In this issue:
by Samantha Rogers, PA-C
I hope this newsletter finds you well today and ready for Spring! We have been especially active at NCAPA with the wrap up of a successful Winter Conference at the end of February and, in early March, a group of 16 PAs and PA students traveled from North Carolina to Arlington, VA for a national conference which you will hear more about below. We are looking ahead to the April Board meeting, and then the national AAPA meeting and House of Delegates in New Orleans, in May. Please make plans to attend one if not all of these upcoming events!
This edition of the Pulse will incorporate our experiences at AAPA’s Leadership and Advocacy Summit which took place earlier this month in Washington, DC. We had many very productive and enjoyable meetings on Capitol Hill with Legislators and their staff. We advocated for the PA’s ability to write a prescription for diabetic shoes when indicated, and for PAs to have the authority to order and oversee home health care for our extra vulnerable patients. While on the Hill, we learned that much like PA practice is about teams and relationships, professional advocacy is best achieved when strong relationships exist between us, the professionals and voters, and those who represent us. We brought a message of unity, service, and increasing patient access, on both of these ‘Asks’ which enables those relationships with lawmakers to be strengthened and prioritized.
And speaking of working closely with legislators, we have our PA Day at the NC Legislature on Wednesday, May 30th in Raleigh. Please make plans to be there!! You’ll be glad you did.
Samantha Rogers, PA-C
by Sarah Wolfe, Assistant Vice-President, McGuire Woods Consulting
At this month’s North Carolina Medical Board meeting, NCAPA requested that the Physician Assistant Advisory Meeting (PAAM) review the supervising physician requirement for PAs who have acquired the Medication Assisted Treatment (MAT) Waiver.
The Comprehensive Addiction and Recovery Act (CARA), which was enacted by the federal government in 2016, expanded access to substance use disorder treatment services. Specifically, CARA allowed for PAs and NPs to qualify for the MAT Waiver once they have completed 24 hours of training, an additional 16 hours of training than the physician requirement. Once the training is completed, PAs and NPs are eligible to apply for a DEA-X, which allows them to prescribe for buprenorphine for opioid addiction treatment.
As North Carolina’s regulations on PA prescribing practices are currently written, it is unclear whether a PA with a MAT Waiver may prescribe buprenorphine for opioid addiction treatment if their supervising physician does not possess the Waiver. Therefore, NCAPA proposed to the PAAM that PAs should be able to provide buprenorphine to patients, as allowed by the CARA Act, under the supervision of a physician who has a DEA license to prescribe Schedule III controlled substances, regardless of whether the supervising physician possesses the MAT Waiver.
North Carolina Medical Board staff stated that a change in regulations is needed in order for PAs to prescribe buprenorphine, consistent with the CARA Act. Therefore, NCAPA is now looking into requesting a rule change to the PA prescriptive authority (21 NCAC 32S .0212) to include an exception for the MAT Waiver. NCAPA plans to make the formal request for the rule change in the coming weeks.
NCAPA strongly believes that this rule change would be a step in the right direction towards combating opioid addiction via expanding patient access to buprenorphine.
Additionally, during the Advanced Practice Provider and Allied Health Committee meeting, a rule change to the PA Prescriptive Authority, 21 NCAC 32S .0212, was unanimously approved by the Committee. This rule change will bring the rule to be consistent with the corresponding NP rule, which was changed last year.
Presently, PAs may not prescribe more than a 30-day supply of schedules II, IIN, III, and IIIN controlled substances. Once the new rule goes into effect (it will become official in the next couple of weeks), the rule will no longer include the line which states that PAs may not exceed a 30-day supply for those schedules.
