In this issue:
President’s Message
Legislature Continues Work on Health Care Legislation
Self-Assessment and Performance Improvement (PI) CME
39th Annual NCAPA Summer Conference
Patient Satisfaction Performance Improvement (PI) CME Now Available!
A Trip to Raleigh: Eye Opening and Enjoyable
NCAPA Regional Chapter Updates
NCAPA Leader Introduction:April Stouder
Pre-PA Program Seeking Shadowing Volunteers
Share the Love of PAs With Your Patients!
NCAPA Partners with HPSO on Liability Insurance
NC Mayor Leads Rally for Rural Hospitals
Let’s Celebrate New Members!
President’s Message
by Marc Katz, PA-C
As I talk to PAs across the state, the question “why be a member of the NCAPA?” occasionally comes up. North Carolina is a very PA friendly state. Our laws are good and jobs are plentiful, right? Why join?
This past week two emails came across my desk. One dealt with restricting PA practice at a community hospital, the other with restricting PAs from performing a procedure in a hospital setting at a different institution. Both had valid concerns. Hospitals do have a right to be more restrictive than the Medical Board regulates, but hopefully this is not a wave of things to come. As disturbing as these emails may have been, equally as disturbing to me was that both individuals who brought them to the attention of the NCAPA were not current members. How can we remain a strong PA voice in North Carolina without an inclusive network of PAs from across the state?
NCAPA is a member based organization providing advocacy, continuing education, and other services to our members. All PAs, members or not, get to take advantage of our hard work and dedication. But to remain a strong, solid voice and to continue to monitor and educate on all issues affecting PAs in the state, we need PAs throughout the state to be members. Please encourage your colleagues to join.
The NCAPA continues to remain vigilant in our legislative efforts. Our bill for a PA only seat on the NC Medical Board is in the NC Senate. We will let you know via email when you should contact your local Senator about sponsorship and/or voting affirmatively on the bill. We continue to push for PAs to be specifically included in every health care bill where appropriate. On the regulatory end, we remain vigilant in making sure every PA service is included and not discounted in every aspect of proposed DMA rules.
NCAPA has been busy with regards to our student members. We held another successful Challenge Bowl at the Stead Center, sponsored by the Student Affairs Committee. A special thanks to Laura Gerstner, who was our Master of Ceremonies. NCAPA has also just completed a video to be shown to incoming students at each of North Carolina’s PA programs. The video will provide historical information about PAs, NCAPA, and the Stead Center. Samantha Rogers, Vice President and the Student Affairs Committee Chair, had the idea of creating a video, so a special thanks to her as well for bringing the idea of a video forward.
The AAPA meeting is now just a good memory. The House of Delegates took on many topics, heavily debated a few, and came away with another successful meeting. North Carolina’s own Gail Curtis was again elected Speaker of the House (third term). With Jeff Katz being President of AAPA this year, North Carolina is extremely well represented within our parent organization!
I can’t end a summer message without reminding everyone about our Summer Conference. The “beach meeting” has been a tradition for 33 years. For me, it always means the summer is drawing to an end, my patients will be starting school, and it is a great time of new and renewed friendships. There are the afternoon activities on the beach and the sand and the surf. Oh yes, and there is CME. 29 hours of it (and additional up to 40 hours for workshops). It’s a great way to network with your peers, get smart, have fun, and maybe find out more about the NCAPA. Hope to see you there!
Thank you,
Marc Katz, PA-C
Legislature Continues Work on Health Care Legislation
by Sarah Wolfe, Assistant Vice-President, McGuire Woods Consulting
The North Carolina General Assembly is approximately five months into their legislative session, and several large health care policy initiatives are still outstanding. House and Senate leaders have yet to come to an agreement on the state budget or the best way to reform the state’s Medicaid program. Additionally, several bills that directly impact PAs, including the bill that will establish a PA-only seat on the NC Medical Board (NCMB), are still awaiting final approval from one of the two legislative chambers.
For the latest updates on the legislation discussed below, check out the “Legislative Action Center” under the advocacy tab at www.ncapa.org.
PA-only seat on the NC Medical Board
HB 724, Amend Composition of the NC Medical Board, is the bill requested by NCAPA. HB 724 would add an additional seat to the NCMB, allowing for both PAs and nurse practitioners (NPs) to have their own seats on the Board. After passing the House unanimously in April, the bill was referred to the Senate Health committee. It is expected that the Senate will take up the bill once they complete the budget process, which is currently occupying most of their time.
