In this issue:
by Charlene M. Morris, DFAAPA, MPAS, PA-C
Lewis Carroll once wrote, “If you don’t know where you are going, any road will get you there.”
On October 4, many NCAPA leaders met to review, rethink and revise NCAPA’s goals and objectives at a strategic planning meeting. Despite the post-lunch somnolence and brain drain, I was heartened with the ideas and tangible plans for the future. We must have a map and, perhaps more importantly, continuity from year to year, month by month. Even with unsurpassed energy and ideas, with no plan, there is no movement. Imagine a sailboat, bobbing and traveling almost on the whim of the wind in the waves. With a navigation plan, the journey begins and, even with inevitable storms and needed mechanical repairs, it continues.
First and foremost, we look towards the future and strive to continue to offer what you, our members, find valuable in NCAPA and also discover how we can continue to increase that value. Secondly, despite our best intentions, volunteers may not be able to accomplish all that we wish to, but the NCAPA staff are capable and motivated to succeed with us. And finally, we remain open to new ideas and energy from our membership. Would you consider running for an office or volunteering for a committee? If so, go to our website and find out how you can get involved.
Forty-nine years have passed since the first PA program began at Duke University. I reflected on this as I stood at the doorway of NCAPA’s Stead Center the Saturday before PA Week began, viewing the replica of Dr. Eugene Stead’s office. Although the office is frozen in time, you can still imagine the erudite physician coming into his office after a long day of teaching his first, or even his last, PA students. As I always do when I visit the Stead Center, I walked through the colorful grounds and have made the decision to find a botanist to accompany me on a guided tour to identify the hundreds of plants that thrive there in the garden. The Stead Center is worth the visit both inside and out!
October is Domestic Violence Awareness Month. Domestic violence can be a difficult and often uncomfortable, if not taboo, topic to discuss. Personally, I cannot fathom returning to just two decades ago before the Violence Against Women Act (VAWA) was passed. Yet, just during this last year, we have learned that North Carolina is in the top 8 for human sex trafficking in the US. Popular singer Ceelo Green was ousted from a lucrative television contract after stating that an impaired woman can’t be raped, if she does not recall the incident. And, of course, Ray Rice, the football player who knocked out his fiancée and now wife, was suspended and, after the video of the event was publicized, released from his NFL Ravens contract.
I grew up in a DV home and recently was punched by a man while I was swimming laps at a club where I no longer belong. I can attest that barriers and misconceptions still exist, including the chance of misplacing the blame on the victim. Just as Vice President Biden eloquently stated in last month’s Time magazine, women used to think or were told it was our fault when we were harmed. Women feared and experienced retaliation, alienation, loss of security and often guilt and anger for what we as a society perceived those same women could or should have done.
NCAPA’s Kat Nicholas previously worked in an organization providing services to victims of abuse and domestic violence and has written a short piece in this month’s Pulse. Be aware that the woman, child and sometimes man you are seeing at your office or ER may be the victim of domestic abuse and ask them a simple question: “Do you feel safe?” Listening is what PAs do best and your vigilance may save a life or lives with nary a prescription or suture required.
In August, I presented “PAlliative and Hospice Care: A Clinician Primer” at the NCAPA Summer Conference. Among all the comments and queries I received on the topic, the promise of a book was the best. Duke PA James Carter, Jr. told me of his father, who was a psychiatrist on faculty at Duke. Despite his father’s untimely death, his legacy continues on with the Carter Clinic. James, Jr. sent me two of Dr. Carter’s books, one on aging, the other on death and dying of African-Americans. I am honored to have received what I consider both a gift and a blessing as I continue my personal and professional experience on how to best provide for my patients and their families as they, and we, face end of life issues.
“One of the deep secrets of life is that all that is really worth the doing is what we do for others.”
Charlene M. Morris, PA-C
A Story of Domestic Violence
by Kat Nicholas, Director of Membership and Marketing
I arrived at the hospital in time for the police, as they entered the room with a barrage of questions, wanting to fill out their report. I was present during the examinations and as the physicians, nurses, pharmacists, interns, and any and every other person working on the floor that night, came into her room to ask questions, give advice, and share information. I sat with her through it all, quietly beside her, assuring her that if she wanted anything or needed a break, I would be her voice if she needed me. After a couple of hours, the busyness subsided and the room was quiet.