The rule change will read as follows:
A physician assistant may prescribe, order, procure, dispense, and administer drugs and medical devices subject to the following conditions:
- In order to prescribe controlled substances,
- the physician assistant must have a valid Drug Enforcement Administration (DEA) registration and prescribe in accordance with DEA rules;
- all prescriptions for substances falling within schedules II, IIN, III, and IIIN, as defined in the federal Controlled Substances Act, 21 U.S.C. 812, which is hereby incorporated by reference, including all subsequent amendments or editions, shall not exceed a legitimate 30 day supply. 21 U.S.C. 812 may be accessed at http://www.deadiversion.usdoj.gov/21cfr/21usc/812.htm free of charge; refills may be issued consistent with Controlled Substance Law and regulations; and
- the supervising physician shall possess at least the same schedule(s) of controlled substances as the physician assistant’s DEA registration;
And don’t forget! This year’s annual PA Day at the North Carolina Legislature has been scheduled for Wednesday, May 30, 2018. Go ahead and mark your calendar so that you can join your PA colleagues from across the state in advocating for the PA profession at the state legislature. As the providers keeping our neighbors healthy across this state, your voice is extremely important in the public policy process! More details will be sent to you in the coming months.
In the meantime, be sure to check out the Legislative Action Center for the latest state government affairs news.
by April Stouder, MHS, PA-C
The 2018 AAPA Leadership and Advocacy Summit took place March 8-10 in Washington, DC. I was fortunate to attend this year as one of the NCAPA constituency organization representatives.
Back row, L-R: April Stouder, Linda Sekhon, Marc Katz, Ryan O’Hara, Danielle Mandir; Front row and extending further to the right: Alyssa Murray, Mia McDonald, Tori Hitz, Heather McBryde, Alisha DeTroye, Truett Smith, Katie Dore, Samantha Rogers, Jeff Katz.
The summit was action-packed, with day one being entirely dedicated to advocating for the profession on Capitol Hill. We heard opening remarks from Reps. Earl Blumenauer (D-OR) and Chris Collins (R-NY), who are both co-sponsors for legislation to improve PA practice and patient access to care by allowing PAs to certify diabetic shoes and home health services via modernization of Medicare laws. These lawmakers clearly understood the quality care PAs provide to patients, and the absurdity of our inability to perform these basic but essential tasks.
Next, we had a crash course in the do’s and don’ts of lobbying and how to “make the ask” to our elected officials to support these important pieces of legislation. AAPA provided talking points, information to leave with staffers, maps, and practical tips for making the most of our time on the Hill. The entire North Carolina contingency, which consisted of PA students, NCAPA representatives, practicing PAs and PA educators, met with congressional staffers for Sens. Burr and Tillis, and then we had separate appointments with our Representatives, based upon our districts. We found the legislative aides well-informed about healthcare and PA issues, and they asked insightful questions about our legislative request for support. It was exciting to see PAs from across the country walking the halls of Capitol Hill, emblazoned with “I’m a PA!” buttons and advocating for our profession. Collectively, we felt AAPA did an incredible job preparing us for our visit to the Hill and ensuring we had the resources and information we needed to represent PAs.
Our remaining time at AAPA LAS included interactive sessions related to advancing state legislative agendas, communication strategies for raising public awareness of the PA profession, leadership pathways, and coalition building. NCAPA leadership also benefited from learning about trends in CME, member services, and engagement through social media. It was wonderful to share ideas with state PA organizations from around the country and gain insights that we could bring back to North Carolina to enhance PA practice and our members’ experience with NCAPA.
I’d like to encourage North Carolina PAs to get involved with advocacy work, as there is tremendous benefit in ensuring our state and federal representatives know about the highly skilled care PAs provide and the impact that care has on the health of their constituents. NCAPA is organizing PA Day at the NC Legislature on May 30th, and it’s a wonderful way to connect with your legislators and ensure PA voices are heard.
by Alisha DeTroye, PA-C
In February 2014, I had the opportunity to share my advocacy story with over 150 PA and PA student attendees at the AAPA Leadership and Advocacy Summit. I shared my experience about a long term breast cancer patient “Robin” who I cared for in my oncology clinic during her six year battle with breast cancer. I was her valued caregiver, able to prescribe toxic chemotherapy, but not able to continue to care for at her most vulnerable time as she transitioned to Hospice and Supportive Care. This was challenging on a particular afternoon when my physician colleagues were at their national meeting and she had a change in status. Her pain management was delayed as I contacted a physician unfamiliar with her case but who had the authority to provide the necessary orders. While writhing in pain, she paused and asked to see pictures of my newborn son. It was in this moment that I was acutely aware that the system had failed to provide continuity of care for “Robin’s” medical home at the end of her life. This experience motivated me to attempt to make a difference in PAs prescribing Hospice.