Firearms
When a new version of the bill was released by the bill sponsors on April 28, HB 562, Amend Firearm Laws, included a provision that would have forbidden a health care provider from asking a patient about lawful firearm and ammunition ownership in any written form, such as on a health-related questionnaire. HB 562 would also have disallowed a provider from sharing any information about a verbal inquiry into lawful firearm ownership and the patient response, with any government official or agency. Several health care professional groups, including NCAPA and the NC Medical Society, were opposed to this provision.
A new version of the bill was released on June 3, and contained much broader language. HB 562 now states that any written form, such as a health-related questionnaire, that a provider asks a patient to fill out must clearly and conspicuously contain a statement that the patient is not required to answer any questions regarding lawful firearm and ammunition ownership.
In this form, HB 562 passed out of the House Rules committee on June 3 on a vote of 14-13. The bill was scheduled to be on the House floor for debate last week, but due to several legislators requesting amendments to other sections of the bill, it was referred back to the House Rules committee for further work.
Health Insurance Mandates
This year, both the House and Senate have introduced legislation that will mandate health insurers to cover a variety of services that are not currently required. Currently, NC has 55 health insurance mandates, one of the highest in the nation. Supporters of these bills say that fairness and compassion are reasons they are needed. Opponents of additional mandates, including the NC Chamber of Commerce and the National Federation of Independent Businesses, say they put an added financial burden on employers, since they raise premium and out-of pocket costs of insured persons.
So far, the House has approved a bill that will require orally administered anticancer drugs to be covered in the same manner as intravenously administered or injected anticancer drugs. They have also agreed to a bill that would prohibit insurers from imposing a limitation on treatment or a higher co-payment for services provided by a chiropractor that are higher than what is imposed on services performed by a primary care physician for a comparable, medically necessary treatment or condition. Both bills are currently sitting in the Senate Rules committee.
The Senate has authorized a bill that will require insurers to provide coverage for the screening, diagnosis, and treatment of autism spectrum disorder. Currently, the bill states that treatment must be ordered by a licensed physician or psychologist. NCAPA is working to amend the bill to include treatment ordered by PAs. The bill, which passed the Senate with only one dissenting vote, is currently waiting to be heard in the House Insurance committee.
Medicaid Reform
Last Wednesday, bill sponsors Reps. Nelson Dollar (R-Wake) and Donny Lambeth (R-Forsyth) released their Medicaid reform plan to the House Health committee. HB 372, 2015 Medicaid Modernization, calls for provider-led entities to implement full-risk capitated health plans to manage and coordinate health care. Under this proposed plan, providers would take on the risk associated with the costs of patient care. There is a six year transition period outlined in the legislation.
While both House and Senate leaders have stated that they want the state’s Medicaid program to transition from fee-for-service into full-risk capitated health plans, their ideas of how to do that differ. Senate Republicans have indicated that they prefer for commercial insurance companies to compete with provider-led entities for the state’s Medicaid managed care business. Senate leaders have also stated that this year’s legislative session will not end until the House and Senate come to an agreement on Medicaid reform.
Performing Executions
HB 774, Restoring Proper Justice Act, passed the House chamber hours before the crossover deadline in April. This bill expands the list of persons allowed in the death chamber to include a PA, NP, registered nurse, emergency medical technician, and emergency medical technician-paramedic.
HB 774 came in response to the de facto moratorium on executions in the state since 2007, when the NCMB threatened physicians who participated in executions with disciplinary action. Even after a lawsuit was won by the NC Department of Corrections, suing the NCMB for those actions, physicians have been reluctant to participate in executions. Bill sponsors hope that expanding the list of persons who may administer the lethal injection will get executions going again in the state. Physicians still must pronounce the person dead.
An amendment to remove PAs, RNs, and NPs from the bill failed. After passing the House chamber, the bill was referred to the Senate Judiciary II committee. It is yet to be heard by the committee. NCAPA is opposed to the inclusion of PAs in this bill because participation in executions is against professional ethics.
State Budget
Shortly after 1 a.m. on Friday, May 22, after almost nine hours of floor debate, the House chamber passed their version of the budget on a bipartisan vote of 93-23. The budget proposal shows that economic times are getting better in the state, with spending topping off at $22.1 billion, a six percent increase from last year’s budget. Also, prior to the House beginning the budget process, the NC Office of State Budget and Management announced that the state would see a $400 million surplus by the end of the fiscal year, June 30.
The proposed state budget now lies in the hands of the Senate. Originally, the Senate’s version of the budget was supposed to be released last week, but when unexpected cost issues with the state’s Medicaid program surfaced, the budget process came to a temporary halt. The NC Office of State Budget and Management reported that the NC Department of Health and Human Services (DHHS) owes numerous providers nearly two years’ of Medicaid payments. This means that not only does the state need to budget for those overdue bills, but this also changes how much the state needs to budget for Medicaid in future years.