“Do you want to talk about what happened?” I asked.
“No, not really. I mean, it was my fault. I really shouldn’t nag him the way I do. I really should know better by now.”
“No. It’s not your fault. At all. There is absolutely no valid reason for him to hit you.” She looked away. “I’d like to tell you more about why I’m here and what resources are available to you, when and if you feel ready.” She nodded her head and I began.
I explained that I was the Crisis Line Manager at an organization providing services for victims of sexual assault and domestic violence. Our crisis line was the first point of entry for many of our services, available 24 hours a day. Our services included a shelter for women and children, individual counseling, support groups, and court advocates to assist with legal needs, such as restraining orders and courtroom support. We trained local police departments and hospital workers on domestic violence and went to local schools to talk about safe dating. And we had committed staff and volunteers, available 24 hours a day, to respond to calls from local hospitals or police departments reporting that an individual had been sexually assaulted or physically abused and was on their way to the emergency room.
After some general questions and answers regarding our services, I paused and asked, “Do you feel safe returning home?” She nodded. “Is there anything more you’d like to share with me? I can even drive you over to our offices when you check out, if you would like to talk to one of our social workers on staff.”
“No, I’m fine. I’m fine going home. I know he didn’t mean it. He really is a good man. I just need to learn to be a better wife.”
“Alright; I can tell you care about your husband and your relationship. I do want to give you this packet of information, though. As I told you earlier when I arrived, my name is Kat. You can call our crisis line any time, day or night, and if I don’t answer, someone else who cares just as much as I do will. But if you want to talk to me directly, feel free to call me anytime during the day at this number.” I gave her my information and she assured me she was fine. We talked a little more about her plans for going home and how to stay safe, though she admittedly didn’t feel that she was in any danger. Eventually, she told me she wanted to get more sleep and said I should go. “I’ll be alright. Thank you for coming.”
I left and drove to the office. I thought about her all day knowing that we had connected; she heard what I was saying, I had no doubt. I smiled at her strength.
I didn’t hear from her that day, or the next, or even the following week. About a month later, as I was walking into our shelter, I heard her voice. “There she is. There’s my angel.” I turned and saw her walking towards me, arms open. We hugged and she told me that she had really appreciated me being there for her that night. She had held onto the information I gave her, hiding it in her car. When she was ready and felt safe enough to ask for help, she called our crisis line and told the volunteer she was prepared to leave. Knowing what a courageous and potentially dangerous choice she had made, I was overwhelmed with gratitude to see her again. She was exactly as I remembered her. She wasn’t a victim. She was a survivor.
How to Help:
Individuals in abusive relationships feel they have no power. Listening and hearing their stories, with empathy and without judgment, is a powerful gift. As much as we all might want to tell them what to do or how to act or what you, yourself, would do, this continues to take away their own power. Ask the questions and assess their safety. Let them know you are available to listen and inform them of the available local resources. Provide them with the information to make their own choice, in their own time. And keep in mind that the most dangerous and lethal time in an abusive relationship is when the person being abused leaves, so don’t rush them to that choice.
- The National Resource Center on Domestic Violence provides information on domestic violence and related issues; (800) 537-2238.
- The National Coalition Against Domestic Violence offers many resources. They also offer a free booklet, “Hope and Power,” to provide information and guidance to domestic-violence victims about managing their finances and obtaining economic security.
- National Domestic Violence Hotline (1-800-799-SAFE ) is staffed 24 hours a day by trained counselors who can provide crisis assistance and information about shelters, legal advocacy, health-care centers, and counseling. There is also a toll-free number for the hearing-impaired: 1-800-787-3224 (TDD).
- Gay and Lesbian National Hotline provides free confidential assistance for gay, lesbian, bisexual and transgender people of all ages.; (888) THE-GLNH. http://www.glnh.org.