The 2014 Leadership and Advocacy attendees used their own stories and many of them used “Robin’s” story to impact change and attempt to pass legislation. This was only one example of an advocacy effort regarding Hospice on one of seven bills pertaining to this important issue over a 20 year period.
On February 9, 2018 Congress passed and President Trump signed into law the Bipartisan Budget Act of 2018. Part of this law allows PAs to manage and provide hospice care to terminally-ill Medicare patients as well as allows PAs to supervise cardiac and pulmonary rehabilitation programs under the Medicare program. The law essentially added PAs to outdated Medicare language which was creating unnecessary barriers to care. The provision that law will allow PAs to order Hospice services as well as serve as an attending providing Hospice care will go into effect in January 2019. A physician must still certify a patient is Hospice eligible, but this significantly improves the continuity of care for PAs at end of life.
For me, this was a significant victory in my leadership and advocacy journey and helped me to see the value of my efforts in “Robin’s” memory. I was brought to tears to see this come to fruition. Now let’s move on to advocacy for ordering home health and diabetic shoes and have another victory for team-based, patient-centered care.
August 19-24th, 2018
Embassy Suites, Kingston Plantation
Myrtle Beach, SC
NCAPA combines the best CME conference for PAs (and NPs!) with a family-friendly beach vacation. We start and end our sessions early so you can have the best of both worlds!
NCAPA has reserved a block of rooms at the Kingston Plantation in Myrtle Beach. Rooms in our block fill up very early, so we recommend you book your room ASAP! You may reserve your room by clicking here or by calling the resort directly at (843)449-0006.
Saturday, March 24, 2018
Wake Forest PA Program
The suturing workshop is a 3-hour workshop designed to review basic suturing techniques including simple interrupted, continuous, vertical and horizontal mattress, deep dermal, and subcuticular stitches. During the workshop we will briefly discuss the different types of suture material, in addition to the different suture techniques, and the indications for the use of each one. The majority of the time is spent practicing hands-on techniques by suturing pigs feet and becoming more comfortable with instrument tying and hand tying. The student to instructor ratio is kept low for maximum interaction and support. Space is limited, so register today!
NCAPA’s PA of the Year award honors a PA who has demonstrated exemplary service to the profession and the community, while providing significant contributions to the health of the citizens of North Carolina. To be eligible for the PA of the Year award, an individual must be a Fellow or Associate Member of NCAPA and have been a practicing PA for at least five years.
May 1 is the deadline for 2018 nominations. Any NCAPA member may submit a nomination, including self-nomination. The 2018 PA of the Year award recipient will be honored at the 42nd Annual NCAPA Summer Conference in Myrtle Beach, SC. In addition to a plaque, the recipient will receive a complimentary full conference registration and one night’s lodging associated with attending the awards presentation. The recipient’s name will also be added to a permanent PA of the Year recognition plaque at the Stead Center.
Visit the NCAPA website to find out more about the PA of the Year and submit your nomination.
by NCAPA Nominating Committee
The NCAPA Nominating Committee is currently soliciting candidates for the 2019 Board of Directors and Nominating Committee. Serving on the NCAPA Board is an important way to contribute to your profession and a wonderful leadership experience. North Carolina became a great state in which to practice as a PA through the vision, leadership, and volunteer work of PAs just like you!
If you know a PA who cares deeply and wants to contribute to the future of the profession, who is a good listener, collaborator, and decision maker—or if you are that person—please submit a nomination for a position on the NCAPA Board of Directors.
The following positions for elected offices are open for nominees: President-Elect, Vice-President, Secretary, Director-At-Large (two positions), and a Nominating Committee Member. To read more about these positions and to nominate yourself or a colleague, click here. The deadline for nominating a colleague is May 31, 2018. The deadline for nominating yourself is August 1, 2018.