Once those numbers are recalculated, they will be able to complete their budget process. Senate budget writers hope to vote the budget out of the Senate chamber by the end of the week. At that point, due to many provisions that will be in contention between the House and Senate, they will then go into a conference committee to work out their differences.
Self-Assessment and Performance Improvement (PI) CME
adapted from NCCPA’s Certification Maintenance Flyer
There are new certification maintenance requirements from NCCPA and many PAs are still confused about what is required and when the requirements apply to YOU. The NCAPA wants to help you by explaining the new requirements.
What’s New?
- All PAs will begin the new 10 Year Certification Maintenance cycle when their current 6-year cycle ends. You can sign into your NCCPA record at nccpa.net to confirm what cycle you are currently on.
- The new 10-year process is divided into five 2-year CME cycles, during which 100 credits of CME must be earned, with at least 50 of those credits being Category 1 CME. (So far, this is the same as the current process)
- The new requirements state that at least 20 of the 50 Category 1 credits must be earned through Self-Assessment CME or Performance Improvement (PI) CME.
- Remember this saying, “40 and 40 in 4”. Over the course of the first four cycles, you have to earn BOTH types of CME-at least 40 credits of PI CME and at least 40 credits of Self-Assessment CME.
To learn more about Self-Assessment and PI CME, and to watch helpful videos that explain the new certification requirements in detail, go to NCCPA’s About CME Requirements. You can also e-mail NCCPA at nccpa@nccpa.net or call NCCPA at (678) 417-8100.
39th Annual NCAPA Summer Conference
Embassy Suites, Kingston Plantation
Myrtle Beach, South Carolina
August 16-21, 2015
Join us at the beach!
Registration is open for our 39th Annual Summer Conference! NCAPA combines the best CME conference for PAs with a family-friendly beach vacation.
Our full agenda is announced and we are proud to present a variety of interesting topics. There is truly something for any provider-each lecture hour on the agenda will include case studies and clinical pearls that will be useful in YOUR clinical practice.
Click here to view the full schedule.
Click here for conference information & registration
Don’t forget to make your hotel reservation soon! Our room block is filling quickly and some properties and room types are already full. Please note that we have 2 different group codes for our room block this year. Make sure you are using the correct code when booking your room to receive our negotiated rates.
Click here for hotel information & room reservations
Embassy Suites & Kingston Condos Group Code NAP
Hilton & Royale Palms Group Code APA
Reserve your room now for the best selection!
Patient Satisfaction Performance Improvement (PI) CME Now Available!
NCAPA has partnered with CME4Life to bring you this Patient Satisfaction Performance Improvement (PI) Project. This project will ship directly from CME4Life and is approved for 20 AAPA Category 1 Performance Improvement CME credits by the Physician Assistant Review Panel.
This PI CME project is designed to increase patient satisfaction and is comprised of 3 stages:
Stage 1: Compare your practice patient satisfaction to national benchmarks, performance guidelines set forth within your practice or other evidence-based standard. This score will be taken from the Press Ganey (or similar) score of your institution or you may complete the self-assessment scoring to give yourself a baseline score.
Stage 2: Using the guidelines of this PI-CME project, PAs will develop and implement the plan for improvement in patient satisfaction. This program will offer you suggestions along with guidance to increase patient satisfaction. You will choose 3 to implement over a 60-90 day period.
Stage 3: Evaluate the outcome of the improvement effort by comparing the results of the original data to new results or outcomes*.
*You do not need to demonstrate actual practice improvement in order to receive CME credit since the primary intent is to help you reflect on your own practice.
You can purchase this PI CME project in the NCAPA online store or by clicking here. NCAPA Members receive a special member discount on this item!
A Trip to Raleigh: Eye Opening and Enjoyable
by Charlene Morris, PA-C, Past-President
Have you ever wanted to meet your Senator or Representative? In early June, I trekked to Raleigh under the auspices of the NC Medical Society and the Kanof Leadership College’s White Coat Wednesday to meet with my legislators, Senator Norm Sanderson and Representative Michael Speciale. As is often the case in my experiences, I learned more than I imparted.
Preparation was a breeze for me. An AAPA member for 37 years, I learned from attending AAPA’s Leadership and Advocacy Summit how to approach and speak with my elected officials. As apolitical as I fancy myself some days, I realized long ago I must be apprised and aware of issues, especially those affecting my lifeblood: practicing as a PA. So I scribed a one page quick-view tool, complete with a North Carolina PA fact sheet and bookmark with my business card in the front pocket of a colorful folder.
