january/february magazine - 2011

NewsNewsOfficial Publication of the California Academy of Physician AssistantsOfficial Publication of the California Academy of Physician Assistants

January/February 2011

CAPA Works to Implement PA Use of Fluoroscopyby Bryce Docherty, CAPA Legislative Advocate

The Magazine\

CAPA continues to regularly meet with the California Department of Public Heath – Radiologic

Health Branch (CDPH-RHB) to implement AB 356 (Fletcher) from 2009. As many of you know, even though the legislation was signed into law that provides a pathway for PA use of fluoroscopy, CDPH-RHB has undertaken development of regulations that could delay implementation for up to two more years.

CAPA Legislative Affairs Coordinator, Beth Grivett and I met with CDPH-RHB on March 3, 2010 and again on October 20, 2010. The purposes of the meetings were for updates

on CDPH-RHB regulatory progress and to offer any needed assistance from CAPA. At these meetings, CDPH-RHB outlined the issues they are addressing with the regulations and why they could take up to two more years. The issues they need to address include:

�� Reconfiguration of internal computer system and IT needs

�� Examine the PA scope of practice

�� Staffing needs analysis for PA applicants

�� Other funding needs (i.e. estab-lishing the PA permit fee, ap-plications process and workload analysis)

�� Examine whether the existing fluoroscopy RT curriculum is appropriate for PAs

CDPH-RHB appears to be addressing all these issues adequately. For example, they have determined that the existing RT curriculum is appropriate for PAs. This is great news; otherwise CDPH-RHB would need to spend much longer developing a PA-specific curriculum. Furthermore, hardly any existing fluoroscopy training programs would accommodate such a new and limited curriculum.

CDPH-RHB asked CAPA to assist them in determining the potential number of PAs who would be seeking the fluoroscopy permit. This will directly correlate to whether or not undertaking such a regulatory effort will get approval and what precisely the application fee will be for the permit. For example, the Office of Administrative Law (OAL), which must approve the CDPH-RHB regulations, may not approve staffing resources for this program for only 50 applicants. Furthermore, the application fee needs to sustain the program resources, so the smaller

number of applicants – the higher the application fee. Therefore, CAPA sent out a survey asking if you would potentially seek this fluoroscopy permit. We are pleased with those survey results and will be passing that information on to CDPH-RHB. Thank you for those who responded to that survey!

CAPA believes that CDPH-RHB will most likely have regulations published by July 1, 2011. Once the regulations are published, CDPH-RHB will have one year to move them through the OAL process. However, CAPA is guardedly optimistic that these regulations could be finalized by the end of 2011. Regardless, Beth Grivett and I will continue to be proactive with CDPH-RHB in hopes of implementing PA use of fluoroscopy as soon as possible.

“The purposes of the meetings

were for updates on CDPH-RHB

regulatory progress and to

offer any needed assistance

from CAPA.”

6 HoursCat. ICME

2011 Schedule of

Controlled Substances Education Courses

Inside on page 13

2 CAPA NEWS

Editor

Gaye Breyman, CAE

Managing Editor

Denise Werner

Editorial Board

Eric Glassman, MHS, PA-CBeth Grivett, PA-CBob Miller, PA-CLarry Rosen, PA-CMichael Scarano, Jr., Esq.

Proofreaders

Paula Meyer, PA-C

CAPA Board Of Directors

President

Eric Glassman, MHS, [email protected]

Vice President

Larry Rosen, [email protected]

Secretary

Cherri Penne-Myers, PA-C, [email protected]

Treasurer

Bob Miller, [email protected]

Directors-At-Large

Beth Grivett, [email protected]

Matthew Keane, MS, [email protected]

Adam Marks, MPA, [email protected]

Greg Mennie, PA-C, [email protected]

Student Representative

Jenn Baltazar, [email protected]

The CAPA News is the official publication of the California Academy of Physician Assistants. This publication is devoted to informing physician assistants to enable them to better serve the public health and welfare. The publisher assumes no responsibility for unsolicited material. Letters to the editor are encouraged; the publisher reserves the right to publish, in whole or in part, all letters received. Byline articles express the opinion of the author and do not necessarily reflect the views or policies of the California Academy of Physician Assistants.

The CAPA office is located at:3100 W. Warner Ave., Suite 3Santa Ana, CA 92704-5331Office: (714) 427-0321Fax: (714) 427-0324Email: [email protected]: www.capanet.org©2011 California Academy of Physician Assistants

NewsNews Program Cuts Red Tape for Volunteer Health ProfessionalsBased on a press release from the HHS, October 2010

The U.S. Department of Health

and Human Services (HHS) has launched a national Web site for the Emergency

System for Advance Registration of Volunteer Health Professionals (ESAR-VHP) to make volunteering in an emergency faster and easier for health professionals. The ESAR-VHP is a federal program developed after complications arose in the use of medical volunteers following 9/11. The program establishes and implements standard guidelines for registering, verifying and deploying medical professionals in the event of a large-scale national emergency.

The new Web site provides a single point of entry for potential volunteers, quickly connecting them to each state’s ESAR-VHP program. According to the HHS, the new process can shave off hours, even minutes, from the time volunteers used to wait to have their credentials verified.

The HHS encourages health professionals to visit the Web site (www.phe.gov/esarvhp) and follow the steps to register with their state system. Registering with ESAR-VHP does not mean that health professionals are obligated to serve. Registered participants can opt in or out when contacted to volunteer.

Currently, ESAR-VHP has 49 state programs in place and almost 150,000 volunteers registered. HHS notes that state coordinators are eager to add to the number of volunteers willing to serve in case of a disaster.

Former Governor Arnold Schwarzenegger appointed Robert Sachs, PA-C to the Physician Assistant Committee of the

Medical Board of California on January 2, 2011. Mr. Sachs had previously served on the

Committee from 1993 to 2008 and as Chairman for 11 years. He currently practices at USC Cardiovascular Thoracic Institute of the Keck School of Medicine since 1995. He served as Clinical Instructor at Keck School of Medicine from 2002 to 2010 in Cardiothoracic Surgery. He is a Past President of the California Academy of Physician Assistants (1988) and received our highest award, the “Pride of the Profession Award” in 2008. He serves as a member of the advisory committees at USC, Riverside, and San Joaquin Valley PA Programs.

He is an Honorary Founding Member of the California Academy of Physician Assistants and is a Distinguished Fellow of The American Academy of Physician Assistants.

“Mr. Sachs Goes to Sacramento”

JANUARY/FEBRUARY 2011 3

Program Cuts Red Tape for Volunteer Health Professional ......2

Mr. Sachs Goes to Sacramento ..............................................2

Now’s The Time ....................................................................3

Medi-Cal & Medicare ... A Quick Review ................................4

L.A.’s Half Marathon Was One Whole Wonderful Experience .....6

A Fine Man ..........................................................................8

The Model Medical Home ...................................................10

Regional Extension Centers Assist PAs Transition to

Electronic Health Records ...................................................11

What’s a PA ... So you think you know your profession? ......12

Timely Access Regulations ..................................................13

Heard Any Great Speakers Lately? .....................................14

2011 CAPA Conference! .....................................................14

Controlled Substances Education Course ..............................15

Embracing Change .............................................................16

What Your Docs are Reading in the

Medical Board of California Newsletter ...............................17

The Third, New and EXPANDED Edition of the California

Physician Assistant’s and Supervising Physician’s Legal

Handbook .........................................................................18

How to Help Patients With Nicotine Addiction ......................21

Facebook: Implications for PA Students and

the Job Market ..................................................................22

Congratulations to the 2011 CAPA Scholarship Winners!!!....23

2011…A New Year of Student Opportunities with CAPA......24

What’s Going On At…USC

Faculty Profile: Anne Walsh ................................................25

The First White Coat ...........................................................26

Welcome New Members .....................................................27

Local Groups......................................................................27

Inside This Issue

I t seems like you can’t have a conversation anymore without bringing up “the future of health

care.” It’s a hugely important topic and so much uncertainty exists that cannot be predicted. I think health care is the most important social topic currently in the United States. We have a rapidly growing retired and aging population who will demand much more health care than we are accustomed to providing now. We are already aware that we have a shortage of primary care providers, but this number is only going to get bigger in the coming years. This is an excellent opportunity for PAs to take a big step forward and help with this potential health care

crisis.

When the Health Care Reform Bill was passed several months ago, you couldn’t go a day without this coming up

in conversation in the work place or a gathering amongst friends. This topic is not just popular with health care professionals, but rather everyone with, or without insurance. This will essentially be affecting all of us to some degree. Even on a recent trip traveling through Thailand, Europeans I met were asking me about our new Health Care Reform Bill. It’s a huge topic with huge potential changes on the way.

When the Health Care Reform Bill was signed, it gave the potential for millions of uninsured individuals to now have insurance. This is great news! Many more Americans can seek medical care when they are injured or sick. But, if we already have a shortage of providers, how will we possibly accommodate all these new patients? It’s not an easy problem to fix. It can make the ability to schedule an appointment with a provider even longer than it is now, it can make ERs more crowded with longer wait times. The obvious answer is the need for more providers to see these patients.

By providing more PAs in the workplace, we can effectively see more patients. This is an obvious statement that PAs are very aware of. Unfortunately we can’t just snap our fingers, double the size of PA schools in this country and find rotation sites for all these new students. But, when the great minds in Washington, DC get together and are looking at ways to now provide care for these patients, I hope they get the idea of what PAs can do to help with this problem. We know that the AAPA is working to make sure we have a voice in this matter.

Another current issue is that as of January 2011, Department of Managed Care implemented something called, Timely Access. This requires health plans licensed by the Department of Managed Care to see patients within a certain amount of time for urgent visits, non-urgent visits, new consultations as well as patient call backs. Imagine a practice that is already busy enough and now

Now’s The Timeby Eric Glassman, MHS, PA-C, President

Continued on page 5

now’s the time

4 CAPA NEWS

O f the many calls I get each week, the majority continue to involve questions about reimbursement, mainly concerning Med-Cal and Medicare. Most

inquiries are from new grads – but many are not. So it seems worthwhile, from time-to-time, to review the basics about how PAs fit into these two enormous reimbursement systems.

Both Medicare and Medicaid are administered under the federal Centers for Medicare & Medicaid Services (CMS). Medi-Cal, as you know, is California’s version of Medicaid. Be aware that although Medicare and Medi-Cal fall under the administration of CMS, the rules and regulations for billing under these two payers are very different. Medicare recognizes a PA as a “provider” and is enrolled as such, while Medi-Cal requires PAs to enroll - but without “provider” status. This contrast results in allowing the PA to bill for Medicare covered services either using their name and identifier OR that of the physician (“incident to” billing – more on this later). However, Medi-Cal requires that covered services provided by a PA may be billed only under the physician (reasoning drawn from the “dependant provider” concept). So let’s do a quick review in hope that this exercise will be useful – especially for the new grads.