All terms begin January 1, 2019. Nominees for officer positions (President-Elect, Vice-President, and Secretary) must have been an NCAPA Fellow member in good standing for the calendar year prior to election. All other nominees must have been a Fellow or Associate member.
The seat on the North Carolina Medical Board designated for a PA will be coming up for appointment this Fall. Applicants must meet the following:
- Hold an active license or approval to perform medical acts, tasks, and functions in North Carolina.
- Have an active clinical or teaching practice. For purposes of this subdivision, the term “active” means patient care, or instruction of students in an accredited medical school or residency, or clinical research program, for 20 hours or more per week.
- Have actively practiced in this State for at least five consecutive years immediately preceding the appointment.
- Intend to remain in active practice in this State for the duration of the term on the Board.
- Submit at least three letters of recommendation, either from individuals or from professional or other societies or organizations.
- Have no public disciplinary history with the Board or any other licensing board in this State or another state over the past 10 years before applying for appointment to the Board.
- Have no history of felony convictions of any kind.
- Have no misdemeanor convictions related to the practice of medicine.
- Indicate, in a manner prescribed by the Review Panel, that the applicant: (i) understands that the primary purpose of the Board is to protect the public; (ii) is willing to take appropriate disciplinary action against his or her peers for misconduct or violations of the standards of care or practice of medicine; and (iii) is aware of the time commitment needed to be a constructive member of the Board.
Candidates who are selected to serve on the North Carolina Medical Board will be required to uphold and abide by the NCMB Code of Conduct.
Further information and application may be found on the North Carolina Medical Board Review Panel web site at http://www.ncmedboardreviewpanel.com. If you have questions about time commitment and/or the responsibilities involved, please contact Marc Katz PA-C at firstname.lastname@example.org.
We are pleased to announce that Alexis Perry and Shanna Newell have joined the NCAPA staff.
Alexis Perry is the Administrative Assistant and will provide general administrative support including board meeting preparations and ECC scheduling. Alexis is a 2016 NC State graduate with a B.S. in Nutrition Science and minor in Psychology. While at NC State, Alexis was the captain of the NC State Women’s Track & Field team and became an All-American track and field athlete. She also competed at the 2016 Olympic Trials in the 100 meter hurdles and the long jump. After graduation, Alexis worked as an office assistant at the NCSU track and field office and competed professionally as a track and field athlete in U.S and international meets.
Shanna Newell is the Membership Coordinator. Shanna will be responsible for member recruitment and renewals, Student Affairs and member support. Shanna joins us after serving 14 years with Habitat for Humanity of Wake County. Her roles at Habitat included volunteer management, event planning and project management. She is excited for the opportunity to pair her nonprofit skills and experience with a health-focused mission.
Welcome to both Alexis and Shanna.
by Kat Nicholas, NCAPA Director of Membership and Marketing
The PA profession is growing.
- In just the last five years, the number of PA programs in North Carolina has grown from 6 to 11.
- In just the last four years, the number of PAs living and practicing in North Carolina has grown from 4685 to 6230, for a total growth of 33%.
- In just the last three years, NCAPA staff has grown from four to seven, to ensure that we can meet the needs of all PAs in the state.
Due to all this growth, we’ve had to make some decisions regarding our infrastructure, and one of those decisions involves changing the way we keep up with our members and the way our members keep up with us. We are currently working on transitioning to a new database, so that all of our member information can be found in one place. There are benefits to us, as well as to you and all PAs in North Carolina. When you log in to the new site, you will:
- Be able to join or renew your membership with NCAPA;
- Have access to your personal financial records pertaining to purchases made through the new site, including obtaining certificates for completed CME (Please keep in mind these records will only be available for purchases made from the time of the new site implementation; not to purchases made prior to March 2018)
- Have access to online CME and other educational information and registration;
- Be able to update your personal information, including changing your email, name, etc.;
- Have access to an NCAPA member directory (for NCAPA members only; opt out available)
We are hoping to go live with our new online portal on April 4th. As can happen when any major “behind the scenes” change is implemented, we expect that there may be hiccups along the way. We realize this can be very frustrating when trying to register for an event or renew a membership, but we do ask that you be patient with us as we work to make our site better for us all. An email will be sent the week prior to our launch to remind all of our members of the change, as well as social media postings. In the meantime, if you have any questions or concerns, please do not hesitate to contact either Kat Nicholas (for membership questions) at email@example.com or Carin Head (for conference and CME questions) at firstname.lastname@example.org.
