In this issue:
by Marc Katz, PA-C
What a great time to be a PA and, especially, a PA working in North Carolina. Advocacy is the theme, as there has been so much going on legislatively this past month. Your Academy successfully got legislation introduced to create a PA-only seat on the Medical Board. As proud as I am that we have passed the first hurdle by getting it through the House (onto the Senate next), I am also very happy to see that over 500 PAs logged into our Legislative Action Center when the email blast went out about our bill.
Other bills that have come up this legislative session affecting PAs deal with:
- Asking patients whether or not they own a gun (I want to emphasize this does not deal with the often emotional debate over whether or not people should own guns; this solely involves the right of a health care provider to ask if someone does own a gun),
- Administering lethal injections,
- Medical Board laws and inclusion of physician assistants when health care providers are specifically mentioned.
These bills have kept our lobbyist, Government Affairs staff and Central Office very busy. The NCAPA has been active and at the table on discussions about Medicaid reform in this state. We are there to ensure there will be no restrictions in our ability to care for our patients. Please continue to visit the Legislative Action Center for an up to date review of what’s going on in the state affecting your profession and respond to the emailed Action Alerts. We each need to be engaged in our profession and continue to ensure that PAs in North Carolina are heard.
Other areas of interest across the state include the newest PA program in North Carolina, at High Point University, which will begin in June of this year. This brings the total number of programs to nine (two with satellites in Western North Carolina). With the addition of two other programs, UNC and Lenoir-Rhyne, potentially starting students in 2016, there will be an even greater need for clinical sites for students. This is a very rewarding opportunity and a great way to give back to your profession. I have yet to preceptor a student and not come away learning something myself. Our Board was given a great presentation by Paul R. Chelminski, MD, MPH, FACP, Clinical Professor of Medicine and Director of the UNC Physician Assistant Program. He provided great information about the new program, which will provide special consideration to veterans who have served in medical military settings.
On a national level, I will be off to San Francisco for the AAPA House of Delegates at the end of this month. There will be a total of 51 resolutions brought this year before the House, many of which deal with bylaw language and policy review, while others deal with removing references specific to supervision, inclusion on national provider lists, and equity of pay for PAs. There are two resolutions which are sure to be debated, one that states AAPA should recognize the term physician associate as well as physician assistant, and one that deals with increasing the entry level into the profession to a doctorate degree. Hotly debated social issues always come before the House and this year there is no paucity of these items. I will provide a review of which resolutions get passed in next month’s President’s Report.
I started by saying this is a great time to be a PA. We need to ensure that it remains that way in the future. The best insurance for this is involvement. Read what is sent, see what excites you, and take some time to give back. There are many ways to do it. I promise it will make you feel even more proud of the profession you have decided to devote your career and life to.
Marc Katz, PA-C
by Sarah Wolfe, Assistant Vice-President, McGuire Woods Consulting
In the North Carolina General Assembly (NCGA), “crossover” refers to a self-imposed deadline by which a bill must pass either the House or Senate in order to remain eligible for the remainder of the session. Bills that are strictly policy in nature, and do not involve spending state funds or imposing fees or taxes, must make it to the opposite chamber by the crossover deadline. This year, the crossover date was Thursday, April 30th.
In North Carolina, there is no constitutional limit for how long the legislature can be in session, nor does the body set a specific date for session adjournment in their rules. In the state’s constitution, however, the NCGA is deemed a part-time legislature, meaning that it is not supposed to be in session on a year-round basis. Therefore, the crossover date is imposed by the House and Senate in order to help limit the overall length of session.
By the end of this year’s crossover date, the House passed 349 bills and the Senate passed 175 bills over to the opposite chamber. You will find a sample of bills of interest to PAs that made the crossover deadline, were not subject to the deadline, and failed to make it to the other chamber before the deadline, below.
Post-crossover, legislators are now focusing on the budget. Speaker of the House Tim Moore recently announced that the budget would be released on either Monday, May 18 or Tuesday, May 19. Speaker Moore said that they expect to vote it out of the House by the end of that same week. At that point, with the budget in the Senate’s hands, they will then amend it as they see necessary. It is expected that there will be many contentious sections of the budget that House and Senate leaders will not agree on, which will send the budget to a conference committee. Hopefully House and Senate budget chairs will be able to come to an agreement on the budget by July 1, when the new fiscal year begins.