Medi-CalThe Medi-Cal billing manual, under a section titled Non-physician Medical Practitioners (NMP), clearly recognizes the services of PAs and explains that reimbursement for physician services provided by PAs is at 100% of what a physician would receive for covered services. This manual also describes enrollment criteria and rules for allowable reimbursement for PAs. In addition, you will find information regarding the enrollment process with the current forms to be used. Enrolled PAs must work with a physician who is an enrolled Medi-Cal provider. The PA is not considered an independent Medi-Cal provider and must therefore, bill under the supervising physician. Find this manual by placing “Medi-Cal Provider Manual” into Google then scroll down to “Medical Services” : “General Medicine”; then scroll to the NMP section.

The billing for covered medical services by a PA is submitted under the (Medi-Cal enrolled) physician’s name and identifier with a modifier “U7”. This modifier is used to indicate the service was provided by a PA. Other modifiers may additionally be required for a particular service. Before 2009, PA billing was severely limited to a short list of CPT codes thereby restricting what services could be reimbursed. CAPA’s legislative efforts resulted in the elimination of that restrictive list and the manual now states:

Covered services for PAs include services performed by a PA within the scope of practice when the services would be a covered benefit if performed by a physician and surgeon.

For PAs who provide first-assistant at surgery services, the same Manual, under the section “Surgery: Billing With Modifiers”, explains how to use modifiers “99 = U7 + 80” along with the appropriate surgical procedure codes when billing under the physician.

Note: When reading this Manual, pay attention to the date in the right lower corner which indicates the last date when any changes were made to the page.

MedicareMedicare is the nation’s largest health insurance program. It provides coverage for more than 40 million people who are age 65 or older or disabled. Even if your practice does not include Medicare patients, the insurance payers that you do work with are, and have been, influenced by the rules and regulations and philosophies derived from Medicare decision making. In many areas of healthcare insurance, Medicare has set the standards which in many cases have become adopted as the benchmark for other companies in the industry to follow.

Medicare is a federal program under the Centers for Medicare and Medicaid Services (CMS). However, rules regarding billing for physician services provided by PAs are very different between Medicaid (called Medi-Cal in CA) and Medicare. Medicare Part B covers professional services such as those provided by physicians and physician assistants. In California Medicare Part B is administered by Palmetto GBA: Medicare, Jurisdiction 1, Part B. Palmetto GBA is the “Medicare carrier” for our state.

The Balanced Budget Act of 1997 clarified and simplified Medicare regulations and reimbursement for PAs. It expanded the areas of coverage for PA provided services and eliminated restrictive requirements. PAs in California should

Medi-Cal & Medicare ... A Quick ReviewBy Bob Miller, PA-C, Professional Practice Committee Chair


Medi-Cal & Medicare ... A Quick ReviewBy Bob Miller, PA-C, Professional Practice Committee Chair

enroll as Medicare providers through Palmetto GBA. When an appropriate bill is submitted using their own name and identifier, covered medical services which are provided by PAs are reimbursed at 85% of the physician fee schedule. Reimbursement is paid to the employer or supervising physician and not directly to the PA. Medicare also reimburses for PAs who are the first assistant at surgery when all appropriate criteria and regulations are met. Medicare reimburses a physician first assistant at 16% of the primary surgeon’s fee and a PA receives 85% of the 16% (13.6%).

Medicare also allows for “incident to” billing for covered services provided by PAs. Services billed as “incident to” are reimbursed at 100% of the physician fee schedule and the bill is submitted using the physician’s name and identifier. There are significant restrictions regarding this type of billing and there is some confusion as to how this is applied in various situations. You should not use this billing option unless you are certain that you are complying with all of the regulations and you have adequate documentation. “Incident to” billing requires that the following criteria are met:

�� Can only be used for services provided in an office / clinic setting. It cannot be applied to hospital or ED services.

�� The service is one that is typically provided in a physician’s office.

�� The physician must be in the suite of offices when the PA provides the service.

�� The service is within the PA’s scope of practice under state law.

�� The physician must personally treat and diagnose the patient on the first visit to the practice and when there is a new medical problem / diagnosis.

(These above “incident to” restrictions do not apply when billing under the PA’s name and identifier)

Medicare limits PA practice in a few other areas of healthcare delivery. PAs cannot order/certify hospice care and cannot yet certify skilled nursing facility care. And although a PA may provide services in the home, the PA cannot order/certify home health services. The AAPA has been working on these issues at the federal level. We will continue to watch for needed changes in healthcare legislation.

Now’s The Time

trying to comply with these new regulations. Not an easy task. But there may be an easier solution. Hire a PA. Share the workload and get patients seen quicker while allowing more time with each patient. CAPA has sent out postcards to managed care organizations throughout California promoting PAs for this main reason. Having patients seen in a timelier manner is better for both patient satisfaction and quality of care.

Health care will always be evolving and changing. Evidence based medicine and the “best practice” model will always prove to help benefit our patients. I know with time as the changes with Health Care Reform come to fruition, we will see PAs being used more prominently and efficiently. This is a great time to be a PA and we can help mold the future of medicine.

Continued from page 3

CAPA FACTDid You Know?

35 Years Ago…Rod Moser, PA called the first CAPA meeting to order on June 26, 1976 in Fresno, California.

“Unfortunately we can’t just

snap our fingers, double

the size of PA schools in this

country and find rotation sites

for all these new students.”

6 CAPA NEWS

L.A.’s Half Marathon Was One Whole Wonderful Experienceby Larry Rosen, PA-C, Vice President and Public Relations Committee Chair

T he closest I ever came to a marathon was last March when my wife, Joyce, and I hosted

a CAPA board member and her 12-year-old daughter at our Culver City home after they had completed the Los Angeles Marathon. We had the fun of providing them with

warm showers, post-run food and drink and a place to put their feet up for a few hours and share the excitement of what they had experienced together.

This mother and daughter duo had accomplished something extraordinary; a 26.2 mile run and they both finished standing! So exciting. But the more they talked, the farther I distanced myself from this phenomena. I remember gasping my way through a 10K in Las Vegas about nine years ago. I would never run a marathon and was perfectly OK with knowing that I could deny myself that life experience; like free falling from an airplane; exciting to watch but not on my bucket list.

Then, last June, I received a call from Dr. Lewis G. Maharam, aka the

“Running Doc.” Dr. Maharam is the Medical Director of the Competitor Group’s Rock ‘N’ Roll Marathon Series and Team In Training Chairman, Board of Governors, of the International Marathon Medical Directors Association. Blessedly, he was not inviting me to run. He was looking for physician assistants to act as Medical Captains during the first running of the L.A. ROCK N ROLL ½ MARATHON, Sunday, October 24, 2010.

The ROCK N ROLL ½ MARATHON series is nation-wide and was coming to Los Angeles for the first time. Proceeds from the event would supply funding for the American Cancer Society, the Leukemia & Lymphoma Society and the unique, L.A. “Grove of Hope” organization. CAPA was happy to oblige Dr. Maharam and we got the word out.

More than a dozen PAs volunteered. Our job was to staff medical relief stations along the race course, providing first aid, medical triage and support to the more than 13,000 runners participating.

Pre-race meetings included lectures by Dr. Maharam on the sports medicine of racing. He takes pride in being at the forefront of a paradigm shift regarding exercise induced hyponatremia and dehydration. Historically, it was felt that hypotonic fluid losses from sweating would produce a rise in serum sodium. Yet, research showed that the development of hyponatremia following such events was attributed to hypotonic fluid replacement greatly exceeding the fluid losses experienced by sweating. Fascinating data and enormously important in gauging the health status of a runner in distress. (For more information on this subject, see the article in the May 2010 issue of Clinician Reviews:

http://www.clinicianreviews.com/index.asp?page=courses/106744/disclaimer.htm&lsn_id=106744).

Sunday, October 24th, 4:00 a.m. is a time for dreaming in soft, toasty beds, not driving to downtown LA to meet colleagues in the cold, pre-dawn darkness. But there we were, me and my CAPA buddies huddled over steaming coffee mugs on the USC medical campus, studying maps, figuring out where we were all stationed along the 13 mile half marathon course.

Impressive from the get-go was the meticulous organization of the event. Tents and supplies showed up on time. Workers helped us put our stations together in short order. Communication with the main medical tent at the finish line was easy and constant.

There were cheerleader teams and bands everywhere. The atmosphere was festive, alive and charged with excitement. My station was at the halfway point. We waited, staring down the empty street that paralleled the Silver Lake Reservoir. We waited and waited and then they came.

First in small groups, the lead runners, looking strong. These runners were cruising; smiling, waving, confident. Next, they came in larger groups and then in thousands. Waves of runners rolling by. Men and women in their 70’s, kids in their teens. Some faces in pain, all faces full of hope, this river of runners thick with pride and well deserved self-satisfaction. I’d seen this on TV but never this close. I remembered as a kid going with my dad to see Joe Louis fight and being impressed by the skin tones of the battered fighters and the noises in the arena. You didn’t see or hear this the same way on TV. This was thrilling.

“I assured the “Running Doc”

that CAPA would again seek

out PAs to support this event

next October. My team was

committed to coming back.”


L.A.’s Half Marathon Was One Whole Wonderful Experienceby Larry Rosen, PA-C, Vice President and Public Relations Committee Chair

Two of the PAs I worked with had both run marathons. They knew these runners and what they needed even before they asked; Vaseline on tongue depressors for chafing, bandages for blisters, Tylenol for aches and pain (we had to mark their badge number if we gave them Tylenol, only one dose per runner.)Lots of muscle spasms and joint pain. Sometimes a quick calf massage got them going again. More often an ACE wrap would bring relief as would ice packs strapped to aching joints with plastic. Only one runner was done. He’d pulled a hamstring and was unable to even walk to the finish line. We called one of a convoy of ambulances that was at the ready all along the race course that led from Griffith Park to downtown Los Angeles.

By noon, the last runner had passed our station. My team ultimately disbanded but with the help of my medical staff auto identification and the generosity of police along the route, I was able to navigate to the finish line to greet Dr. Maharam.More than 13,000 runners had turned out and Dr. Maharam was very pleased. Most importantly, there were very few serious injuries and no hyponatremia. He would have liked to have had more medical volunteers. There are never enough. I assured the

“Running Doc” that CAPA would again seek out PAs to support this event next October. My team was committed to coming back.

So, circle October on your 2011 calendar for the ROCK N ROLL ½ MARATHON in Los Angeles. CAPA

will be promoting it on the web page and at conference. Don’t miss out next year. The causes are worthy and your skills are needed. It makes for an exciting day and the work is fun.For me, being at the finish line was its own reward. Those prideful, weary faces were a treat to see; making it across the line, cheered on by thousands of spectators, bands, greeters who high-fived them as they passed by.

Almost made me want to be one of them. Almost.

My child is home sick. Barely get to the office on time. Waiting room ispacked. The office manager is out on vacation. Meet with supervisingphysician to discuss patients. Grab stethoscope. In first room is 3-year-old Emma. Pink eyes, a cough and ear infection. “Gifts” from daycare.Record on chart. Next room. A pleasant 55-year-old woman in noacute distress. She describes a new cough and onset of chest pain.Order EKG, chest x-ray and labs. Minor emergency of the day –16-year-old Sammy fell off his skateboard while ‘performing an Ollie.’