- GLBTQ Domestic Violence Project provides direct services and resources to allow gay, lesbian, bisexual, and transgender individuals to remove themselves from violent situations and relationships.
- Health Resource Center on Child Custody Protection provides information related to child protection and custody in the context of domestic violence; (800) 527-3223.
- American Bar Association Commission on Domestic Violence lists phone numbers and resources to help you find a lawyer.
Thank you to everyone who voted in the election to select leaders for the 2015 Board of Directors. The results are in and the following candidates were elected:
President Elect: Wanda Hancock (President-Elect from January 1, 2015 – December 31, 2015, followed by one year as President and one year as Immediate Past President)
Vice President: Samantha Rogers (January 1, 2015 – December 31, 2016)
Secretary: Linda Sekhon (January 1, 2015 – December 31, 2016)
Directors-at-Large: Frank Caruso and April Stouder (January 1, 2015 – December 31, 2016)
Nominating Committee Member: Ryan Vann (January 1, 2015 – December 31, 2016)
In addition, the following student members were appointed by the Board of Directors to fill two newly created Student Director-at-Large seats on the Governing Board: Kondie Lykins and Ashton Youngers. Their terms begin immediately and will last until December 31, 2015.
Thank you to everyone who showed their support for NCAPA by volunteering to run for a seat on the Board of Directors and congratulations to those who were elected!
NCAPA is seeking candidates to fill two vacant seats as alternates for our AAPA House of Delegates delegation. The NCAPA Board of Directors will select two Fellow members to serve as alternate delegates for abbreviated terms that begin on January 1, 2015 and end on June 30, 2015. Alternates will be expected to attend the AAPA HOD meeting in San Francisco May 23-27, 2015. Expenses will be paid by NCAPA.
In order to be considered, you must:
- Be a Fellow Member of NCAPA and AAPA in good standing through the previous calendar year.
- Submit a letter of intent (include your AAPA member ID#) and a brief platform statement to the NCAPA office no later than October 20, 2014.
The Board of Directors will consider eligible candidates and select two at the November 8, 2014 Board meeting, after which you will be notified of their decision. Submit materials by October 20th to NCAPA’s Executive Director, Cathie Feild, at Cathie.email@example.com or by fax at 919-479-9726. Questions may be directed to Cathie Feild at 919-479-1995.
Sheraton Imperial Hotel & Convention Center
February 23-27, 2015
Make your plans NOW to attend the 29th Annual NCAPA Recertification Exam Review Conference. Continuing education credits will be awarded to Physician Assistants, Nurses and Athletic Trainers!
The conference agenda is based on the NCCPA PANRE exam blueprint and will be geared 100% toward a basic review of all organ systems. Even if you are not up for recertification or don’t take the PANRE, this conference is a wonderful basic review of all organ systems for any health care provider. The full agenda with speakers will be announced in December 2014.
NEW for 2015! BLUEprint PANRE Pre-Test Live! This 2 evening workshop consists of a BLUEprint PANRE Pre-test that is administered live with John Bielinski, MS, PA-C and Robert Baye, MS, PA-C. This PANRE Pre-test is taken live with an audience response system (answered anonymously from your seat) with each question reviewed and dissected. Robert Baye is the former chairman for the PACKRAT committee and understands the psychology of test writers. Seats are strictly limited due to the number of audience response units – a wait list will be available when seats are filled. Just like all of our workshops, you can register for this event even if you are unable to attend the conference.
NCAPA plans to request 34 hours of AAPA Category 1 CME credit for the general sessions and 12 hours in workshops from the PA Review Panel. The total number of credit hours is yet to be determined.
The Sheraton Imperial Hotel and Convention Center has reserved a block of rooms for NCAPA conference attendees. Conference rates are available for all reservations booked for the conference before January 27, 2015, or while availability lasts.
For hotel reservations, click here or call (919) 941-5050.
The Federal Motor Carrier Safety Administration (FMCSA) now requires all medical examiners who wish to provide DOT/CDL exams to be trained and certified. NCAPA has developed a DVD series to train Commercial Driver Medical Examiners according to the new FMCSA standards and prepare them for the FMCSA Medical Examiner Certification Test. This course is approved for 6 hours of Category I CME*.
