MAPA would like to recognize all those who were affected by the Boston Marathon bombings on April 15th. We would like to draw attention to the heroic efforts of those involved with rescuing and treating the injured on that day. Physician Assistants were an integral part of the treatment areas staged at the marathon finish line as well as in the numerous health care settings engaged in subsequent rescue and treatment efforts. To all who have suffered loss or injury to
themselves or a loved one – we are deeply sorry for what you have experienced. To all of you who helped in the recovery and treatment efforts – thank you for all that you have done.
Shortly after the Marathon bombings, MAPA conducted its third State House visit on Thursday, April 18th. Though the context under which the visit was conducted drastically changed because of what happened only days before, the presence of several dozen PA students in short white coats among lawmakers at this solemn and poignant time was well received. The students did lobby for bills that would affect PA practice in the Commonwealth, but that was no longer their primary reason for the visit. Rather, students focused on the strength of the health care system within Massachusetts because of the support provided at the legislative level for integration of PAs into practice standards. This support has allowed for creation of health care teams that, when confronted by tragedies such as the marathon bombings, provide the necessary care
when needed most. Lawmakers and staffers at the State House were appreciative of our presence and readily listened to what we had to say about the profession.
After several years of working with various regulatory bodies, MAPA is pleased to announce that PAs can finally begin seeking proper credentialing for appropriate clinical use of ionizing radiation. Please read the legislative update of this newsletter for more information. MAPA would like to thank all those who have helped make this possible – your efforts have finally paid off.
Sean T. Robinson, MS, PA-C
Call for Nominations
Pam McColl, MHP, PA-C
It is time for the annual election for the Board of Directors of MAPA. As you know, MAPA is your state representation on regulatory and legislative matters. This is an exciting time to be part of MAPA. With changes in healthcare regulations, the need for PAs is expanding. MAPA is at the forefront of engaging with regulators, legislators, and healthcare professionals to promote PAs as medical providers. Please consider becoming part of our dedicated and engaged board.
The positions currently open for elections are:
- Director at-Large (2 seats available)
House of Delegates
- Delegates to the 2014 AAPA House of Delegates, to be held in Boston (4 total delegates: 3 delegates and 1 chief delegate)
Term of Office
The Treasurer and Director-at-Large positions are two-year terms. Officers and Directors will assume office on July 1 of the year of their election. With the exception of President-Elect, there will be no limit on the number of successive terms which may be served.
Eligibility and Qualifications of Candidates
Officer and House of Delegates candidates must be Fellow members in good standing with MAPA AND the AAPA.
Director-at-Large candidates must be Fellow, Affiliate, Honorary or Retired members in good standing with MAPA.
Declaration of Candidacy
Nominations (self-nomination or otherwise) must be received by May 15th, 2013 and are only accepted from and for MAPA members.
Time of Elections
The election will be conducted by electronic ballot which will be made available to eligible voting members by May 16th, 2013. Voting will end on June 1, 2013 for tabulation.
If you are interested in a position or would like to nominate a MAPA member, please email us at MAPA@Chamberlainmedical.com as soon as possible.
Heather Trafton, MBA, PA-C
Director-at-Large, Chair of the Legislative and Regulatory Affairs Committee
MAPA has filed two pieces of legislation for this legislative session:
- SB1009: An Act Clarifying the Minimum Requirements for Licensure of Physician Assistants (Sponsor: Senator James Eldridge) – The current Massachusetts General Laws (MGL) and Code of Massachusetts Regulations (CMR) state that applicants for registration as a physician assistant in Massachusetts must have “received a bachelor’s degree from an accredited college or university or an equivalent approved by the board.” As written, this language does not enable those who have obtained a master’s degree without the issuance of a formal baccalaureate degree, to register with the Board and obtain a license.
PAs with master’s degrees were denied licensure in the past year, something we feel strongly about preventing in the future.