Suture knee and write prescription for the pain. Fifteen minute breakspent getting caught up on paperwork. Supervising physician e-mailed

an article titled, “In a courtroom, your documentation can be your bestfriend or worst enemy.” Good thing I have HPSO!

Make sure your story has a happy ending.

This program is underwritten by American Casualty Company of Reading, Pennsylvania, a CNA Company.Healthcare Providers Service Organization is a division of Affinity Insurance Services, Inc.; in CA (License #0795465), MN and OK, AIS Affinity Insurance Agency, Inc.; and in NY, AIS Affinity Insurance Agency. ©2011 Affinity Insurance Services, Inc. E-8858-111

A physician assistant’s story…

Professional Liability Insurance for Physician Assistants

888.273.4686 • www.hpso.com/capa

®

E-8858-111_E-8858-111 12/14/10 11:09 AM Page 1

Larry Rosen, PA-C and Marathon participant

8 CAPA NEWS

the PA Advisory Committee (which did not include any PAs). The most technical of the tasks allowed by the State was the removal of cerumen, if you can believe it.

CAPA did not exist. As a matter of fact, no one was really sure where these unlicensed PAs were hiding. It took over a year for me to smoke them out, and one of the first ones that surfaced was Harvey Fine. At that time, I was living in San Anselmo (Marin Co), and working in San Francisco. Harvey was living with his wife, Ginny, in a little, one-bedroom beach house in Marshall, CA, about thirty miles away. PA jobs nearly non-existent, Harvey was working for a weight-control specialist in San Jose, just a little 2.5 hour, one-way commute. This was not his first choice of jobs. He was supposed to work with a physician in the nearby town of Petaluma, but the doctor died before Harvey graduated.

Harvey was born in San Jose in 1932, so he knew his way around. Among his many PA duties, was the counting of pills – a demeaning position for a PA who had served his country as a Navy corpsman in Korea, and was a graduate of the first class from the Stanford PA Program (1973). At age 39, Harvey was the oldest student. Borne out of our growing frustrations with PA regulations, Harvey joined our rag-tag, five-member team – The Organizational Committee of the California Academy of Physician Assistants. With Harvey’s help, CAPA was born.

A nurse practitioner friend of mine joined the Navy during the Vietnam era, trying to avoid being put in harm’s way as a ground soldier. Once in the Navy, it sounded like a good idea to become a Navy Corpsman. He looked at me and said, “As God

A Fine Manby Rodney Moser, PA, Ph.D, CAPA Founding President

On November 26, 2010, my friend and colleague, Harvey Fine, one of the first licensed

PAs in California, lost his battle with lung cancer. Harvey was candidly open about his years as a chain smoker and was not surprised when he was diagnosed. He knew it was his fault and told me he had expected it. He died peacefully in his sleep under the compassionate hands of Hospice. For those of you who attended the CAPA conference this year, you may have seen him walking by with his portable oxygen tank, fighting for each breath. Even though he moved to Arkansas a few years ago, he continued to attend this annual event. As far as I know (myself included), Harvey Fine is the only PA who has attended every CAPA conference since the first one in Fresno in 1976. I am honored to be considered the Father of CAPA, but I can tell you that CAPA had more than one parent. I came to California after graduating from PA school in 1973 at a time when there were only a handful of PAs, tactfully hiding in clinics and doctor’s offices across the state. Why? PAs were not licensed, but we were tolerated…to a point. The Department of Consumer Affairs knew we were here, so we were being carefully watched to make sure we were not doing anything beyond the laundry list of tasks assigned by

is my witness, I had no idea that Navy Corpsmen were assigned to Marine ground units.” When Harvey became a Navy Corpsman, he knew this in advance. He was assigned to Baker Company, Fifth Marines, First Battalion in 1950, a year before I was born. Harvey spent two years of active duty in Korea on the 38th Parallel, shivering most of the time at 40 below zero. When I was learning how to walk, Harvey participated in numerous ground assaults and saved countless lives of soldiers under his care.

CAPA’s office was my home in San Anselmo. Since Harvey was elected Secretary/Treasurer, running unopposed, I might add, it seemed only fitting that the home office should be in his home in Marshall. Harvey’s wife, Ginny, was hired for about a $100 a month to help. CAPA dues were only about $30 a year, so her salary required that we have at least 40 members. Ginny maintained our books and knew our bottom line, so she rarely was paid and seldom complained.

When the Fines moved to Stockton, they took CAPA and their two Doberman Pinchers with them. As a side note, I was once bitten in the ass by one of them (one of the dogs!) while leaving a meeting.

In 1984, Harvey Fine, having served CAPA as Secretary/Treasurer since the beginning, was elected President during a very turbulent period for our fledgling organization. It was really his turn.

Ginny died a few years before Harvey. A few of the old CAPA dinosaurs all met in Marshall, rented a boat, and spread Ginny’s ashes in Tomales Bay just off-shore of their former home. Sometime this year,

L to R: Harvey Fine, PA, Rod Moser, Ph.D., PA, and Juan Baltierra, PA


A Fine Manby Rodney Moser, PA, Ph.D, CAPA Founding President

we will do this for Harvey. I last saw Harvey at the last CAPA conference in Palm Springs. When I suggested that his ashes be mailed to me to be scattered at Marshall, he cried and two men hugged. We both knew this would be the last time that we would see each other.

Harvey’s PA career included a string of jobs that very few of us would even consider today. PA jobs were few and far-between, so decisions were often more economical than logical. If there was a “borderline” physician out there looking for a PA to be his scut-puppy, Harvey somehow ended up working for them. He often felt that being older was a growing

disadvantage in a competitive job market. Sadly, I don’t think he ever found a PA job that he truly loved. He never looked for trouble, but trouble often found him. Having lost his PA license for a few years for prescribing Tylenol with codeine without a “patient-specific order,” he spent his entire savings to try and defend his case to no avail. He was able to work as a PA in Saudi Arabia for a few stressful years, relegated to brewing his own beer as a geographic consequence. Harvey loved his beer.

I thought he would never retire, but he finally hung up his stethoscope and moved to Arkansas to be close to his brother. He spent his remaining

years active in the local VFW, planning Navy reunions, and taking a few cruises. You just can’t get Navy boys off of the water.

I called him often to see how he was feeling, and he always said, “Fine.”He was a fine man. He was my friend and a friend of CAPA’s. He bravely served his country and served his profession to the end. We will miss him.

Life Is Too Short Not ToHAVE IT ALL!

Love what you do! Love where you work! Love where you live!

Recently named by Modern Healthcare Magazine as one of the best places to work in healthcare, Valley Emergency Physicians is commited to help you find the right balance between your career and lifestyle you deserve.

Learn more at www.valleyemergency.com or call 1-(925)-CALL-VEP .

CAPA’s first office in Harvey’s home in San Anselmo.

10 CAPA NEWS

P rimary care clinics, especially those in rural areas, are fluid entities. These clinics are

continually conforming to current legislation and patient demands with the goal of increasing access to quality health care. As the new health care legislation gets under way, the primary care world is looking at a push in the development of medical homes. Some clinics have begun to restructure their foundation with the

goal of creating a working medical home, while others a simply remodeling to better-fit health care legislation.

Rachel Farrell is a physician assistant and mid-wife in the small town of Linda, California. A graduate of

the Stanford PA Program in 1989, Rachel has dedicated her professional career to her community within Yuba County; she has done so through Harmony Health Medical Clinic. Rachel founded Harmony Health in 1999, but her medical home was not transformed overnight. Throughout the day and late into the night, since Harmony’s inception, Rachel has had bursts of inspiration that slowly have become reality. What was once a clinical practice has transformed into a clinic, resource center, birthing center and a flourishing set of social businesses.

Harmony Health Medical Clinic includes four physician assistants, a nurse practitioner, and a pediatric and infectious disease doctor who see patients on a regular basis. The clinic

sees roughly 1,500 patients a month; ranging from private insurance to sliding scale patients. Along with the medical providers is an assortment of ancillary staff including behavioral health specialist, licensed clinical social workers and even lactation specialists. Rachel has developed a wide array of medical resources in one medical home in order to meet a diverse patient population.

Apart from her clinic, Harmony Health Medical Center has a family resource center. The Center provides education on community resources, intervention programs and a variety of medically relevant classes. The family resource center is where community education becomes the focal point. The Center reaches out to kids of all ages with their program called “R Spot.” This program is a youth group that the organization has created to help educate children within the community. Children participate in outings, like camping or social events hosted by Harmony. Harmony’s Family Resource Center is available to anyone despite their financial status and its funding is as innovative as the services it provides.

The Harmony Health Center derives part of its funding from what Rachel calls “Social Businesses.” Rachel has gradually developed these businesses over the life of the clinic, all of which help fund the programs, educational courses and the community outreach that the Resource Center performs. Along with creating a source of funding, they also integrate the community into the business. For example, Yuba County has a large number of teen mothers. Rachel has developed classes that she brings in the mothers and teaches them how to cook healthy and cost effective foods. The Eating Well Café opens as a soup like kitchen providing food

to the needy within the community. Recently the clinic obtained a small strip mall that includes laundry facilities. Rachel uses this not only for its monetary value, but gives the attendees of her classes a token that they can redeem for laundry services. She is able to reward class participants by improving their health along with helping their socioeconomic needs. While Rachel’s social businesses are dependent on the medical staff and community activist, they are very effective ways of generating services for those in need. While it can be difficult to find funding, Rachel and Harmony Medical clinic are finding innovative ways to make their medical homework.

Harmony Medical Health Center has derived its success from looking at the needs of the community, assessing those needs and finding ways in which they can expand their services. Rachel’s “grassroots” approach to medicine has created a strong following. Rachel’s ability to take on different roles and find ways to make her organization successful is evident through its success and ambitious future projects.

Harmony Medical’s goal is to become a Federally Qualified Health Center (FHQC) that would allow for further funding and increased patient access. They have plans in the works to build a birthing center and Rachel is actively pursuing UC Davis students whom she would like to rotate through her facility with the hope that they will become active and passionate members of her medical home.

Yuba County’s socioeconomic problems will not disappear

The Model Medical Homeby Adam Marks, MPA, PA-C, Director-At-Large

Continued on page 11

“What was once a clinical

practice has transformed into a

clinic, resource center, birthing

center and a flourishing set of

social businesses.”


Regional Extension Centers Assist PAs Transition to Electronic Health Recordsby Reena Samantaray, M.P.A., Director of Outreach and Education, California Health Information Partnership and Services Organizations (CalHIPSO)

Three federally funded Regional Extension Centers (RECs) opened in California last year

to assist provider’s in implementing and using Electronic Health Record (EHR) systems. LA County is served by HITEC LA, Orange County is served by CalOptima REC, and the rest of California is served by The California Health Information Partnership and Services Organization (CalHIPSO).

RECs are nonprofit, vendor-neutral, support centers that offer a variety of programs and services designed to help clinical providers transition from a paper-based practice to one that successfully uses EHRs. All three RECs have extensive products and services designed to help providers navigate through the complicated world of EHR implementation.