The DVD series includes 4 DVDs and a Course Workbook. A Post-Test & Answer Key with feedback will be e-mailed to you as well.
Read what other PAs are saying about NCAPA’s training:
“Thank you for producing an excellent DVD based course which was very helpful in passing the FMCSA Certified Driver Medical Examiner National Registry Examination. The lectures, review materials and summary of waiting periods are well organized and geared for Physician Assistants.” Nelson Zec, PA-C
“I was unable to attend an in-person class, so I ordered the NCAPA’s DVD set to gain my required Certified Medical Examiner training. This program exceeded my expectations in every way. The information presented was clear and thorough, and all of my questions were answered during the program. The accompanying written materials were a great supplement to the information provided by the lecturers, and will be a resource I use often in my clinic. I would recommend this affordable DVD program to anyone who cannot easily attend an in-person class.” Ryan Vann, PA-C
Click here to purchase the DVD set!
*This program has been reviewed and is approved for a maximum of 6.00 hours of AAPA Category I CME credit by the Physician Assistant Review Panel. Physician assistants should claim only those hours actually spent participating in the CME activity.
by Kat Nicholas, Director of Membership and Marketing
Thank you for your continued support and membership in the North Carolina Academy of Physician Assistants. Your commitment has been invaluable to NCAPA as we continue to be the only organization in North Carolina devoted exclusively to promoting and representing the physician assistant profession.
In 2014, NCAPA continued to advocate for you, speaking up and fighting for your rights as a PA. Much of this work is done through our Government Affairs Committee as they track legislation and regulations of interest to PAs and provide oversight and coordination with lobbyists, allied organizations and the General Assembly. This past year:
- NCAPA worked with the NC Medical Board on several projects including providing input for revisions to the position statement on the use of opiates to treat pain and the practice guide, “The Doctor is Out: A Physician’s Guide to Closing a Practice.”
- We provided input to the NCMB’s Allied Health Committee when it was proposing changes to the PA practice rules and we requested that they change the requirements regarding CME from 40 hours of AAPA Category 1 CME hours every two years to 50 hours to mirror the NCCPA’ s requirements.
- On the national front, NCAPA sent a letter to Senator Burr, who is the ranking member on the Subcommittee on Primary Health and Aging, requesting that he include PAs in any legislation related to primary care, and we provided information to Representative Renee Ellmers when she was considering her vote to repeal the Medicare Provider Payment Modernization Act.
NCAPA also continues to provide excellent CME opportunities. In 2014, NCAPA developed the Commercial Driver Medical Examiner Training DVD series to prepare medical examiners according to the new FMSCSA standards. We also hosted our 38th Annual Summer Conference, attracting over 1300 individuals from 34 different states. (All CME opportunities are offered at a discount to our members!)
None of these things are possible without your support. We count on your participation. We count on your voice. We count on you. Please be sure to renew your membership for 2015. We have lots of plans for the future of NCAPA and we look forward to you being a part of it.
Look for your renewal notice in the mail later this month or renew NOW online. Also, encourage a colleague to join. We strive to be the voice of ALL PAs in North Carolina!
by Lisa P. Shock, MHS, PA-C
Did you know?
Healthcare Providers Service Organization (HPSO) offers a 10% discount on professional liability insurance for Physician Assistants who are members of NCAPA. I personally have had coverage with HPSO since 2007 and it has afforded me many benefits.
- I am able to be free in my choices to moonlight in varying clinical settings as I have my own coverage.
- I am able to negotiate a higher hourly rate for my clinical work as I am already covered by my own policy.
- I will have my own lawyer if the need should ever arise.
With only employer provided coverage, you are not covered for any outside or additional work. In addition, should there ever be a license related complaint against you, you would not be covered under your employer’s policy.
There are two types of coverage – occurrence and claims made. You may find other companies that charge less for coverage, but make sure that you are comparing equal types of coverage. HPSO offers both. I have occurrence coverage which provides coverage for an injury or damage that takes place during the policy period, regardless of when the claim is reported. Therefore, an occurrence policy provides long-term protection for any covered claim that may arise at any time in the future – up to the limits of the policy in force at the time of the incident that led to the claim.