- HB1983: An Act Relative to Physician Assistants and Interscholastic Athletic Head Injuries (Sponsor: Representative Patricia Haddad) – The current Massachusetts General Laws (MGL) and the current Code of Massachusetts Regulations (CMR) put forth by the Department of Public Health in June, 2011 do not include physician assistants (PAs) in the list of medical professionals who can provide written authorization for a student athlete to return to play following a head injury. This legislation would amend the Massachusetts General Laws (MGL) to add physician assistants to the list of medical professionals who can provide written authorization for a student athlete to return to practice or competition following a head injury sustained during play. Last year during the time the regulations were promulgated comments were sent in from physicians and parents in support of including PAs. However, the DPH did not change the language. This has a tremendous impact on many of our PAs working in orthopedics and neurology who are qualified to make these clinical decisions.
Updates on Chapter 224 Legislation:
Insurers: Progress continues to be made in collaboration with insurers on implementing Ch 224 changes. BCBS is finalizing its internal process and infrastructure which will allow contracting and credentialing with PAs. Their first task is to list willing PAs who work in the primary care setting as primary care providers (PCPs) and to allow them to carry their own panel of patients in internal medicine, family medicine or pediatrics. Once that process has been completed, primary care PAs who do not wish to carry their own panel and PAs working in any other areas of medicine will then be contracted and credentialed. We will send information out as soon as we have it on the process in both scenarios. The Division of Insurance has sent out to all insurers a document that hopefully clarifies this process to allow for timely implementation and adaptation by all insurers and inclusion of PAs within these mandated changes.
Ratios and Prescription Writing: We have received several inquiries about other aspects in Ch 224 which updated PA practice. Regulations CMR 243 and 263 have not been updated to reflect the changes in the law; however, law takes precedence over regulations. Changes to both CMR 243 and CMR 263 can take several months to complete, sometimes as much as 7 or 8 months. This should not be a reason for your institution to not proceed with the changes. Institutions can choose to have policies that are more restrictive then law but it is our recommendation that you work with leadership to ensure that your scope of practice is consistent with State and Federal laws. If there are questions within your institution regarding the removal of the PA to MD ratio and the elimination of the supervising physician’s name on your prescription please consult Massachusetts General Laws for specific verbiage of the current law.
Changes to PA Board of Registration regulations CMR 263 have been finalized to complete the regulation changes that were needed to allow for reimplementation of PA use of ionizing radiation. Radiation Control and AAPA/ASRT have been working on the operational components of the process.
Currently, this is what we know of the process:
- The AAPA is currently offering an online fluoroscopy training course which must be completed by a PA who intends on utilizing ionizing radiation in their clinical practice. The PA must successfully complete the course followed by 40 hours of supervised use of fluoroscopy
- The AAPA will notify the DPH/Radiation Control that the PA has successfully completed the APPA course. At this time, it is uncertain if the DPH will require submission of documentation verifying supervised use of fluoroscopy to the AAPA or the DPH.
- The PA will receive notification from the DPH stating eligibility to take the ARRT examination
- The PA will take the ARRT examination and be notified of exam results
Here are some helpful links:
- BORM 243 CMR 2.08(6) http://www.mass.gov/eohhs/docs/borim/reg-243-cmr-2.pdf
- PA Board of Registration 263 CMR (changes not posted yet)
- Information on required course: http://qa.alliancetek.com/fluoroscopy/Home/Default.aspx
Please keep in mind that MAPA dues allow us to work with a lobbying team that has been instrumental in our efforts to keep PAs and your legislators at the State House informed and voting on key PA issues.
Jay Chamberlain, PA-C
Chair of CME Committee
The MAPA Spring Pharmacology CME Event was held in March at the Lahey Clinic, providing over 6 hours of Pharmacology CMEs for PAs. A post-conference survey of participants revealed high satisfaction scores for the speakers as well as high relevance of conference content to practice settings. This year’s talks included pharmacologic management of diabetes, headaches, nosocomial infections, and many others. In between lectures, attendees were able to network with their PA colleagues over breakfast and lunch and approach conference presenters with questions.