The three RECs in California are primarily supported through stimulus

funding made available from the federal Office of the National Coordinator for Health Information Technology to support the ability of 100,000 “Priority Primary Care Providers” nationwide to adopt EHRs by the year 2014.

PAs practicing in a primary care field are eligible to receive subsidized REC services if they work in one of the following practice care settings:

1) Private practice of 10 providers or less

2) Non-profit primary care clinics including community health centers

3) Ambulatory care clinics associated with public, rural, and critical access hospitals

4) Other medically underserved settings

Membership benefits of RECs can vary, but generally include:

•� Access to group purchasing discounts for EHR products

•� Assistance locating qualified EHR vendors

•� Project management services•� Readiness and workflow

assessment•� Access to extensive training and

education•� Assistance with demonstrating

meaningful use in order to begin receiving federal incentive payments, for eligible providers

If you are interested in learning more about CalHIPSO, visit the CalHIPSO website at www.calhipso.org and click on “Join Now.” If you are located in Los Angeles County and would like more information about HITEC LA, please visit www.hitecla.org. For more information about REC services for Orange County, please e-mail CalOptima REC at [email protected].

The Model Medical Home

overnight, yet it is nice to know that a diverse group of medical, professional, and community activists have opened their medical home, inviting those who are in need of any type of assistance. As I finished interviewing Rachel, I had to sit back and really let what she is doing sink in. In my short time as a physician assistant, I have seen some basic medical home models. I am even lucky enough to be in an organization that is making that transition, but I can’t help but marvel at the innovative, comprehensive community based approach that Harmony is taking in Yuba County. PAs like Rachel are

what make our profession so profoundly important in today’s brave new world of medicine. The team-based approach to medicine, which is the foundation of the PA profession, will continue to endure as long as PAs like Rachel continue to exist in the system.

I would really enjoy hearing from other health care professionals who have innovative ideas, improved delivery of medical services, or unique patient outreach. Please continue to contact me at [email protected].

Continued from page 10

12 CAPA NEWS

Answers to Quiz

1. The answer is a. 26 mosThe average PA program is 26 mos. Currently there are approximately 115 graduate PA programs.

2. The answer is d. MexicoThe physician assistant concept was introduced to Australia in 1999. There are two pilot programs underway. Al Forde (PA Faculty from the University of Utah) transplanted to Australia to be a senior lecturer at James Cook University in Townsville, Australia. As of October 2010, three UK universities, Birmingham, St George’s of London and Wolverhampton are currently training Physician Assistants. In June 2003, the Canadian Medical Association recognized the PA as a health professional.

3. The answer is b. William StanhopeA surgical technician in the US Army, Stanhope trained at the Duke University Physician Assistant Program in 1967. During his time at Duke he met one of the original Duke graduate PAs, Richard Scheele, and together they founded the American Association of Physician’s Assistants.

4. The answer is a. The AAPA’s first female president In 1982 Judith Willis became the AAPA’s first female President.

5. The answer is a. June 1976.....................and still going strong.

6. The answer is c. Alderson BroaddusIn 1969 William Stanhope was recruited by Dr. Myers to work as a surgical PA and in the PA Program at Alderson Broaddus. As part of his recruitment enticements Dr. Meyers offered Stanhope the opportunity to complete his baccalaureate at the University. The college was the first to offer a degree to PA students.

Back for more outstanding trivia...

I’ve gathered more information from multiple sources (PA Historical Society, AAPA, CAPA, Wikipedia, and Google) and put together a few short quizzes to share with you over the next few editions of the CAPA News. Enjoy and don’t forget to dazzle your friends and colleagues with the incredible knowledge of YOUR profession.

1. The average PA Program is how many months in length.

a. 18b. 22c. 26d. 30

2. The PA concept is alive and well across the globe except for:

a. Australiab. UKc. Canadad. Mexico

3. In 1978 the AAPA elected this PA as its first president:

a. Michael Casillasb. William Stanhopec. Bob Millerd. Larry Rosen

4. Who is Judith Willis:

a. The AAPA’s first female presidentb. Founder of the PA education

Associationc. CAPA’s first Presidentd. The first PA Ph.D. candidate

5. CAPA was founded in:

a. June 1976b. October 1976c. December 1971d. June 1980

What’s a PA ... So you think you know your profession? Part 3by Greg Mennie, PA-C, MSed, Director-At-Large

6. This University was the first to offer PAs a degree.

a. USCb. Washington Medexc. Alderson Broaddusd. Duke University

See answers to quiz below.

Jeff Heinrich and Judith Willis, 1985

Photo property of www.pahx.org


Timely Access to Care California law requires health plans to provide health care appointments and telephone advice in appropriate time frames.

Appointment Wait TimesBeginning January 17, 2011 health plan members have the right to appointments within the following time frames:

�� Within 48 hours of a request for an urgent care appointment for services that do not require prior authorization,

�� Within 96 hours of a request for an urgent appointment for services that do require prior authorization,

�� Within ten (10) business days of a request for non-urgent primary care appointments,

�� Within fifteen (15) business days of a request for an appointment with a specialist,

�� Within ten (10) business days of a request for an appointment with non-physician mental health care providers, and

�� Within fifteen (15) business days of a request for a non-urgent appointment for ancillary services for the diagnosis or treatment of injury, illness, or other health condition.

Telephone Wait TimesBeginning January 17, 2011 health plan members have the right to the following telephone services within the following time frames:

�� Triage or screening services by a qualified health professional to decide the urgency of a health

condition: 24 hours a day, 7 days a week. If a call-back to the member is required, it must be within 30 minutes.

�� Speak to a plan’s customer service representative within 10 minutes during normal business hours.

While the law sets these time frames, health care providers can be flexible in scheduling appointments if a longer time frame is appropriate for the member’s health. It must be noted in the member’s record that a longer waiting time will not be harmful to the health of the member.

Timely Access RegulationsReprinted from the State of California Website

In geographic areas with provider shortages, if timely appointments are not available, a health plan must refer members to, or, in the case of a preferred provider network, assist members in locating appropriate contracted providers in neighboring service areas.

For More Information visit: http://www.hmohelp.ca.gov

Mailing Address: Department of Managed Health Care California Help Center 980 9th Street, Suite 500 Sacramento, CA 95814-2725

As of January 17, 2011, Health Plans Licensed by the Department of Managed Care Must Fully Implement the Policies, Procedures and Systems Necessary To Comply With Rule 1300.67.2.2

PAs = Excellent, Cost-Effective and TIMELY Access to Health Care

In December of last year, CAPA sent out a large postcard to 500+ Medical Directors and Medical Group Administrators letting them know that hiring a PA or more effectively utilizing the PAs they

currently employ could help with implementation of the Timely Access Regulations.

Timely Access Regulations Urgent Care Appointment Not Needing Pre-Authorization48 Hours

Urgent Care Appointment Needing Pre-Authorization96 Hours

Non-Urgent Primary Care Appointment10 Business Days

Call Backs During Business Hours10 Minutes

Health Plans Licensed by the Department of Managed Care Have Until January 17, 2011 To FullyImplement The Policies, Procedures and Systems Necessary To Comply With Rule 1300.67.2.2.

After Hours Call Back30 Minutes

Non-Urgent Appointment for Ancillary Services15 Business Days

California Academy of Physician Assistants3100 W. Warner Avenue, Suite 3Santa Ana, CA 92704-5331

Address Service Requested

PRSRT STDUS POSTAGE

PAIDSANTA ANA, CAPERMIT NO 949

Physician assistants work in a physician-led team practice model within any specialty of medicine to diagnose, treat, educate, refer and write drug orders for your patients. Instead of considering how you might have to work harder and longer hours, think about how adding a PA to your practice could increase productivity, decrease patient wait times and increase patient access to timely care.

IN MEDICINEPARTNERS

California Academy of Physician Assistants3100 W. Warner Avenue, Suite 3, Santa Ana, CA 92704

Timely Access Regulations –PAs Can Help!

Call CAPA to set up a phone consultation for further information and/or consider being a preceptor for a physician assistant student.

Website: www.capanet.orgPhone: (714) 427-0321Contact: [email protected]

Post A Job

14 CAPA NEWS

E very year at the CAPA Conference in Palm Springs we hear it said: “You guys have the best speakers. How do you do it?” The answer

is we hand pick them based on referrals, feedback and firsthand experiences.

Please help us identify the great speakers out there. Keep your ears open for interesting topics and excellent speakers. Please let us know what/who they are. You can email us, call us and/or fax us the information.

We have a new Conference Planning Committee comprised of CAPA members who help us identify gaps in medical knowledge of PAs working in various practices/specialties. Once we identify the needs of our potential audience, we will come up with lecture topics. We will then need to find exceptional speakers to address those topics. We are very discerning in our speaker selection which makes for an excellent program and ensures a quality conference for those who attend. This is no easy task, but with the help of every CAPA member, it is manageable. If you know of an exceptional speaker; one who is knowledgeable, entertaining and engaging, please let us know. We will add them and their lecture topic to our list. Once our conference program topic “wish list” is developed, we can start to match speakers with topics. Your help is invaluable. We hope you will take a moment, throughout the year as you hear speakers to let us know the names of the ones you enjoyed and learned the most from.

Please give us a call or send us an e-mail!Email: [email protected]: (714) 427-0321Fax: (800) 480-2272

Thank you and we hope to see you at the CAPA Conference on September 22-25, 2011

If You Can Only Attend One CME Conference in the West This Year – It Should Be the

2011 CAPA Conference!

• AttendingtheCAPAConferencehelpstosupporttheonly organization working solely to promote and protect California PAs.

• TheCAPAConferenceisexactlytherightsize.Bigenough to take over the entire Renaissance Hotel and, small and friendly enough to allow you to feel at home and part of this wonderful California Community of PAs.

• TheCAPAConferenceistherightprice.Ifyoureserveyour hotel room early, you can stay at the Renaissance or the Palm Springs Hilton for just $169 a night. Compare that to the room rates for other conferences. Save about $100 a night!

• TheCAPAConferenceincludes5ormoremealswithnowaiting in line for a seat. This is your conference and our goal is to make you feel welcome.

• TheCAPAConferencehasthebestspeakers,handpickedby PAs for PAs. We listen to what you want and bring back your favorites.

Heard

Any Great

Speakers

Lately?


Controlled Substances Education Course Registration FormPlease select ONE seminar location: Western University of Health Sciences, Saturday, March 19, 2011 Samuel Merritt University, Saturday, April 23, 2011 Renaissance Palm Springs Hotel, Wednesday, September 21, 2011

Name ____________________________________________________ PA-C PA Other PA License # ___________

Address ________________________________________ City ______________________State _____ Zip Code ____________

Phone (____) _________________________________ Email ___________________________________________________

CAPA Member - $110 Non CAPA Member - $200

Late Registration Fee after 3/11/11 for Pomona location - Add $20 Late Registration Fee after 4/15/11 for Oakland location - Add $20 Late Registration Fee after 9/14/11 for the Palm Springs location - Add $20 Total Amount Due: $ _______________ Check enclosed (make check payable to CAPA)

Name on Card _________________________________ Signature _____________________________ Exp. Date __________

In accordance with the Americans with Disabilities Act, please check here if you have any special needs. You will be contacted by CAPA.