by Lisa Shock, MHS, PA-C, NCAPA Past President
James W. “Lanny” Parker, a Past President of NCAPA, died in June of 2004. As a devoted advocate for PAs, he left behind a legacy of service to NCAPA and the PA profession. He served on the NCAPA Board of Directors, including a role as President in 2002, and served on many Academy committees as well. The NCAPA Endowment Board of Directors voted to establish the Lanny Parker Memorial Fund to perpetuate his memory and recognize either a PA student or practicing PA who upheld Lanny’s interests in PA Leadership, reimbursement,and health policy.
Lanny was regarded by many on both the state and national level to be an expert on Medicare and other reimbursement issues. It is largely in part due to the work of Lanny Parker that there is a standardized credentialing form for PAs within the managed care community and he also contributed significantly to the legislation allowing PAs to be included in provider directories. He taught the basic principles of Medicare reimbursement to PA students at Wake Forest, ECU, and Duke and helped to educate his PA and NP colleagues at NCAPA reimbursement seminars. Michael Powe, AAPA Director of Health Systems and Reimbursement Policy, regarded Lanny as a true expert on issues related to Medicare and often referred member queries to him.
I had the honor and pleasure of working with Lanny in a rural family practice where he practiced for more than 20 years. He was my “big brother” PA and it is because of him that I became involved in legislative and advocacy efforts. He inspired me to work for our profession and serve at the state and national level.
The NCAPA Endowment is proud to name Danielle Mandir, a PA student at Wake Forest University, the recipient of the 2018 Lanny Parker Memorial Fund. Danielle was chosen for her commitment to seeking leadership opportunities and commitment to advocacy for our profession. Due to the award, Danielle was able to attend the 2018 Leadership and Advocacy Summit held March 8-10th, 2018. She commented that this was a great experience to attend as a student. She was able to learn about the key advocacy concerns of ordering diabetic shoes and home health and participate in conversations with legislative staff to convince bi-partisan support of these important PA issues. Additionally she enjoyed the leadership wisdom gained from networking with PA leaders and other students from around the nation. We are happy to support her efforts and look forward to her success in the future.
Did you know that the NCAPA Endowment awards a grant to one PA student PER PA PROGRAM each year? That means, 11 programs, 11 grants!
June 11 is the deadline to apply for 2018 NCAPA Endowment Scholarships. You must be a current student member of NCAPA and enrolled in your clinical year in a NC PA program in September of 2018.
To be considered, we must receive your completed application and an official transcript (no copies, please) from your PA program, postmarked by June 11, 2018. Transcripts should be mailed to:
NCAPA, att. Student Grants, 1121 Slater Road, Durham, NC 27703.
The NCAPA Endowment congratulates Ms. Leesha Gunnink as the 2017 NCAPA Endowment scholarship recipient of the William Franklin Cobb award earmarked for a clinical year student at Duke University PA Program. Ms. Gunnink completed her undergraduate studies with a 3.988 GPA in Spanish and Biochemistry at Calvin College in Michigan. During her sophomore year, she studied abroad, with full Spanish language immersion, in Peru. In her later college years, she worked as a biochemistry research assistant, and also served in leadership of the pre-PA club.
Leesha maintains involvement in community service projects such as Refugee Health Initiative, St. Baldrick’s Foundation, Keep Durham Beautiful and multiple church-related activities. Her professional aspirations include working with underserved patients, in the US or abroad. She is also quite interested in working within her community to enhance health policies in order to improve the care of patients who are socioeconomically disadvantaged.