Amend Composition of NC Medical Board (H724): Adds an additional seat to the NCMB, allowing for both NPs and PAs to have their own seats on the Board. This is the bill that NCAPA requested to be filed this year. HB 724 passed the House unanimously in April, and now awaits a hearing in the Senate Rules committee.
Establish Chiropractor Co-Pay Parity (H528): Would prohibit insurers from charging higher co-pays than they do for primary care physicians for medically similar services. Does not apply to the NC State Health Plan for Teachers and State Employees.
Jim Fulghum Teen Skin Cancer Prevention Act (H158): Prohibits teens under the age of 18 to use a tanning bed. The bill is named after former Rep. Jim Fulghum, a retired neurosurgeon from Wake County, who died last year after a battle with cancer. This legislation was one of his top priorities while serving in the legislature.
Require Hospitals to Offer Influenza Vaccine (H925): Requires hospitals to offer inpatients, aged 65 or older, the flu shot.
Restoring Proper Justice Act (H774): Permits PAs, nurses, and emergency medical technicians to administer the lethal injection to inmates sentenced to the death penalty. The bill does not require the physician to be present at that time of the lethal injection, but does require the physician to pronounce the prisoner dead. Rep. Gale Adcock, a Wake County nurse practitioner, offered an amendment to take out nurses and PAs from the legislation. The amendment failed in the House, 35-81. NCAPA is currently looking into options for removing PAs from this bill in the Senate.
NOT SUBJECT TO CROSSOVER, STILL IN PLAY
Modernize Nursing Practice Act (S695/H807): Would allow NPs, Certified Nurse Midwives, and Clinical Nurse Specialists to be licensed by the NC Board of Nursing as an advanced practice registered nurse (APRN).
Second Amendment Affirmation Act (H562): This bill, which would prohibit health care providers from asking their patients about firearms ownership, among other provisions, is still alive after bill sponsors attached an appropriation to the bill. Bill sponsors did this in order to keep the bill alive, which would have no longer been eligible after the crossover deadline otherwise. The North Carolina Medical Society, NCAPA, and many other health care provider groups are opposed to this particular provision of the bill.
2015 Medicaid Modernization (H372/S574): The first of several Medicaid reform proposals that legislators may consider. This legislation, with a version filed in both the House and Senate, intends to allow for provider-led capitated health plans. The bill currently lacks many details, but that is most likely going to change in the coming weeks.
Medicaid Modernization (H525/S696): This Medicaid reform plan also has both a House and Senate version. The proposal would allow for both provider-led and private managed care organizations in the state. It also calls for the Medicaid and NC Health Choice programs to be taken out of the NC Department of Health and Human Services by creating an independent board that would administer and govern the programs.
Medicaid Transformation (S703): This bill, proposed by Senate President Pro Tempore Phil Berger, would transform Medicaid from a fee-for-service program to a capitated, risked-based managed care program. The legislation calls for the state to enter into at least three contracts with Medicaid managed care organizations.
WHAT DID NOT MAKE CROSSOVER DEADLINE
Enact Stricter Immunization Requirements (S346): Would eliminate the religious exemption for immunizations for children. Never received a committee hearing after senators were hearing concerns from citizens across the state. President Pro Tempore Phil Berger’s office also sent out a press release proclaiming that the proposed legislation was “dead.”
Medical Marijuana for Terminally Ill Patients (H317): After an emotional House Judiciary committee hearing in March, a measure to allow for the use of medical marijuana failed the committee unanimously.
PLEASE reach out to your Federal Representative and urge him or her to support HR 1202, the Medicare Patient Access to Hospice Act of 2015, which would authorize PAs to provide hospice care. AAPA has been working like crazy in the halls on Capitol Hill, and we have found that there is a lot of support for this bill. HOWEVER, offices are also telling us that they’re not hearing from constituents back home, and, as you know, they look to constituents to make issues personal, relevant, and local.
YOU are the ones who ultimately have a big say in whether a legislator supports a bill or not. Please contact your House member and urge them to support authorizing PAs to provide hospice care by cosponsoring HR 1202. The more cosponsors we get, the more likely (and the sooner) the bill could be considered for a vote. Take action online here. Please be sure to personalize the suggested text with your name, facility, and a personal example or story.