It has been well worth the expense to have my own liability policy and the 10% discount is a great benefit. My own discount is nearly $400 a year which far exceeds the cost of my dues to NCAPA.
Whether you are a PA who is interested in moonlighting or you simply want the flexibility and peace of mind that you are covered completely in your clinical practice – it is well worth it.
Time is of the essence – spaces are limited in our upcoming Student Leadership Retreat! On November 1st, NCAPA will host its Fifth Annual Student Leadership Retreat at the Stead Center in Durham. The retreat is geared specifically to the unique concerns of PA students about to enter the profession. We have some great speakers on the agenda and are looking forward to an inspiring day.
For more information, contact your NCAPA Student representative or Kat Nicholas, NCAPA Director of Membership and Marketing, at firstname.lastname@example.org.
from the AAPA
A new nationwide study confirms that patients believe PAs add value to healthcare teams and provide excellent patient service. The study, conducted by Harris Poll on behalf of AAPA, surveyed more than 1,500 U.S. adults. Among an oversample of 680 Americans who have interacted with a PA in the last year (meaning either they personally saw a PA or were present for the visit of someone they care for), the survey revealed strong support for the care PAs deliver:
- 93 percent agree PAs are going to be part of the solution to address the shortage of healthcare providers.
- 93 percent agree PAs are trusted healthcare providers.
- 92 percent agree having a PA at a practice makes it easier for a patient to get an appointment.
- 91 percent agree PAs improve health outcomes for patients.
- 91 percent agree PAs improve the quality of healthcare.
In an era when only 24 percent of U.S. adults say they have found a primary healthcare provider whom they like and trust, the findings show that PAs get high marks for the way they interact with patients. Read the full article here.
Reprinted from the NC Medical Society
Election Day is less than a month away. Feedback from our members suggests that many provider’s schedules do not allow them to get to the polls on Election Day, though. If that is your case, do not worry. There are ways to cast your ballot before then. Here is what you and your patients need to know.
You must be registered to vote. The deadline to register for the 2014 general election is October 10. For information about where and how to register, click here.
Any registered voter in NC can request a mail-in ballot. To request a mail-in ballot, you must return this form to your County Board of Election by 5:00pm on October 28. The form can be mailed, faxed, or emailed.
Your ballot will be mailed to the address you provide. Fill it out in front of two witnesses. It will come with a return envelope that has a form for you and your witnesses to sign. Ballots can be returned to your County Board of Elections by mail or in-person.
The deadline to return a mail-in ballot is 5:00pm on Election Day. Ballots returned by mail will be counted if they are postmarked before the deadline and received no later than three days after Election Day.
You can vote in-person at your County Board of Elections starting October 23. Some larger counties have several early voting sites. Look up sites in your county here. You must vote in the county in which you are registered.
Early voting ends the last Saturday before the election, November 1, at 1:00pm.
NCAPA recently received a request from a PA student at Wagner College on Staten Island, NY. He and four of his fellow students are working on a research project. Due to the large number of PAs in North Carolina, they asked if our members might be interested in helping with their thesis. The purpose is to investigate whether the title “Physician Assistant” is appropriate and to determine whether the title “Physician Associate” better represents the profession and its duties.
“Our methodology includes a survey we have designed with two parts, demographics and research. The demographics includes gender, age, professional title, certification status, years practicing medicine, primary setting of practice, level of professional interaction with a PA, primary specialty, environment of practice, and geographic region of practice. The research section includes questions regarding the title “Physician Assistant” and opinions on the proposed title of “Physician Associate.” We use a Likert scale of 1-5 to assess the participant’s opinion. This survey will be distributed electronically to physicians and physician assistants in the United States.” – Kylie Tanabe
If you are interested in participating in the survey, you may find it here.
from the National Governors Association
The National Governors Association recently released a report highlighting the benefits of PAs in the changing healthcare environment. The report states, “Physician assistants (PAs) make up a small but rapidly expanding part of the health care workforce. Their training and education produce a sophisticated and flexible medical professional who can function in many specialty areas and within many practice structures. Because of their adaptability and lower cost, PAs can play an important role in the health care delivery system.” (Read the entire report).
from the NC Division of Medical Assistance
An amendment to the Medicaid State Plan was approved by the Centers for Medicare & Medicaid Services (CMS) to convert the “Be Smart” Family Planning Waiver – to the “Be Smart” Family Planning Program, effective October 1, 2014.