Plans are already well underway for the Fall CME Event at the Boston Omni Parker House Hotel in September. Our CME partner, Chamberlain Medical Resources, is also working on a CME event at Baystate Medical Center in Springfield for late Fall. Check the MAPA website for more developments on these CME opportunities.
Pam McColl, MHP, PA-C
President-Elect, Chair Student Affairs Committee
Two new PA programs will be opening in Massachusetts in the near future – Boston University and the Massachusetts General Hospital (MGH) Institute of Health Professions. These programs join the two newest PA programs, Bay Path College in Longmeadow and Tufts University in Boston, to create a total of seven PA programs in the Commonwealth. The PA profession is growing in leaps and bounds and MAPA looks forward to working with and supporting the many PA graduates emerging from this expanding list of programs.
MAPA recently sponsored a student-led showing of the documentary film Escape Fire. The film, recently featured on CNN, reflects on the current status of the US healthcare system which has historically had an incentive to foster disease care rather than health care. Around 60 students from the three Boston-based PA programs convened at MCPHS Boston to watch the documentary and discuss its message. The MAPA Board of Directors unanimously supported this event as they felt students would significantly benefit from seeing the film in the context of current changes to the US and local healthcare systems. Changes such as allowing PAs to act as Primary Care Providers in Massachusetts, though not explicitly addressed in the documentary, will hopefully help in the transition from disease care to healthcare over the next several years. Having not yet worked as PAs in the Commonwealth, it is hoped that the students who watched the film will take away the significance of legislative triumphs such as Chapter 224 of the Acts of 2012 (aka the Massachusetts Healthcare Cost Containment).
Bay Path College Update
Since the last newsletter the students and faculty at Bay Path have been on a whirl wind adventure. Bay Path received a one million dollar HRSA grant which is being used to promote primary care in the community. This will help reduce the costs associated with our primary care rotations. This grant has allowed the faulty to hire 6 part time professors. These professors will also become our mentors out in the community while we are on our rotations.
We have been very busy in the community during our last couple of semesters. Students have been involved with cardiac screening of local communities’ high school athletes. These screenings are meant to raise awareness of unknown congenital heart defects and identify possible risk factors. The screening events involve taking blood pressures, EKGs done by the students and nurses and echocardiograms are done by a pediatric cardiologist. To date 200 high school athletes have been screened with more events to come. As a class we will also be sending 15 people to represent Bay Path on April 18th out in Boston at the State house with everyone else from MAPA. Bay Path’s first PA class will begin our clinical rotations in June and we look forward to working with our PA preceptors!
MCPHS University Update
On February 21st, the MCPHS University Boston PA Student Society (PASS) held a networking event to give nearly 100 students an insider’s perspective on clinical practice. Eight currently practicing PAs discussed their diverse specialty areas, which included primary care, orthopedics, pediatrics, neurosurgery, cardiac surgery, interventional cardiology, dermatology and oncology. Through small group interactions with these PAs, students were able to gain a better understanding of how a PA fits into various work settings. It also provided an opportunity to network with those working in a particular field of interest. Many students commented on how valuable the experience was and that it helped clarify which specialty they would consider upon graduation. PASS hopes to make the event annual with even more specialties in the future. Thanks to the PAs who attended this event and made it so successful!
Northeastern University Update
During their April vacation from school, a group of 14 Physician Assistant students from Northeastern University will join a medical mission team in Guatemala. They will spend 8 days in a remote region of Guatemala with Jungle Medic Missions, an organization that takes teams of medically trained personnel into villages along the Rio Dulce River Izabal area. These villages are in areas that otherwise have zero access to medical or dental care, where even basic needs such as proper nutrition and shelter are grossly inadequate. They will invest their time, skills and supplies to run clinics and provide routine and emergency medical treatment, dental care and health education. Good luck to the students and their sponsors!