I found the e-mails of my Senator and Representative on the NC government website www.ncleg.net. I wrote to both and received affirmative responses to my request for a meeting. “We’ll make it work,” stated Rep. Speciale’s wife and Legislative Assistant.
“Of course we remember you and would love to meet!” was the response from Senator Sanderson, when I reminded him we’d met and that I’ve cared for his wife’s mother over these past several decades.
Sporting a brand new white coat, off I trekked to Raleigh. My first visit was with Rep Speciale. I thanked him for supporting HB 724 that would create a designated PA seat on the Medical Board. Although he did not support it, I also cited the passing of the tanning booth bill and told the tale of my patient who just lost half his ear to melanoma. Also, I mentioned the bill that will potentially prevent and fine us for discussing guns with our patients and their families. After he inquired, I assured him I was a 1st and 2nd Amendment advocate and that my mission is patient safety and advocacy.
Although a huge topic, we also discussed subsidized medicine and how cost containment is potentially devastating to the rural Family Practice. I related my serving on the CMS COPD committee last year for AAPA and how our care and attention to patients cannot predict good or not so acceptable outcomes. Further, I asked that PAs be allowed enhanced reimbursement to KEEP NC citizens healthy.
Representative Speciale escorted me to the vast, but empty hearing chambers where I saw where the NC representatives are seated and got a quick education about speaking queue and voting procedures. He also imparted that he WANTS people to contact and visit him. My efforts are evidently not a usual occurrence.
Crossing the bridge to the Senate offices, I met first with Senator Norm Sanderson’s wife and Legislative Assistant, Linda, and got a quick photo as the Senator apologetically left swiftly for his committee meeting. Time flew as I learned of Senator Sanderson’s calling to work for the citizens of NC.
When he returned, we spent a long time again discussing the main issues I had outlined. Senator Sanderson pledged his support for HB 724, asking if I would like to be the PA to sit on the future Medical Board seat. It was a high compliment, coming from a man I had met just a few times before. We also touched on the federal issue of Hospice, which is so near to my heart.
All told, I spoke an hour with each of these men, elected by my neighbors, patients and friends. I wrote personal thank you notes and plan to send follow up e-mails in the near future.
Please consider meeting with, or at least writing or calling your legislators. Our governmental monitors tell us of bills and issues we cannot possibly follow closely in our busy lives. THAT is why NCAPA is SO very important to us all. Sometimes we PAs are the experts on what we do and our duty is to assist those impacting our profession by providing information that can indeed positively influence a vote.
Contact me or NCAPA’s Executive Director Cathie Feild if you’d like a gentle nudge and tutorial about how to visit your legislator. Until that time, we have many active and vigilant people in our own NCAPA and AAPA working for and with us. Join us!
NCAPA Regional Chapter Updates
Far West NC Physician Extender Associates’ (FWNCPEA) 2nd Annual Fall Conference will be on Saturday, September 26th from 9:00am to 4:00pm. The conference is FREE and includes continental breakfast and lunch. It will be held at the Balsam Mountain Inn, Balsam, NC. Lectures include Hypertension Update, Acute Abdomen, Testicle Cancer, Concussion Evaluation, EKG review, and ENT Pearls, providing 6 hours of AAPA (approval pending) category 1 CME. Register at www.FWNCPEA.com
Metrolina Association of Physician Assistants (MAPA) members participated with Habitat for Humanity on May 30th, 2015. We helped install windows and secure the framework of a new home in the Charlotte, NC area. It was a GREAT feeling, because we were working side by side with the new homeowner, who was truly grateful for our presence there. A good time was had by all.
NCAPA Leader Introduction: April Stouder
April Stouder, PA-C, is an NCAPA Director-at-Large and is the chair of the Education Development Panel. She graduated from Duke University’s PA program in 2000 and is currently the Director of Clinical Education and specializes in Hematology/Oncology in rural NC. April grew up in a small town in Indiana and moved permanently to North Carolina in 2002. She is married and resides in Chapel Hill with her husband and two children, ages 3 and 8. She enjoys running, traveling and reading.
What do you like best about being a PA?
Being part of a care team with physicians, nurses and other staff – many heads are better than one when tackling patient care! Caring for patients who are often facing a challenging diagnosis, and walking with them on their journey.
How did you become involved in NCAPA?
I have been a member since 2002, and began volunteering on the Professional Development Review Panel several years ago.
Why do you think it is important to be involved in NCAPA?