Mail completed Registration Form and make checks payable to: California Academy of Physician Assistants, 3100 W. Warner Ave., Suite 3, Santa Ana, CA 92704-5331. Phone: (714) 427-0321 . Fax: (714) 427-0324 . Toll Free Fax: (800) 480-2272

Controlled Substances Education CourseA Course Which Upon Successful Completion Will Allow You To Write For

Controlled Substances Without Patient Specific Approval*

*California Code of Regulations Sections: 1399.541(h), 1399.610 and 1399.612. A PA may administer, provide, or issue a drug order for Schedule II through V controlled substances without patient specific approval if the PA completes specified educational requirements and if his/her Supervising Physician delegates the authority to them.

6 Hours

Cat. I

CME

“Great course!”

“Good course. Good pace. Good facility. Food was excellent!”

“Great class!! Great examples from Dr. Lowe’s personal experience. He knows my patients.”

“This was an excellent presentation on behalf of both speakers. Thank you.”

Saturday, March 19, 2011Western University of Health Sciences

Lecture Hall 1309 E Second St

Pomona, CA 91766

Saturday, April 23, 2011Samuel Merritt University

Fontaine Auditorium, Health Education Center

450 30th StOakland, CA 94609

Wednesday, September 21, 2011Renaissance Palm Springs Hotel

888 Tahquitz Canyon WayPalm Springs, CA 92262

(Prior to the 2011 CAPA Conference)

16 CAPA NEWS

What would you think if you were a PA looking for a new job and part of the

job description and requirements were to take out the trash every day at the end of your shift? Would you do it? To my knowledge, PA job descriptions have not yet started asking PAs to perform such tasks. However, more and more jobs are asking PAs to take on more administrative and clerical duties as part of their conditions of employment. As the number of insured patients increases and the number of primary care physicians continues to decline PAs are going to be needed more than ever to help carry the patient load. Part of the carrying may be performing administrative work.

One of my colleagues who has worked in Orthopedics for over 15 years recently told me that in his opinion, our jobs as PAs are to do whatever is necessary to keep as much of the patient burden off of our surgeons. As a new PA, I wasn’t quite sure what to make of that statement when I first heard it. I always assumed that we would see the patients assigned to us, and our supervising physicians would do the same, and also be available and willing to address all of our questions and uncertainties. The longer I have worked as a PA in a hospital based specialty clinic, the more dynamic I have found my true job as a PA to really be.

In school we learn how to treat diseases and do physical exams. We were not taught how to fill out a referral, schedule a surgery, or complete a Workers’ Comp. form, etc. As a PA there are a ton of things we learn on the job, and these things vary from office to office, and provider to provider. In the clinic there is much more

than just patients to be seen and prescriptions to be written. The administrative duties of a practice can be just as much, if not more, time consuming than actual patient care. I work for an extremely busy orthopedic surgeon who performs up to 25 arthroscopic and joint replacements procedures. That’s a lot of surgery, which can be very mentally and physically draining. Therefore, it is very important that I do everything within my scope and power to protect my surgeon from being burdened with paperwork, administrative tasks and office staff questions, allowing him time to recover and focus his energy on the upcoming surgery schedule. Now don’t get me wrong, I am not left alone on an island to function in isolation, my supervising surgeon is always available and willing to answer questions or discuss a case, but there is an expectation that I be competent to handle most of the day-to-day tasks within the office.

As the world of medicine continues to change and evolve, we PAs need to be willing to change and evolve as well. As PAs, we are

Embracing Changeby Matthew Keane, PA-C, Director-At-Large

January 2011 Page 9Medical Board of California Newsletter

Th e following information will assist physicians who supervise physician assistants in becoming familiar with new legislation, which became law January 1, 2011. Th ese changes may impact your practice.

SB 1069 (Pavley/Fletcher), sponsored by the California Academy of Physician Assistants, allows PAs to do the following, unless otherwise indicated in the Delegation of Services Agreement (DSA):

• Order durable medical equipment.

• Approve, sign, modify, or add to a plan of treatment, or plan of care, for home health services (PAs are still unable to order home health and hospice care for Medicare benefi ciaries. Solutions to this problem are being worked on at the federal level.).

• Certify that certain school district employees, including educators at community colleges, are free from communicable diseases for purposes of employment.

• Provide the statement attesting to the need of an Epi-pen to be carried by pupils while at school.

• Order medications and provide the statement attesting to the need for medications to be available to a student during school hours.

• Certify the parent’s request to waive a school-based visual acuity test.

• Perform physical examinations required for participation in interscholastic athletic programs.

• Certify the needs of an individual who has been diagnosed by a physician as being deaf or hearing impaired to retain a telecommunications device for the deaf or hearing impaired.

Supervising physicians and PAs should update their DSA if this law allows the PA to do something not already covered in that document. To read the bill in its entirety, please go to https://www.capanet.org/pdfs/SB1069Chaptered.pdf.

Recent legislative changes to Physician Assistant (PA) scope of practiceby Beth Grivett, PA-C, Legislative Aff airs Coordinator California Academy of Physician Assistants

Pertussis Booster

Finally, health care providers are reminded that vaccine products have similar names and abbreviations that can be confusing to school staff who will be keeping records for the new law. Be sure to document immunizations clearly and accurately. Schools report that immunization records are not always clear whether the student received Tdap, which meets the new requirement, and Td, which does not. Make sure the patient’s Tdap immunization record clearly states that Tdap was given.

For general information about pertussis disease and immunization, visit www.cdph.ca.gov/HealthInfo/discond/Pages/Pertussis.aspx. You also can contact CDPH Immunization Branch and your local health department immunization program for additional information.

* Similar expansion in recommendations made by the federal Advisory Committee on Immunization Practices (ACIP) in October 2010.

(continued from page 8)

Check your physician profi le on the Medical Board'sWeb site

www.mbc.ca.gov

Click on "Licensees" tab and "Check My Profi le."

Th e mandatory physician survey data is used to update your online physician profi le on the Board's Web site.

Remember, your address of record is public.

Signed address changes may be submitted to the Board by fax at (916) 263-2944, or by regular mail to:

Medical Board of CaliforniaLicensing Program2005 Evergreen Street, Suite 1200Sacramento, CA 95815

not independent practitioners, we are members of a team and must act accordingly. As a member of a team, we must be willing to do whatever is asked of us for the good of the team in order to be as successful as we can. This changing environment may require us to take on more and more administrative responsibilities. We have to embrace change and be flexible when it comes to our role in the PA/Physician model. There will always be jobs that are more clinically based than others. Not all PAs will be asked to do more administrative tasks. Fortunately for PAs, our license and training allows us to choose where we want to work and the type of work we want to do. If at your job you are not asked to do more administrative tasks, you may be asked to take on additional duties like call or see more patients, or assist in surgery and so on. As PAs we will always be expected to fill a role or ease a burden, and we have to be willing to step up for the good of the team and take on these new and evolving roles.

CAPA FACTDid You Know?

1994: CAPA succeeds in passing SB 1642 allowing PAs to issue written prescription drug orders


What Your Docs are Reading in the Medical Board of California Newsletter

Board-sponsored legislationAB 1767 (Hill, Chapter 451)Th is bill requires the Offi ce of the Attorney General to provide representation to a licensed physician who provides expertise to the Medical Board (Board) in the evaluation of the conduct of a licensee when, as a result of providing the expertise, the physician is subject to a disciplinary proceeding undertaken by a specialty board of which the physician is a member. It also extends the sunset date of the two members of the Health Professions Education Foundation that are appointed by the Board, from January 1, 2011 to January 1, 2016.

SB 1489 (Sen. B&P Comm., Chapter 653)Th e provisions in this bill relating to the Medical Board were sponsored by the Board, and do the following: delete and correct obsolete references related to the Board’s Division of Licensing and exams; correct by reinstating the postgraduate training requirement for licensure; allow the Board to consider good cause or reason, time spent in various training programs, and current and active practice in another state or Canadian province when considering the period of validity of the written examination scores required for licensure; and clarify provisions related to the reporting requirements for licensed midwives.

Other legislation signed into lawAB 52 (Portantino, Chapter 529)Th is bill requests the University of California (UC) to develop a plan to establish and administer the Umbilical Cord Blood Collection Program (UCBCP) for the purpose of collecting units of umbilical cord blood for public use, which is defi ned as blood units from genetically diverse donors that will be owned by the UC. It increases the fee for birth certifi cate copies by $2 to provide funds to implement the UCBCP, and requires the UC to implement the plan, contingent on an unspecifi ed amount of funds being available in the UCBCP Fund.

AB 583 (Hayashi, Chapter 436)Th is bill requires health care practitioners to disclose their name, license type, and highest level of academic degree to their patients in their offi ce or in writing in at least 24-point type in a specifi ed format. It also requires physicians and surgeons, including osteopathic physicians, to disclose the name of their certifying board or association.

AB 867 (Nava, Chapter 416)Th is bill authorizes the California State University (CSU), until July 1, 2018, to establish a Doctor of Nursing Practice (DNP) degree pilot program at three campuses chosen by the Board of Trustees to award the DNP degree. Th is bill distinguishes the DNP degree from the doctor of philosophy degree off ered at the University of California. It requires the DNP degree pilot program to be designed to: enable

IN THIS ISSUEPresident's Report . . . . . . . . . . . . . . 2

Legislator profi le . . . . . . . . . . . . . . . 3

CURES prescription monitoring update . . . 4

Pertussis Booster (Tdap) . . . . . . . . . . . 8

Healthier physicians motivate patients . . . 10

Screening Recommendations: Chronic Viral Hepatitis . . . . . . . . . . . . . . . . . . . . 12

New Electronic Health Records Incentive Programs . . . . . . . . . . . . . . 17

Physician supervision of allied health professionals . . . . . . . . . . . . . . . . . 18

Administrative actions . . . . . . . . . . . . 20

A Quarterly Publication www.mbc.ca.gov Vol. 117, January 2011

Legislative Update

The mission of the Medical Board of CaliforniaThe mission of the Medical Board of California is to protect health care consumers through proper licensing and regulation of

physicians and surgeons and certain allied health care professions and through the vigorous, objective enforcement of the Medical Practice Act, and, to promote access to quality medical care through the Board’s licensing and regulatory functions.

(continued on page 5)














Pertussis Booster






www.mbc.ca.gov



















Pertussis Booster






www.mbc.ca.gov



















Pertussis Booster






www.mbc.ca.gov



















Pertussis Booster






www.mbc.ca.gov






Check your address of record with the Physician Assistant CommitteeRemember, this information is available to the public.

www.pac.ca.govOnce you are on the website, click on the Licensees tab at the top and then the fifth option will be Verify a License. Enter your name and/or license number and you will see what the public sees. If you would like to change your address, you can do so at the same Licensees link. Physician Assistant Committee2005 Evergreen Street, Suite 1100 Sacramento, CA 95815Telephone: 916 561-8780FAX: 916 263-2671

18 CAPA NEWS

of PAs a supervising physician may supervise from two to four; and reduced the percentage of charts a supervising physician must review when a PA functions pursuant to protocols from 10% to 5%.

