Whether you assume an administrative role, transition into an academic position, or take a job in a research setting it is important that you maintain your active licensure status. Even if you don’t plan to practice clinically, you can keep your license active as long as you maintain your national certification. For questions regarding licensure please contact the State Board of Medicine at the following location.

State Board of Medicine
P.O. Box 2649
Harrisburg, PA 17105-2649
Phone – (717) 783-1400
Fax – (717) 787-7769
ST-MEDICINE@state.pa.us

EMS ACT OF 2006

After many months of being on “the back burner,” Act 45 revisions, know as the EMS Act of 2006, is again on the move. The Pennsylvania Emergency Health Services Council has requested input on their web site before the final draft is presented to the Department of Health and to the Legislature for final consideration. As liaisons to the PEHSC, Lane Bower and I have been actively following the EMS Act for the last few years. The current Act 45 does not have any provisions for Physician Assistants to serve in Pre Hospital roles, unless they have Paramedic or EMT certification and function in those roles.

Thankfully, the new revisions to the Act include PAs in several areas. The first mention is in the definitions, where Pre Hospital Physician Assistants (PHPA) are defined as certified by the DOH as a PHPA.

The bulk of PHPA discussion occurs in Section 18, where specific credentials of PHPA’s are listed, and include age above 18, BLS and ACLS certified, and written as well as practical examination requirements that will be created by the DOH. This section also discusses continuing education requirements for PHPA’s. Gratefully, our language is very similar to the language of the following section regarding Pre Hospital Physicians.

The last change involves vehicle coverage. The language used for staffing BLS ambulances, ALS ambulances, and ALS squad vehicles does not preclude PAs from staffing these vehicles. Of note, the Air Ambulance language did not change, and does not allow a PA to staff the aircraft.

Lastly, PAs are not included in Medical Command language in Section 25. We will continue to monitor this and make appropriate suggestions when the opportunities arise. If you would like to read the EMS Act of 2006 for yourself, it may be found on the PEHSC website at www.pehsc.org, and click on the “Star of Life” icon.

ELECTIONS NOW OPEN

PSPA Elections are fast approaching! We are in need of PAs and students to run for office- each position is for a 2 year term except the student position is for 1 year. Remember, that you don’t need to run for a position to volunteer- you can simply sign up for a committee today!
Positions available:

Please send letter of intent, resume, 350 word platform statement, and headshot picture to Chad Jackson

Student deadline is March 15, 2013 & Fellow deadline is April 15, 2013

HOUSE BILLS FAIL TO PASS IN 2011-2012 SESSION

In a disappointing ending to the 2011-2012 legislative session, House Bills 1832 and 1833 failed to move out of the Senate Professional Licensure Committee. As you know, these bills sought to eliminate countersignature of our charts and change the written agreement process with the state boards from an “approval” process to being “filed” with the boards. The Society and our lobbyists’ spent a full year garnering support for these bills before their introduction. We had the backing of many groups as well as the Pennsylvania Medical Society. In the late summer, the Medical Society pulled their support after concerns were voiced by several Board of Trustee members. This came as a complete surprise to not only the PSPA but the Senate Professional Licensure Committee (SPLC). Alternative language was then developed in an attempt to salvage the legislation. We met with the Medical Society in an attempt to change their minds, but were unsuccessful. Without their support, the bills did not move out of the SPLC.

In October of every year the leadership of the Medical Society changes. Their newly elected president has voiced the desire to work with us in developing amenable language. We will be working on that over the next few months and reintroduce legislation next year. As with the previous legislative session, you and your supervising physician will be asked to once again write letters in support of our new bills. Watch your email, snail mail, PSPA web site and this newsletter for further information. Thank you for your continued support of the Society. We will persevere in making the necessary legislative changes to advance the PA profession and the physician/PA team.

Please complete our survey so that we may be able to better understand the challenges you face as a PA in Pennsylvania. Thank you.

CONFERENCE WRAP UP

Hopefully you were among the over 400 PAs and 119 students who attended the 37th Annual PSPA CME Conference at the Valley Forge Casino and Resort. The Clinic of Phoenixville was the recipient of $7,681 and two van-loads of goods donated from across the state. Lock Haven and DeSales were the two schools who raised the most money and goods respectively for this year’s host city charity. You can still donate if you wish!

Please help us congratulate this year’s award winners:

  • PA Educator of the Year 2012: Tracy Wright
  • Humanitarians of the Year 2012: Brett and Corinne Feldman
  • Nate Alston Student Scholarship Awards: Alyssa Gundrum (Philadelphia), Brendan Greenaway (Lock Haven) and Sylvie Fadrhonc (Lock Haven).
  • Health Disparity award winner – Eric Paulson, PA-S DeSales University

The Challenge Bowl was another exciting time, with Seton Hill University taking home the Spirit Award. First place went to DeSales University, second place to St. Francis University, and third place to Seton Hill University. And last, but certainly not least, the PAC Silent Auction brought in $11,045. You can still help us get our voices heard by donating to the PAC today!

Save the Date: 38th Annual PSPA Conference Oct 16-19 in Erie, PA!

50% OFF FOR STUDENTS

Students who are graduating this year should receive a 50% off coupon from their program good towards their first year of Fellow PSPA Membership dues. Please check with your program for your own coupon and renew your membership in the PSPA. Remember only members have access to the Career Centerregional meetingsdiscounted conference rate and all the member benefits to help you succeed at your new job.
If you have any questions, please contact us pspa@pspa.net.