The name is being changed to reflect that the program is no longer a waiver (demonstration), but the “Be Smart” designation will be maintained to minimize confusion.
Under the “Be Smart” program, eligible recipients receive basic family planning services and supplies: annual exams and physicals, most FDA-approved birth control, screenings and treatment for sexually transmitted infections, and screening for HIV and sterilizations for both women and men.
Changes to the “Be Smart” program associated with the State Plan Amendment include:
- Expanded coverage to include the same family planning services and supplies that general (full-coverage) Medicaid recipients receive. The program will continue to cover one annual exam or physical per year and up to six inter-periodic visits per year.
- Removal of eligibility restrictions based on age. It will cover family planning services and supplies to all individuals who meet the state’s income and other eligibility guidelines.
- Expanded coverage, screening and treatment for sexually transmitted infections (STI) and screening for HIV, which can occur at any of the six inter-periodic family planning visits per year. Under the Waiver, screening and treatment for STIs and screening for HIV was limited to one visit and one course of treatment per year, all of which were required to be performed in conjunction with, or pursuant to, the annual exam.
- Coverage of non-emergency medical transportation to and from family planning appointments. This service was not previously covered under the Waiver.
Examples of services not covered under the new program are:
- Emergency room visits
- Ambulance services
- Inpatient hospital services
- Treatment for complicated women’s health care problems, such as endometriosis
- Non-family planning services, including psychological and psychiatric services, infertility services, hysterectomies, abortions, AIDS and cancer treatment, dental and optical services, chiropractic services, or services required to manage or treat a medical condition, such as diabetes or hypertension, and,
- Other health care problems discovered during a screening, such as breast lumps.
Eligible recipients of the new family planning program will have an income of no greater than 195% of the federal poverty level. There are no co-payments for the “Be Smart” program.
More information about the “Be Smart” Family Planning Program can be found on DMA’s Family Planning web page.
Registration Open for Provider Training Courses in October
Registration is now open for several instructor-led training courses for providers that will be held in October at the CSC facility in Raleigh. The courses include hands-on training and will be limited to 45 participants each. The duration varies depending on the course. Following are details on the courses, the dates and times they are being offered, and instructions for how to enroll:
Monday, October 20 – 9:30 a.m. to 12:00 p.m. – Prior Approval – Medical (Professional)
This course will cover submitting Medical (Professional) Prior Approval (PA) Requests to help ensure compliance with Medicaid clinical coverage policy and medical necessity. It will also cover Prior Approval inquiry to check on the status of the PA Request.
Monday, October 20 – 1:00-4:00 p.m. – Submitting a Professional Claim
This course will focus on how to submit a Professional Claim via the NCTracks Provider Portal. At the end of training, providers will be able to enter a Professional claim, save a Draft claim, use the Claims Draft Search tool, submit a claim, and view the results of a claim submission.
Tuesday, October 28 – 9:30 a.m. to 12:00 p.m. – Prior Approval – Pharmacy
This course will cover submitting Pharmacy Prior Approval (PA) Requests to help ensure compliance with Medicaid clinical coverage policy and medical necessity. It will also cover Prior Approval inquiry to check on the status of the PA Request.
Providers can register for these courses in SkillPort, the NCTracks Learning Management System. Logon to the secure NCTracks Provider Portal and click Provider Training to access SkillPort. Open the folder labeled Provider Computer-Based Training (CBT) and Instructor Led Training (ILT). The courses can be found in the sub-folder labeled ILTs: On-site. (Refer to the Provider Training page of the public Provider Portal for specific instructions on how to use SkillPort.)