This Third Edition of the Legal Handbook was published in January of this year to cover new legislation sponsored and passed by CAPA in 2009 and 2010 and other new legal developments of interest to PAs. To summarize, the new information in this Third Edition covers the following:

� A new law that will permit PAs to obtain fluoroscopy permits and to perform fluoroscopy procedures by taking a course and passing an exam to be administered by the California Department of Public Health.

� Amendments to the Education Code permitting PAs to examine and certify school district and community college district employees as being free form Tuberculosis and otherwise fit for duty, and to examine and certify students as being fit for participation in school athletics.

� The impact on PAs of the medical marijuana law.

� An amendment to the Physician Assistant Practice Act permitting PAs to order durable medical equipment and make arrangements for home health and personal care services.

� An amendment to the Public Utility Code authorizing PAs to certify the need for special

The Third, New and EXPANDED Edition of the California Physician Assistant’s and Supervising Physician’s Legal Handbookby Bob Miller, PA-C, Professional Practice Committee Chair and Gaye Breyman, CAE, Chief Operating Officer

telecommunications equipment by disabled individuals.

� Updated information regarding the requirements for PAs to receive reimbursement from Medicare and Medi-Cal.

� Information about reports of adverse peer review actions and insurance payments to the National Practitioner Data Bank.

� An expanded discussion of how a PA obtains a DEA number.

� Updated information regarding the HIPAA patient privacy requirements, and new state laws that make it illegal to “snoop” into the records of patients for whom a practitioner has no clinical responsibility.

� Case studies intended to illustrate how the laws governing PA practice work in “real life” have also been added at the end or each chapter, at the suggestion of PA educators.

The Legal Handbook helps CAPA perform its mission, which includes keeping PAs and their supervising physicians up to date and educated in legal as well as clinical matters. CAPA has performed that role over the last thirty years by responding to countless questions from PAs on a wide range of issues, such as:

� What risk do my supervising physician and I face if he/she does not comply with the requirements for delegating services, establishing protocols, reviewing charts, etc.?

Hot Off The Presses and Available Now!

California

Physician Assistant’s

and Supervising Physician’s

Legal Handbook

T H I R D E D I T I O N

C A L I F O R N I A A C A D E M Y O F P H Y S I C I A N A S S I S TA N T S

R. Michael Scarano, Jr.

Foley & Lardner LLP

CAPA General Counsel

The first edition of the Legal Handbook was published in 2007 and was intended to

meet a pressing need among PAs and their supervising physicians. While physician assistants emerge from their academic programs and preceptorships well equipped for the

clinical challenges they will face, many are not as knowledgeable regarding the laws and regulations that govern PA practice. Many supervising physicians also lack information regarding the rules applicable to the

physician-PA relationship. Failure to know and understand these rules can have dangerous, even career ending consequences, particularly as licensing agencies and government reimbursement programs become increasingly vigilant in policing professional misconduct.

The second edition was authored in 2008 to incorporate changes in the law resulting from AB 3. AB 3 expanded Medi-Cal coverage for PA services to make it commensurate with the coverage of physician and nurse practitioner services; eliminated the requirement for patient-specific authority for a PA to write drug orders for controlled substances if the PA has met certain educational requirements; doubled the number


The Third, New and EXPANDED Edition of the California Physician Assistant’s and Supervising Physician’s Legal Handbookby Bob Miller, PA-C, Professional Practice Committee Chair and Gaye Breyman, CAE, Chief Operating Officer

� Can PAs own, or share ownership of, a medical practice?

� What should be included in an employment agreement?

� What are the requirements to bill Medicare for “incident to” services?

� Are PAs exempt employees, or do they have to be paid overtime?

� Does the supervising physician have to be present when I “close” a surgical patient?

� Can PAs give orders to nurses or medical assistants?

� What kind of insurance should I have?

� How do I protect myself from malpractice claims?

In answering these and other questions, for twenty five years CAPA and its members have often looked to attorney Mike Scarano, CAPA’s general counsel. Mike has not only provided CAPA and its members with guidance on a myriad of issues, he has helped shape the legal face of the PA profession by writing most of the statutes that CAPA has sponsored over the years to enhance PAs’ ability to treat their patients. Mike has authored issues and position

papers for the American Academy of Physician Assistants, as well as for CAPA, and is nationally recognized in the area of physician assistant law.

As PAs have grown in number, and the laws governing the profession have become increasingly complex, there is a need for a “one stop” authoritative source for legal information regarding the PA profession and other basic health law concepts every PA should know. This Legal Handbook meets that need.

Order FormCalifornia Physician Assistant’s and Supervising Physician’s Legal Handbook: CAPA Member - $29.95 or Non-Member - $49.95

Name ________________________________________________________________________________________________

PA-C PA PA-S MD DO Other _____________________________________________________

Address _______________________________________________________________________________________________

City ________________________________________________________State___________ Zip Code _________________

Phone (____) _______________________________________Fax (____) _________________________________________

Amount: $ ____________ + $5.00 shipping per book = $ _____________ (Shipped via USPS)

Credit Card: Check ____________________________________________________________________________________SIGNATURE EXP. DATE

Mail completed Order Form and make checks payable to:CAPA California Academy of Physician Assistants3100 W. Warner Ave., Suite 3 . Santa Ana, CA 92704-5331Phone: (714) 427-0321 . Fax: (714) 427-0324 . Toll Free Fax: (800) 480-2272

3rdEdition

C

M

Y

CM

MY

CY

CMY

K

My DoctorAd_Full Pg-Outlined.pdf 1/3/2011 2:39:18 PM


C

M

Y

CM

MY

CY

CMY

K

My DoctorAd_Full Pg-Outlined.pdf 1/3/2011 2:39:18 PM

D espite reductions in smoking in recent decades, tobacco use remains the leading cause of

premature death among Americans. Not surprisingly, many patients seen by health care providers are

tobacco users suffering from tobacco-related illness. This fact presents both a challenge and an opportunity. The challenge is to provide adequate treatment for the presenting concerns of so many tobacco-using patients. The opportunity

is to help them make healthy choices to prevent such illnesses in the future.

Recognizing the tremendous value of this opportunity, the California Smokers’ Helpline recommends that health care providers follow the Ask, Advise, Refer intervention at every patient visit:

•� Ask all patients if they use tobacco

•� Advise those who do to quit

•� Refer them to cessation resources such as the California Smokers’ Helpline (1-800-NO-BUTTS)

Providers who consistently follow these steps can have a dramatic

How to Help Patients With Nicotine Addictionby Gary Tedeschi, Ph.D., Clinical Director, California Smokers’ Helpline, UCSD Moores Cancer Center

impact on the prevalence of tobacco use among their patients.

The Helpline has been scientifically proven by UCSD researchers to double a smoker’s chance of quitting successfully. Together, the provider and the Helpline ensure that patients have the best possible chance of success.

To make referral easy, providers can simply hand their patients a gold Take Charge card. These durable plastic cards look like credit cards and list the Helpline’s toll-free number on the front and a brief description of services on the back. Providers can order Gold Cards and other patient materials free of charge at www.nobutts.org.

Every patient interaction is a teachable moment in which patients

Did You Know?

2002: CAPA succeeds in revising the California Labor Code to clarify that PAs may treat Workers’ Comp patients

CAPA FACT

may realize the connection between quitting and improved health, and all health care providers--not just physicians--can help them reach this point.

The California Smokers’ Helpline (1-800-NO-BUTTS) is a free evidence-based telephone counseling service available to California residents wanting to quit tobacco. Services are available in six different languages (English, Spanish, Cantonese, Mandarin, Korean, and Vietnamese) and specialized services are also available for teens, pregnant women, and tobacco chewers. The Helpline is funded by the California Department of Public Health and First 5 California. To order free patient materials, visit www.nobutts.org.

Ask. Advise. Refer.Three Minutes or Less Can Save Lives

“Every patient interaction is

a teachable moment in which

patients may realize the

connection between quitting

and improved health…”

Students Students Students Students Students Students

22 CAPA NEWS

Facebook, LinkedIn, My Space and Twitter are some common social media sites. One of the

most used, Facebook, was founded in 2004 and currently boasts of over 500 million users, and still growing. Users of Facebook create personal profiles that can include

photos, personal interests, contact information, and other types of personal data. Facebook appeals to many age groups, but the main market is the Millennial Generation (those born in the years 1978-2000). Everyone is getting onboard with the

Facebook train. For example, my son, a high school freshman, is a member of his school’s Student Government Association (SGA). The preferred and main method of communication for the forty SGA representatives is Facebook.

Undoubtedly, many of you hold Facebook accounts and have

discovered the joys of finding old friends or connecting with geographically distant friends. Facebook also provides various types of connectedness outside social events, such as dissemina-tion of articles, news events and professional grouping. Facebook is a valuable communication and network resource in which you can advertise yourself. This is espe-cially attractive to students who will be hitting the job market in the near future.

Not all that glitters is gold. Facebook and other social media sites are now frequently being used by universities and employers to screen potential applicants. Research has indicated that between 40 to 70 percent of recruiters access information about applicants through programs like Google or media sites such as Facebook, Twitter or LinkedIn (1) (2) (3). Up to 79% of authorized hiring personnel have used information to better assess a candidate (1). Sometimes the assessment is not good for the applicant. Employers disregard candidates when they find certain “red flags” in the online sources (4). Some of the red flags may be obvious, some others not as obvious. Table 1 lists items that have negatively swayed a potential employer/school (5). One of the not so obvious items that have caused an applicant to be

disregarded has been the use of “emoticons” e.g., smiley face and text language such as w8 (wait) or b4 (before) in an e-mail or job application.

Studies have shown that potential employers have begun using social media sources as a determination if a candidate is a good fit for the position/practice. One way they have used social media is by checking on applicants to make sure they have not misrepresented himself/herself or their qualifications. Employers may also feel that if an applicant posts something that is inappropriate, that action displays poor judgment. Today’s employers look for other qualities in applicants such as loyalty and discretion. Posting inflammatory information about a company, person, instructor, or physician on the Internet can be construed as poor judgment.