PAs who practice clinically benefit from keeping abreast of practice legislation and the advocacy provided by NCAPA in this regard. Being involved in NCAPA is a way for PAs to network, give back to their profession, be involved in leadership if desired, earn CME, and mentor those new to our profession. We are fortunate to have very supportive and favorable practice laws in this state, and shouldn’t take them for granted!
Pre-PA Program Seeking Shadowing Volunteers
from the UNC-Chapel Hill Pre-Physician Assistant Program
The UNC Chapel Hill Pre-Physician Assistant Club is about to begin their second year as an organization and are looking to expand their Shadowing Program. The program was designed to create opportunities to interact with and observe the PAs in the Chapel Hill, Durham, and surrounding areas, with a goal for members to learn more about the PA profession and the various sub-specialties. Hopefully, the interaction and experience will answer questions and solidify their passion to become a PA and open the door to gain future experiences and to create relationships within the medical community.
Caroline Hooker, the Shadowing Coordinator, is looking for any PAs that may have an interest in being involved in the program. The program includes allowing a UNC-Chapel Hill Pre-Physician Assistant Club member to shadow you for an hour. Any additional involvement or time available would be something that could be individualized and customized at the discretion of the practitioner and student. Your commitment would be allowing one student to shadow you for one hour, one time in the upcoming school year, or as much as allowing two shadowing opportunities per week.
If you are interested, please contact Caroline at echooker@live.unc.edu or call at (919) 924-4689.
Share the Love of PAs With Your Patients!
NCCPA has created a great patient-directed flyer about PAs. Download it here and see if your practice or workplace might be willing to place them in an area to better inform patients of the wonders of PAs. Spread the news!
NCAPA Partners with HPSO on Liability Insurance
HPSO provides professional liability insurance for over 1 million healthcare professionals, and is now offering the same quality coverage, financial strength, and level of service to physician assistants.
NCAPA members can receive a non-cumulative 10% risk management credit applied to their annual premium for up to three years by attending either of our conferences and attending six or more eligible educational sessions. For complete details, visit the HPSO website or call toll-free.
Before you purchase or renew your individual professional liability insurance, NCAPA encourages you to look at what HPSO has to offer, and to compare rates with what you’re paying now. In many cases, a policy through HPSO can save you hundreds of dollars a year in premium. For more information on the HPSO program or to compare rates, visit them on the web at www.hpso.com/ncapa or toll free at 888-273-4686.
NC Mayor Leads Rally for Rural Hospitals
From National Rural Health Association
Fifty-three hospitals have closed; 283 more are on the brink of closure. Since January 2013, more rural hospitals have closed than in the previous 10 years —combined. Continued cuts in hospital payments have taken their toll, forcing far too many closures and leaving many of our nation’s most vulnerable populations without timely access to care. If Congress doesn’t act to stop the bleeding and closures of these hospitals, 700,000 patients would lose direct access to care; communities and the local economy will suffer. Without Congressional intervention, layoffs, reduced wages, economic loss, reduced service, or worse, closed doors will occur in rural communities across the country.
Led by Belhaven, NC Mayor Adam O’Neal, a group of advocates from 11 states are walking 283 miles – one mile for every hospital in immediate danger of closing – from Belhaven, NC to the U.S. Capitol to draw attention to the dire situation that rural hospitals and communities are facing. Walkers will be representing North Carolina, South Carolina, Texas, Alabama, Washington State, Virginia, Tennessee, Florida, New York, Georgia and California.
The walk concludes on June 15 at 11 a.m. on the east grounds of the Capitol. For more information about this issue, contact Erin Mahn at emahn@nrharural.org or Diane Calmus at dcalmus@nrharual.org.
Let’s Celebrate New Members!
As you may have noticed, we have been highlighting NCAPA leaders each month so that our members can get to know us a little better. We would also like to begin to highlight our new Fellow and Associate members each month so that we can get to know YOU a little better! These are individuals who have joined in the current membership year who have never been members of NCAPA in the past. In future issues of the Pulse, I will also include their town, so that all of us will be aware of new members in our area and, if the opportunity arises, be sure and greet them and welcome them to NCAPA. For our initial list, I have included all new members that have joined thus far in 2015.
(Please keep in mind that we transferred member databases just over a year ago, so some of our data may have been “skewed” during the transition. If you see a mistake – you’ve been a member for a while, for instance, and are on the list – or – you are a brand new member and are NOT on the list – please contact me at kat.nicholas@ncapa.org and let me know. If any new members have been missed, I will certainly include the correction in our next issue. Thank you for your patience and understanding!)