Thank you for your advocacy!
Embassy Suites, Kingston Plantation
Myrtle Beach, South Carolina
August 16-21, 2015
Early Bird Pricing through May 31! Register today!
Registration is open for our 39th Annual Summer Conference! NCAPA combines the best CME conference for PAs with a family-friendly beach vacation. Register and pay by May 31 for our Early Bird registration rate!
Our full agenda has been 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 fills up very quickly and some properties and room types are already full. Please note that we have two 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.
Embassy Suites & Kingston Condos Group Code NAP
Hilton & Royale Palms Group Code APA
Click here for hotel information & room reservations. Reserve your room now for the best selection!
Are you interested in Continuing Medical Education? Do you have a passion for bringing the latest and greatest CME to North Carolina PAs? Then we are looking for you!
NCAPA is developing a new sub-committee of the Continuing Education Committee called the Educational Development Panel. The Educational Development Panel will ensure that NCAPA can provide CME through a variety of ways, such as online, webinars, and one-day workshops. The sub-committee will also assess ways in which to provide the new Self-Assessment and Performance Improvement CME required by NCCPA.
The chair of this sub-committee is April Stouder, MHS, PA-C. If you are interested in serving on this sub-committee, please contact Carin Head, NCAPA Director of Conferences & CME, for a committee application. Carin can be reached via e-mail at email@example.com or by phone at (919) 479-1995.
Don’t forget! June 11 is the deadline to apply for 2015 NCAPA Endowment Student Scholarships for current student members who will be entering or newly enrolled in their clinical year in September of 2015. To be considered, we must receive the completed application, done either online or by mail, and an official transcript postmarked by June 11, 2015. Transcripts (no copies please) should be mailed to:
NCAPA, att. Kat Nicholas, 1121 Slater Road, Durham, NC 27703.
Each year the Metrolina Association Of Physician Assistants (MAPA) presents scholarships to local PA students. Congratulations to this year’s winners from Wingate University!
Truett Smith, PA-C, MAPA Vice President, Robert Hehre, Lauren Caraway, Jacquelyn Stembridge, and Ray Brown, PA-C, MAPA President
Kondie Lykins is one of two Student Directors on the NCAPA Board of Directors. He initially became involved as Campbell University’s NCAPA Student Representative in 2014 and began his role on the BOD in 2015. Kondie currently lives in West End, NC, and will graduate from Campbell’s Master of Physician Assistant Practice program in December of 2015. He is leaning towards a specialty in Pain Management.
What aspect of becoming a PA do you like best?
Helping people every day, flexibility of career choices
Why do you think it is important to be involved in NCAPA?
As PAs our ability to contribute to people’s lives is dependent on our ability to practice. NCAPA allows us to shape the environment in which we work and the added advantage of helping colleagues.
Do you have any personal information you would like to share?
My wife’s name is Melody; we married in January of 2000. We have seven children: Keegan, Spencer, Preston, Avonelle, Elisa, Porter, and Bryant. I grew up on a farm in Elizabethtown, Indiana, and still love being outdoors and working with plants and animals. I’ve discovered that I also love the ocean. I am the ninth of ten children, all of whom were forced by my mother to learn to play piano, for which I am now grateful. My wife and I both play piano and she is teaching (at times by force) our children to play.
I served on a two year mission for my church in Mexico and have come to love the Mexican language and people (the food not so much, except for a few things). Our family is active in the LDS church, my wife having also served on a mission for our church in Chile. I am also a volunteer indexer for FamilySearch.com and Ancestry.com. I used to run but have since changed from running to rucking. Being from Indiana I had no choice, I had to play basketball, although I also enjoy soccer and racquetball.
by Kat Nicholas, NCAPA Director of Membership and Marketing
Thirty-two students, representing six PA programs in the state, competed on four randomly selected inter-collegiate teams in the 2015 Student Medical Challenge Bowl held on Saturday, May 9th. The Challenge Bowl is a Jeopardy-style game with two rounds of play, each with five categories of questions ranging in point values from 5-25 points, with a number of “daily doubles” thrown in. Buzzer technique and strategic wagering on Final Jeopardy are key, as is phrasing the answer in the form of a question. Question categories included neurology, dermatology, anatomy, physical exam, PA history, cardiology, pulmonary, EENT, musculoskeletal, and gastroenterology.