Is it fair for an employer to use social media to further assess an applicant? Currently there are no specific laws that prohibit employers from checking applicants on the Internet, Facebook, Twitter or LinkedIn. There is some protection, however. State and federal laws do discuss “too much information.” How does an employer explain the knowledge of a medical condition that was not presented in the

Facebook: Implications for PA Students and the Job Marketby Roy Guizado, MS, PA-C, Student Affairs Committee Chair

Table 1

1. References to drug abuse2. Extreme/Intolerant views

including racism, sexism, and homophobia

3. Criminal activity4. Evidence of excessive alcohol use5. Inappropriate pictures – with or

without nudity6. Foul language7. Links to unsuitable websites8. Lewd jokes9. Silly email addresses10. Members of silly or pointless

groups11. Display of poor communication

skills12. Bad-mouthing previous

employers, co-workers, or clients



application or interview? The employer must demonstrate how they did not use that piece of information when disregarding the applicant. Some employers use a third party to conduct searches on an applicant’s background. Usually an applicant provides written consent for someone to perform a background check, which provides time for applicants to remedy their social site. The catch is consent needed if a third party performs the search; no consent may be needed if the search is performed directly by the employer. Finally, some states have mandated that off-duty conduct is exempt from consideration for hiring a candidate, especially if the off-duty conduct is legal, such as drinking. However, if a direct link can be demonstrated to a job’s formal responsibilities, then that information can be used to deny hiring, i.e., drinking to excess frequently when the job requires the employee to be on call or ready to serve at a moment’s notice, as a function of the job (6).

With this new found knowledge of employer Facebook fishing, subscribers have tried to change their names on Facebook. Many have found this too cumbersome and revert back to their original name in a few months. All is not lost if you use common sense and take the following advice. Check your privacy settings by limiting who has access to information. If you are in networks, consider the real need – you must weigh the potential of job contacts versus social contacts. Clean

up your profile, checking for the information listed in the Table. It is important to “untag” all questionable photos. Keep your profile clean especially in commenting of other people’s photos, walls, etc.

This information is provided to assist you in maximizing the use of Facebook and other social media programs to your advantage. Facebook can be a great tool for networking, job and school communications. A well thought out social site can support an applicant’s professional qualities, attributes and creativity. The crafted site can highlight solid communication skills and well-roundedness (2). Use of common sense and the realization that anyone can check Facebook should be the guide when posting information. Now go and update your Facebook profile and security settings.

Congratulations to the 2011 CAPA Scholarship Winners!!!

Community Outreach ScholarshipAlan Valenzuela, PA-SSan Joaquin Valley College

Ray Dale Memorial ScholarshipJoy Dugan, PA-STouro University

Ruth Webb Minority ScholarshipChristina Guzman, PA-SSan Joaquin Valley College

Works Cited

1. Goldberg, Stephanie. Young job-seekers hiding their Facebook pages. CNN Tech. [Online] March 29, 2010. http://articles.cnn.com/2010-03-29/tech/facebook.job-seekers_1_facebook-hiring-online-reputation/2?_s=PM:TECH.

2. 45% Employers use Facebook-Twitter to screen job candidates. Oregon Business News. [Online] August 24, 2009. http://oregon-businessreport.com/2009/08/45-employers-use-facebook-twitter-to-screen-job-candidates/.3. Skinner, Carrie-Ann. Half of employers check Facebook. Macworld Business Center. [Online] January 2010. http://www.macworld.com/article/145719/2010/01/facebook_jobs.html.

4. Finder, Alan. For Some, Online Persona Undermines a Re-sume. The New York Times. June 11, 2006.

5. Make Sure Your Facebook Profile Doesn’t Lose You A Job. Dumb Little Men. [Online] February 2009. http://www.dumb-littleman.com/2009/02/make-sure-your-facebook-profile-doesnt.html.

6. Ford, Jackie. Why employers should reconsider Facebook fishing. Market Watch. [Online] February 11, 2009. http://www.marketwatch.com/story/story/print?guid=885560B4-7672-481C-AE84-9AFE18AF9F70.


24 CAPA NEWS

E very year around this time I find myself making a list of “Personal New Year’s Resolutions.” To be

honest, some years are better than others for meeting the goals I have set out to achieve. This concept got me thinking, “what if I could make a New Year’s Resolution list specifically for the new career that I will be officially entering in 2011.”

As a PA-S finishing up my first year of school at Western University of Health Sciences, it would be very easy to bury myself in the books, rotations, and a thesis…not to surface until the PANCE is over and my license number is issued. But, as with any great career, success depends on many factors above and beyond test grades. So my article this month is not only for me, but also for all my fellow CAPA students. It is a “Physician Assistant 2011 New Year’s Resolution List” that can actually be completed with confidence and the help of CAPA student-wide resources:

“Top Ten List of Physician Assistant Resolutions

1. Statewide Physician Assistant Laws, Legislation and Regulations. Stay up-to-date and current about my career via CAPA’s Facebook page, eNews updates, and CAPA News

2, Physician Assistant Networking. Attend CAPA’s Annual Conferences in Palm Springs and Napa. These are great opportunities to network with PA students and graduate PAs statewide for educational and future job opportunities

3. PANCE Study Advice and Resource. Read archived CAPA News July/August 2008 article accessed from CAPA’s website, “Surviving Clinical Rotations Workshop”

4. Great Clinical Preceptors Relationships. Putting your best foot forward in this area is key. Read the archived CAPA News May/June 2010 article accessed from CAPA’s website, “Taming the Clinical Monster”

5. Lessen My Financial Debt. Decrease the financial burden of PA school by applying for one of the three $1,000 scholarships available through CAPA. There are other financial aid programs listed on the CAPA website. Links can be found at: http://www.capanet.org/student_otherfinancial.cfm

Deadline to apply for CAPA Scholarships is December 31 each year.

• The Ray Dale Memorial Scholarship $1000

• Ruth Webb Minority Scholarship $1000

• Community Outreach Scholarship $1000

6. Volunteer Opportunities Statewide: This is a great way to stretch my legs and practice my school knowledge on actual patients while bettering my community. These opportunities are listed at: http://www.capanet.org/index.cfm

7. Electronic/PDA PA Software.It’s so important to stay up-to-date with current medical knowledge from prescription medications to anatomy to treatment guidelines. A great jumping off point to decide what programs are best can be accessed at CAPA News July/August 2008 Archive found on the web titled, “Surviving Clinical Rotations Workshop”

8. Hands-On Training Workshops.CAPA’s Annual Conference in Palm Springs offers hands-on training with top professors, physicians, and other expert PAs in a variety of fields to practice the skills I will need for whatever PA career field I enter

9. Controlled Substance Education Course.For graduates, multiple locations and dates are offered throughout the year at a discounted rate for all CAPA members

10. Post Graduation Job Search.CAPA’s website offers great job listings for recent graduates to search for new opportunities at: http://www.capanet.org/joblistings.cfm

Happy 2011 and good luck with your future career.

Jenn Baltazar, PA-SStudent [email protected]

www.capanet.org

2011… A New Year of Student Opportunities with CAPAby Jennifer Baltazar, PA-S, Student Representative



Anne Walsh, PA-C

Attention: PA Program Directors, Class Presidents, Student Society Leaders, Faculty and Students

L et CAPA know what you are doing by submitting an article and include a photo if possible. Or, you may simply send a photo with a descriptive caption. We want to let our

readers know the wonderful things that are happening at our PA programs. We will print submissions on a space available basis. Send your article/photos, etc. to [email protected]. Thank you!!

I had an opportunity to catch up with Anne Walsh, Interim Director of the PA Program at the

University of Southern California, at the recent Physician Assistant Education Association meeting in Baltimore, Maryland. “Catch up” is an apt term. Anne continues to work long clinical hours in a gastroenterology practice while taking the reins of the program from which she was graduated in 2000. But leadership is not new, Anne was

co-president of a PA class voted Outstanding SAAAPA chapter. Not surprisingly, she got into PA education “by default.” She was first hired to teach medical students, then recruited into the PA program where she now teaches GI

modules to first year students and laboratory skills, a topic which came naturally to her based on her pre-PA experience as a cytotechnologist.

Still glowing (and gloating) about USC’s victory in the CAPA Student Challenge Bowl at the October CAPA Conference, Anne took time to reflect on the future of PA education. Like many PA faculty, she feels the changing face of the profession, reflected in the changing population of PA students, will dictate where PA education goes over the coming years. She spoke

of the challenges educators face in imparting practical information to an ever younger, less experienced student population. She believes, “[The] strength of the profession has been in the maturity and experience of our students, the commitment to previous experience and an emphasis on clinical skills.” Less seasoned students means taking the time to provide training PA programs once took for granted. She also expressed concerns about the effects of changing degrees, and the emphasis masters level PA training programs place on the baccalaureate degree relative to previous clinical experience.

The issue of younger students with less professional experience also came up when I asked about CAPA and its relationship to PA training programs. Anne stated that she feels CAPA will need to focus on advocacy more than it ever has in order to impress upon new PAs the professional obligation to support and expand

the profession. Additionally, CAPA plays an important role in providing a venue for PA educators in the state to meet, share ideas and, hopefully, identify more graduate PAs interested in a role in education.

USC is in the midst of a number of exciting changes, including Kevin C. Lohenry, MPAS, PA-C becoming the PA Program Director in March 2011.The Department is also adjusting to its new home – a 22,000 square foot, $1.5 million training facility custom designed by program faculty. The new facility contains dedicated state-of-the-art classroom space for all three classes, library, wireless internet, student lounge and study space, and 10 rooms dedicated to clinical scenario examination (OSCE). USC is also currently seeking a new faculty member. With another accreditation cycle on the horizon, the USC PA program has much to celebrate and a dedicated leader to help guide them through this exciting time.

What’s Going On At…USC Faculty Profile: Anne Walshby Michael De Rosa, MPH, Ph.D, PA-C, PA Program Relations Committee Chair

“USC is in the midst of a

number of exciting changes,

including Kevin C. Lohenry,

MPAS, PA-C becoming the PA

Program Director in March

2011.”


26 CAPA NEWS

The UC Davis FNP/PA Program, of Sacramento, CA, hosted its first annual White Coat

Ceremony on December 8, 2010. The White Coat Ceremony is a tradition among many programs that marks the student’s transition from didactic studies into the clinical portion of their training.

The ceremony was coordinated by the 2011 Class Student Society and faculty members: Kris Himmerick, MS, MPAS, PA-C, Ceremony Coordinator and Marcia Ceesay-Slater, MPH PA-C, Student Society Faculty Advisor.

The event began with two amazing Keynote Speakers, Sonny Cline, PA-C and Beth Grivett, PA-C.

Sonny has worked in family, emergency, and psychiatric medicine for over 10 years and has also been a guest lecturer for UC Davis as well

as Stanford. He delivered a very memorable and sobering speech, driving home both the privilege and responsibility the white coat symbolizes.

Beth, who currently practices family medicine, has held many positions of leadership within our profession including President of CAPA 2002-2003. She has worked tirelessly as the Chair of the Legislative Affairs Committee for CAPA for the last 10 years. Beth gave a very motivational speech about becoming an active member within our profession, remembering those who have come before us and helped carve the path we now travel, as well as the importance of paying it forward with our participation and future leadership.

First Year and Second Year FNP/PA Students and the faculty attended

the Ceremony. Together, both classes participated in reciting the Physician Assistant Processional Oath, lead by Student Society President Chris Davis, PA-S. The ceremony was completed by the second year FNP/PA students, already having been in their clinic setting for some time, placing the white coats on the First Year Students, who begin their clinical rotations in January 2011.

This is the beginning of a wonderful tradition for UC Davis! The symbolic meaning of white coat will be remembered by all and carried forward throughout the years at UC Davis and in the careers of its students.

