Hawaii Academy of Physician Assistants

Senate Bill 2103  passed the Senate and House Conference Committees and has been enrolled to the Governor.

The bill amends the nursing statute (HRS 457-2) to clarify that the practice of nursing as a licensed practical nurse and as a registered nurse, respectively, includes carrying out the prescribed medical orders of a licensed physician assistant practicing with physician supervision and acting as the agent of the supervising physician. HAPA considered this a “housekeeping” item to have the statute accurately reflect what occurs in practice and to reflect the previous nursing board opinion that nurses could execute physician assistant orders.

The University of Hawaii School of Nursing and Dental Hygiene, Hawaii State Center for Nursing, Hawaii Medical Association, American Academy of Physician Assistants, Hawaii Academy of Physician Assistants, Puna Community Medical Center, Hawaii Pacific Health, Queens Health Care System, and numerous concerned individuals supported this bill.  The Board of Nursing submitted comments of nonopposition. Unfortunately, a five year "sunset" provision was added to the bill by the House conference committee, and this will need to be repealed prior to 2017. "Sunset" provisions are not uncommon in legislative bills. They are usually repealed by a subsequent bill as long as no problems arise during the "trial period", in this case 5 years.  This language was necessary to satisfy all the legislators involved in the house conference committee. This bill provided the HAPA legislative representatives another great opportunity to meet with and provde our legislators with additional educational information about the PA profession and physician-PA team based approach to patient care.

The Physician Assistant Advisory Committee to the Hawaii Medical Board (HMB) submitted proposed rules changes to the board for consideration on 1/12/2012.  These proposed rules changes are now under review by the Hawaii Medical Board. Vince Tenorio, PA-C, Chaiperson for the PAAC, had the opportunity to answer HMB questions as did Fielding Mercer, PA-C, HAPA President, and Christopher Flanders, DO, HMA executive officer. Proposed amendments can be seen here.

Fielding Mercer, PA-C (HAPA) and Vince Tenorio, PA-C (PAAC) were also at the March 8, 2012 HMB meeting and had another opportunity to discuss the proposed amendments and answer questions for board members. Dr. Takanishi, M.D., (Chairperson) and other HMB staff attended the upcoming  Federation of State Medical Boards (FSMB) 100th Annual Meeting, April 26-28, 2012, in Fort Worth, Texas. Dr Takanishi met with Ann Davis, PA-C of the AAPA at the meeting and had an opportunity to discuss the proposed amendments regarding PA rules with her and other Federation members. He has asked for additional supporting documents from the FSMB regarding other state's regulatons regarding physician-PA ratios for supervision, Schedule II drug standards, and chart review requirements.  

Dr. Takanishi indicated that the Board was aware that the medical model is changing and acknowledged the need for some rules revisions. He advised us that they are interested in continuing an ongoing dialogue regarding the issue and will appreciate input from both HAPA and the PA Advisory Committee. HMA has indicated general support for the amendments and will continue be involved in ongoing discussions regarding the proposed amendments.

Dr. Takanishi also noted the trend of other state medical boards including at least one PA on the board and he indicated to Ann Davis that he was open to that idea for Hawaii.  This would require a legislative change to HRS 453 next session, but this is would be a positive change to have actual PA representation on the state medical board. HAPA will continue this dialogue with the Hawaii Medical Board in the coming months.

It has been fourteen years since the rules were revised.  A lot has changed regarding the practice of medicine since the last rules revision. HAPA submitted a detailed revision to the PAAC which addresses prescriptive authority for Schedule II drugs (36 states now have the authority to prescribe Schedule II drugs), record review requirements, and the number of PAs that can be supervised by a supervising physician. The HMB had advised HAPA that revisions to the current administrative rules were expected to be implemented this fall and had suggested that HAPA present recommendations to the PAAC for their review, prior to new rules changes going into effect. HAR, Chapter 85 currently includes administrative rules for MDs, DOs, PAs, EMTs and Podiatrists. Public hearings will be required prior to implementation of any rules changes.

Kaiser Permanente -
8th Annual National Surgical Symposium
Thursday - Saturday, April 19 - 21, 2012  Makena Beach Resort, Wailea - Makena - Maui, HI.  This will include the FIRST break-out session devoted to physician assistants in the history of this conference. The surgeons want to hear from and work more closely with us - the surgical PAs.  We have been asked to put this together to facilitate teamwork. Your voice is valued and important.  Approved for:
15.75 hours AMA PRA Category 1 Credit(s)^TM

Please join or renew your membership and support HAPA.

We now have ONLINE MEMBERSHIP registration and payment. HAPA dues are among the lowest in the country at $50/year. HAPA would greatly appreciate your support through membership in 2012.

Some ask why we should support a state organization. What is the function of the state organization? Two primary functions always come to the forefront. Does your state academy provide CME opportunities and do they have a job board which helps PAs to find jobs. HAPA provides both. HAPA will be providing our 24th Annual Fall CME Conference.  As usual, we maintain and update our job listing page.

HAPA MEMBERS GET DISCOUNTS ON CONFERENCE COSTS!
In addition, HAPA works directly with our state legislators and Medical Board to assure that PA concerns are addressed and that state law accurately reflects PA scope of practice. HAPA is there to represent PAs as important issues arise. HAPA is also an AAPA Constituent Charter Organization and maintains this status anually through the required reporting and officer membership requirements. Constituent organizations are independent organizations that are officially chartered or recognized by AAPA. The AAPA supports their Constituent Organizations in many ways and has supported HAPA through grants, state advocacy and outreach, as well as legislative and reimbursement support.

HAPA needs your support through membership and welcomes volunteers to help provide ongoing services.

We would like to thank all of you who have already shown your support through membership! Mahalo.

This e-mail address is being protected from spambots. You need JavaScript enabled to view it is our Membership Committee chairperson, please contact him with any questions. 808-778-6726. HAPA welcomes new members.