Laura Gerstner, the Director of Clinical Education at Campbell University and Student Affairs committee member, served as the MC for the tournament. Cathie Feild, NCAPA Executive Director, was the mistress of the buzzers and Kat Nicholas served as scorekeeper.
Team 1 Team 2
Team 3 Team 4
The eight students on each team worked well together during their deliberations, with only one “Oops, I didn’t mean to press the buzzer!” moment. Team 2 was in the lead at the end of the first round with 70 points and won the game with a total of 220 points. A huge comeback was made by Team 3, who ended the first round with -10 points and came back to take second place with a total of 110 points. All teams took home cash prizes, enabling them to indulge in luxuries ranging from a cup of coffee to an elaborate dinner found in a drive-thru. Win or lose, everyone had a lot of fun!
Students participating in this year’s Challenge Bowl included:
- Campbell students: Will Ashby, Rebecca Babski, Angela Cheung, Crystal Fischer, Tiana Jansen, Jimmy Lisowski, and Sara Suh;
- Duke students: Kelli Kay, Abigail Pettigrew, and Alex Shamburek;
- ECU students: James Burns, Foster Hunt, and Taylor Robinson;
- Elon students: Zach Dedden, Pete Guertin, Ashley Meyer, Scottie Springer, Brittany Wiseman, and Katie Young;
- Wake Forest students: Joey Baker; Samantha Condon; Brit Donaldson; Karim Ghanem, Amy Rodriguez, and Max Vinograd;
- Wingate students: Tiffany Austin, Greg Bernardi, Elissa Bolling, Karis Kevorkian, Amy McGraw, Christina Spinaris, and Ross Williams.
Alexandria, VA – PAs won a significant victory in the bipartisan Medicare reauthorization legislation that was signed into law by President Obama on April 16, 2015. The statute includes an increase in Medicare payment rates for PAs and other providers for each of the next five years, reduces a number of barriers to effective PA practice under the Medicare program, and elevates the profile of PAs as vital healthcare providers to America’s seniors. Importantly, changes in the Medicare program are a bellwether for changes in private insurance practices, as well. Read the full story here.
by Community Care of North Carolina
The NC Medicaid Outpatient Pharmacy Program will implement changes to three important programs that will all affect antipsychotic prescribing/use for NC Medicaid beneficiaries effective Friday, June 5, 2015. These programs are: Antipsychotics – Keeping Documented for Safety (A+KIDS), Adult Safety with Antipsychotic Prescribing (ASAP), and the antipsychotic portion of the Preferred Drug List (PDL). Read about all the changes here.
from Centers for Disease Control and Prevention
You can play a key role in fighting tobacco use, the number one cause of preventable death and disease in the United States. No matter what your specialty is, you know the drastic effects that smoking can have on your patients’ health. You know the toll secondhand smoke can take on their children and families. Many smokers want to quit. Getting started often takes support and motivation from trusted sources, like you. Read more here.
from NC Department of Health and Human Services
The North Carolina Pesticide Incident Surveillance Program, a program within the NC Division of Public Health, monitors the frequency of acute pesticide poisonings in the state and requires health providers to report confirmed or suspicious cases to them. Like many illnesses linked to environmental exposures, however, pesticide poisonings are commonly under diagnosed due in large part to barriers in seeking care and lack of recognition. Read more here.
from HealthDay News
Many patients with chronic heart disease will receive the same quality of care from a PA or nurse practitioner as they would from a physician, says a new study.
That’s good news because the recent expansion of U.S. health coverage has many public health experts warning of a future with too few physicians for the patients on hand.
Shortages of heart physicians, in particular, are a priority and “a hot topic for many state legislators and policymakers,” said Brahmajee Nallamothu, MD, a spokesman for the American Heart Association.
Increased use of PAs and nurse practitioners is one attempt to close the gap — one that builds on the idea of team-based medicine, said Nallamothu, an associate professor of internal medicine at the University of Michigan in Ann Arbor.
Read the full story here.
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.