Thank you to those who organized and attended this event and congratulations to the Classes of 2011 and 2012.

The First White Coatby Stacy L. Frazer, PA-S, Constituent Chapter Student Representative of the 2011 Student Society, UC Davis FNP/PA Program

Faculty: White Coat Ceremony Coordinator:Kris Himmerick, MS, MPAS, PA-C

Student Society Faculty Advisor:Marcia Cessay-Slater, MPH, PA-C

Student Society 2011President:Chris Davis, PA-S

Vice President:China Milligan, PA-S

Treasurer:Neda Raheen, PA-S

Secretary:Sharon Perez, PA-S

AOR Representative:Fallon Lopez, PA-S

Constituent Chapter Student Representative:Stacy Frazer, PA-S

Diversity Chair Committee Representative:Kim Harris, PA-S

Student Society Historian: Martin Ceballos, PA-S

External Affairs Committee:Suzy Choi, PA-S


Welcome New MembersNovember 11, 2010 through February 1, 2011

Candice Abdou, PA-CGabriel Aguilar, PA-SMaria Aguilar H., PA-CJamie Ahner, PA-CAnne Alexis, PA-C, MSCarlos Alvarez, PA-CKrupa Andalkar, PA-SGeorge Anderson, PALisa Asfahani, PA-SAdela Ashraf, PA-CBrynn Bailey, PA-CKelly Baldwin, PA-SStephanie Baron, PA-CBret Batchelor, MDMandi Battles, PA-CMichelle Bauer, PA-SRodney Beaty, PA-CAmy Becerra, PA-CLisa BeedleVerenisse Bejarano, PA-CGilbert Benitez, PA-CArnie Bergula, PA-CMaria Betancourt, PABrigette Beyer, PA-SRakhi Bhatia, PA-CAsbel Bolado, PA-CRandy Bonds, PA-SRolando Bonilla, PA-CTricia Borchers, PA-CRichard Bowling, PA-CChrista Bradley, PA-CJulia Brenta, PA-SLinda Broussard, PA-CLeah Burnett, PA-CEmily Bush, PA-STiffany Butler, PA-SKelly Calkins, PA-CRobert Carleton, PA-CCharlotte Carlson, PA-SLeo Carpenter, PA-CChuah Cha, MABrenda ChandlerLissette Chao, PA-CMark Christiansen, PA-CJohn Clark, PA-CMolly Cobb, PA-SDonna Colobong, PA-SLara ConovaloffCrystal Cox, PAJenna Curtis, PA-SLauren Cypert, PA-CElena Da Silva, PA-SJacqualine Dancy, PA-C, MPASJason Daughety, PA-STiffany Day-Neutill, PA-SRobert deBos, PA Nina DeWeese, PA-CErin Dean, PA-CMari Jo Dedeker, PA-CAnne Denslow, PA-CLisa Deppmeier, PA-CTrung Dinh Thomas Dowell, PA-CMatthew Dowell, PA-SAndrew Duncan, PA-CChris Ediss, PA-CIrene Edmunson, PATerri Edwards, PAMikhail Esfandier, PA-CCelia Espinoza, PA-CSudi Fahim, PA-CMarlene Farronan, PA-CBrandi Fleischmann, PA-CJorge Flores, PA-SRobert Fonseca, PA-CVera Fonseca, PA-C

Anthony Fraser, PA-CJason Frazer, PA-CAlexis Fruge, PA-CMargaret Galileo-Rojas, PA-CMeghan Galloway, PA-CHeather Gerstl, PA-CJennifer Gerwick, PA-SKirsten Gipson, PA-CMaria Glover, PA-SElida Gonzalez, NPKellie Goudreau, PA-SGeoffrey Green, PA-CSteve Gruer, PA-CVictor GunnLiv Hagstrom, PA-CWesley Hardin, PA-SKristin Harrington, PA-CKristin Harris, PA-SJanet Hendrickson, PA-SDaliya Heng, PA-SLong Her, PA-SJoshua Hess, PA-CRachel Himelstein, PA-SColeman Ho, PA-SDanny HoCandie Hochnadel, PA-CElizabeth Hollo, PA-SJoy Horstman, PA-SChase HungerfordRie Inaba, PA-SKarl Inbody, PA-CDina Jackson, PA-CMarvin Jones, PA-C, FNPNavjot Kaur, PA-CAshkan Kaviani, PA-SSarah Khan, PA-CEsther Kishimoto, PA-SJennifer Kokesh, PA-CSteve Kotarek, PA-CErasmus Kotey, PA-CVitaley Kovalev, PA-SPetra Krupp, PA-CMichelle Lancaster, PA-CTeresa Latham-Kockinis, PA-CKatherine Lauchaire, PA-CSheila Lederer, PA-CJessica Lee, PA-SShane Leininger, PA-SBrandon LewTina Lewis, MMSc, PA-CEmily Liao, PA-SBethany Lindstrom, PA-CAmelia Lopez, PA-CJacob Loya, PA-SGabriel Maalouf, PA-CJessica MacDonald, PA-SMegan Maddock, PA-CSirintorn Mann, PA-CAlison Marcus, PA-SMonique Mariscal, PA-SStephanie MaybergMatthew McCartt, PA-SLibbey Michelini, PA-SRafael Miranda, PA-CErin Montgomery, PA-SBrianna Morris, PA-CGlenn Morrison, PA-CCorinna Morton, PAYvonne Muro, PA-CAngela Nguyen, PA-S Matthew Nothern, PA-CAllison O’Boynick, PA-SFrancisca Obiora, PA-CAmbar Oregel, PA-SAngela Passanisi, PA-CYana Pechenik, PA-C

David Pena, PA-CLarisa Petrison, PA-CArineh Petrosian, PA-CAnthony Pinner, PA=CLaura Pittenger, PA-SGhazal Pooya, PA-CTerence Potter, MS, PA-SWing Kay Pui, PA-CAlison Quammen, PA-CAlfonso Quant, PAReynaldo Quinonez, PA-CDaniel Ramos, PA-CShannon Rathbun, PA-CAmber RichterRomulo Romero, PA-CRafael Romero, PA-CRagna Rostad-Ruffner, PAHamid Sakhi, PA-SSamuel Samalin, PA-CTony Sanchez, PA-CSarah Schrader, PA-SJennifer Schroeder, PA-CJudith Seargeant, PA-CAdam Shiffman, PA-CBrett Sibley, PA-SJoseph Silverstein, FNP, PA-CDeborah Smallwood, PA-CVance Snyder, PA-CJim Spears, PA-CJenny Spencer, PA-CIrina Spivak, PA-CJulie Stackhouse, PA-CJames Stafford, PAEmily Stuhr, PA-SChristine Szafranic, PA-CHoward Taliercio, PA-CEmily Talmich, PA-SVictoria Tang, PA-SGloria Taylor, PA-CBonnie Taylor, PA-SJaroslava Teet, PA-CDania Tenorio, PA-SJuly Torres, PA-SJacie Touart, PA-CJoseph TrajanoEric Travis, PA-CJohn Trent, PAMiguel Trujillo, PA-CSandy Valle, PA-CLinda Van Horn, PA-CErika Van Hulzen, PA-CValerie Venghiattis, PA-CAnthony Vennik, PA-CLauren Vento, PA-CIvan Ventura, PA-CKimberly Veres, PA-CShilpa Vichare, PA-CRenee Vinyard, PA-CConnie Volpi, PA-CAnne Wadham, PA-CHeidi Wang, PA-CAgnes Warhover-Kotarek, PA-CSusie Wegner, PA-CCharles Wetter, PA-CSteven White, PA-CBart White, PA-STessa Whiteley, PA-CKellie Williams, PA-CJason Williford, PA-SPatrick Wong, PA-CSamantha Wood, PA-CAlfred Yang, PA-CAlbert Yun, PA-SSahar Yusufi, PA-SRobert Zapotosky, EMTJason Zartman, PA-C

1. Redding Area PA/NP AllianceSummer Ross, PA-C; (530) [email protected]

2. Physician Assistant Society of Sacramento (PASS)Carlos De Villa, PA-C, PASS President; (916) 973-6185, [email protected] Sharma, PA-C, MMS, MPH, CHES; (916) 397-6035, [email protected]

3. Contra Costa Clinicians AssociationBrian Costello, PA-C; (707) 651-2705, [email protected]

4. San Francisco Bay Area Physician Assistants (SFBAPA)www.sfbapa.com, PO Box 14096, San Francisco, CA 94114-0096Martin Kramer, PA-C; (415) 433-5359, Fax: (415) 397-6805, [email protected]

5. Bay Area Mid-Level PractitionersRose Abendroth, PA-C; (650) 697-3583, Fax: (650) 692-6251, [email protected] Dillon, PA-C; (650) 591-6601, [email protected]

6. Bay Area Non-DocsLinda O’Keeffe, PA-C; (650) 366-2050, [email protected]

7. Northcoast Association of Advanced Practice CliniciansJohn Coleman, PA-C; (707) 845-6008, [email protected]

8. Stanislaus County NP/PA NetworkBrian Cormier, PA-C; (209) 605-4966, [email protected], www.nppanetwork.org

9. Stockton MidlevelsEmma Calvert, PA-C; [email protected]

10. Journal Club for PAs and NPs (Fresno area)Cristina Lopez, PA-C; (559) 875-4060; Fax: (559) 875-3434, [email protected]; 2134 10th St, Sanger, CA 93657

11. Tulare/Kings NP/PA AssociationSteve Henry, PA-C; Pager: (559) 749-4348, [email protected]

12. Central Coast Nurse Practitioners & Physician AssistantsKris Dillworth, NP; [email protected]

13. So Cal PAsLinda Aghakhanian, PA-C; [email protected]

14. Orange CountyHung Nguyen, PA-C; (714) 846-8178; [email protected]

15. San Gabriel Valley Local GroupM. Rachel DuBria, PA-C; (818) 744-6159, [email protected]

16. San Fernando/Santa Clarita Valley GroupJonah Tan, MPT, PA-C; (818) 634-0007, [email protected]

17. Coachella Valley Physician Assistant GroupMatthew Keane, MS, PA-C; [email protected]

18. San Diego AreaJeremy Adler, MS, PA-C; (619) 829-1430, [email protected]

Local Groups

NEW

NEW

California Academy of Physician Assistants3100 W. Warner Avenue, Suite 3Santa Ana, CA 92704-5331

Address Service Requested

PRSRT STDUS POSTAGE

PAIDSANTA ANA, CAPERMIT NO 949

CAPA’s 35th Annual ConferenceSeptember 22-25, 2011

Optional Workshops, September 22 and 24

Controlled Substances Education CourseSeptember 21, 2011 – Prior to the CAPA Conference

CAPA’s home away from home is looking a bit more like a palace! The renovation is complete and the Wyndham Palm Springs is no more. A new and very much improved CAPA Conference experience awaits you at the Renaissance Palm Springs. And, the

special CAPA Conference Rate is just $169! You may reserve your room today.

january/february magazine - 2011

Documents