Leesha Gunnink and Ms. Emily Adams, NCAPA Executive Director
The NCAPA Endowment board extends a heartfelt thank you to all who have made these scholarships and other grants possible through their generous donations. Please consider making a donation today to support PA students and practicing PAs who continue to do the work of providing excellent health care services in North Carolina.
Remember the game show “Jeopardy”? If you’re a current student member of NCAPA, now it’s your turn to play! The 2018 Student Medical Challenge Bowl is set for Saturday, April 14th, at the Stead Center in Durham.
Here’s how the PA Student Medical Challenge Bowl works:
- Competition is inter-collegiate: to the extent possible, each team will consist of students from every PA program in North Carolina. Teams are pre-determined, based upon who registers;
- Responses to all questions require a question prefix (e.g. “What is… or Who is…”). Only one response per question per team.
- Questions must be answered within 10 seconds, and points are deducted for incorrect answers. Teams “buzz-in” to answer questions as a group. The team that accumulates the most points wins.
- Prizes for all!
Registrations are due by March 30. Students should contact their NCAPA Student Representative to register.
Save the Date! The Piedmont Association of Physician Assistants (PAPA) will be holding its Annual Fall Seminar on Saturday, October 13th at the Forsyth Medical Center in Winston-Salem, NC.
Welcome to our renewing and our brand new members!
The following members have joined or renewed their membership since our last issue.
Thank you all for your support of NCAPA and all PAs in North Carolina!
Ashley Areheart, Charlotte
Katie Barber, Winston-Salem
Raul Canchari-Ames, Winston Salem
Chiara Carter, Maxton
Virginia Christman, High Point
Richard Cowan, Durham
Anthony Curiale, Fair Bluff
Greg Dion, Hampstead
Kelly Durham, Swansboro
Earl Echard, Garner
Mark Efird, Gastonia
Kodi Ethridge, Hickory
Pauline Faircloth, Roseboro
Andrew Fink, Wilson
Sunnie Flowers, Winston-Salem
Erin Floyd, Tabor City
Cheryl Flynn, Columbus
Carla Foster, Lynchburg, VA
Rebekah Garrison, Salisbury
Amanda Goowin, Clio, MI
Molly Gudger, Goldsboro
Jennifer Hall, Fayetteville
Caroline Harris, Fort Bragg
Danielle Harris, Raleigh
Stewart Harsant, Chicago, IL
Lisa Hasan, Durham
Nneka Hay, Knightdale
Jessica Hedrick, Wake Forest
Leana Higgins, Zebulon
Beth Holthusen, Winston-Salem
Shawn Hopkins, Greenville
Robin Hunter Buskey, Raleigh
Kathy Jones, Fayetteville
Michael Keene, Durham
Theodore Kistemaker, Winston Salem
Amy Kosich, Elmhurst, IL
Lauree Kruyer, Raleigh
Kayla Lerro, Raleigh
Patricia Lowe, McCormick, SC
Tristan Lunde, Charlotte
Jennings Lyons, Lumberton
Gail Marion, Winston-Salem
Gary McDaniel, Raleigh
Rebecca McGowan, Asheville
Rashonda Mintz-Smith, Harrisburg
Roger Mitchel, Southern Pines
Alyse Moses-Lebron, Carrboro
James Mosier, Lexington
Kimberly OBrien, Greenville
Lisa Ogata, Huntington Station, NY
Macarthur Payne, Winchester, VA
Megan Payne, High Point
Kyle Pelligra, Cary
Amanda Petree-Mabe, Belews Creek
Miguel Pineiro, Cary
Peyton Potts, Fayetteville
Shervon Robinson, Charlotte
Douglas Ross, Virginia Beach, VA
Kara Sloan, Raleigh
Sarah Stanley, Chapel Hill
Ami Steele, Gastonia
Matthew Strupp, Greensboro
Courtney Stump, lincolnton
Sarah Suggs, DURHAM
Akhila Takkallapalli, Lawrenceville, GA
Glenn Tripp, Angier
Louis Velazquez, Ahoskie
Royce Weeks, Willow Spring
Brian Wood, Franklinton
Anne Yarbrough, Winston Salem
Maureen Young, Pine Knoll Shores