Cideous Posted April 23, 2023 Share Posted April 23, 2023 Has anyone been paying attention to AZ? https://www.aapa.org/news-central/2023/04/arizona-becomes-fourth-state-to-remove-the-legal-tether-between-pa-physicians/ Well done them. 1 1 Quote Link to comment Share on other sites More sharing options...
mgriffiths Posted April 23, 2023 Share Posted April 23, 2023 Am I reading that correctly as AZ PAs are no longer dependent providers once they reach 8000 hours of experience? 1 Quote Link to comment Share on other sites More sharing options...
Ty2PA Posted April 23, 2023 Share Posted April 23, 2023 1 hour ago, JenGintheED said: We are collaborating providers, not dependent. I need to reread the law when I'm not on my phone in bed half asleep. However, my first glance through earlier this week left me with the impression that a collaboration agreement is still required after the hour requirement, although the collaboration agreement does not need to name a specific physician unless the PA is working for a solo physician provider. That's definitely an improvement over the past, but I don't quite see it as "cut legal tethers" described in the AAPA article (I think they were a little generous in the article). Unfortunately, the new law reaffirms the physician's legal responsibility for the acts of the PA up until the hour requirement is met and certified, which continues to be a barrier to hiring new grads in the state. I don't love the requirement to actually get a certificate "certifying" the hours of experience worked in the prior 5 years, but I do like that it's a body of PAs who will promulgate policies on what this certifying process will entail. And theoretically, it should be a "one time" thing. Overall, definitely a step (not quite a leap?) in the right direction. Congrats AZ PAs! In terms of what "collaboration" does to the job environment.... Idaho went to "collaboration" a couple of years ago and it has actually made a significant difference. A collab agreement is required with the clinic or a physician, UNLESS the PA is working for a health system who has a credentialing process in place, in which case no specific agreement of any kind is required. Just this week, listening to a local MD who is now the chief medical officer at a local health system, they've been happier to hire PAs ever since 2021 because of it (they no longer need to cajole docs into "supervising" them outside of what their own credentialing system requires). Also, I have an NP friend who owns some UCs around the state; he hired only docs and NPs....until 2021. He now has a handful of PAs with several more ads posted to attract more. He has a part-time doc on salary who checks the box for his clinic to be able to collab with PAs, and in the last year has hired more PAs than any other class. While I love the direction MT, UT, WY and others have gone (although WY scares me a little), I still see a lot of benefit to states requiring collaboration agreements vs outdated "supervision". 1 1 3 Quote Link to comment Share on other sites More sharing options...
Febrifuge Posted April 23, 2023 Share Posted April 23, 2023 Would have been nice of the AAPA to name the other 3 states, making AZ the 4th one. Pretty sure we in MN have had this for almost 3 years. It's good. More! https://www.aapa.org/news-central/2020/05/minnesota-pas-celebrate-new-law-removing-references-to-supervision-delegation-and-physician-responsibility-for-pa-care/ 1 Quote Link to comment Share on other sites More sharing options...
SedRate Posted April 23, 2023 Share Posted April 23, 2023 From ASAPA: "With the signing of H.B. 2043, PAs in the Grand Canyon State are now empowered to expand patient care through more modernized, team-based healthcare. In addition to removing the supervision agreement for those PAs with 8,000 or more hours, the legislation will also update who is responsible for the care provided by the PA, allow the Arizona Board of Physician Assistants to determine appropriate regulations for changes in specialty, and allows for direct payment to PAs. The new law will take effect at the end of the calendar year." Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted April 23, 2023 Moderator Share Posted April 23, 2023 2 hours ago, Febrifuge said: Would have been nice of the AAPA to name the other 3 states, making AZ the 4th one. Pretty sure we in MN have had this for almost 3 years. It's good. More! https://www.aapa.org/news-central/2020/05/minnesota-pas-celebrate-new-law-removing-references-to-supervision-delegation-and-physician-responsibility-for-pa-care/ Montana, Utah, and North Dakota, I believe. OR passed collaboration last year as well. 2 Quote Link to comment Share on other sites More sharing options...
Mayamom Posted April 23, 2023 Share Posted April 23, 2023 5 hours ago, Ty2PA said: I don't love the requirement to actually get a certificate "certifying" the hours of experience worked in How does this occur? Documentation from your past and current SP? Some place on a state web site to log? Quote Link to comment Share on other sites More sharing options...
Ty2PA Posted April 23, 2023 Share Posted April 23, 2023 1 hour ago, Mayamom said: How does this occur? They haven't issued the guidelines for this yet. If I read it correctly (still need to reread it), a PA board will issue the rules for certifying your 8,000hrs, as well as what will then be needed to certify if switching to a new specialty. I prefer things be spelled out in law, but administrative rules aren't bad either, especially because it is a PA board. 1 Quote Link to comment Share on other sites More sharing options...
iconic Posted April 24, 2023 Share Posted April 24, 2023 NPs: graduate with independence. PAs: get supervised then after 4 years “collaborate” go us 3 Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted April 24, 2023 Moderator Share Posted April 24, 2023 Just now, iconic said: NPs: graduate with independence. PAs: get supervised then after 4 years “collaborate” go us there is the issue of competence.... Quote Link to comment Share on other sites More sharing options...
TeddyRucpin Posted April 24, 2023 Share Posted April 24, 2023 18 hours ago, EMEDPA said: Montana, Utah, and North Dakota, I believe. OR passed collaboration last year as well. I'm curious if people have info on Maine? Their law passed in the beginning of COVID; super fast tracked. Collaboration under 4K hours; no written agreement if over that. Just need to "consult" as needed. It sounds like one of the better practice laws but never seems to come up here. Awesome state too. All of NE is great for practice with recent updates to NH and VT as well. Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted April 24, 2023 Moderator Share Posted April 24, 2023 Vt is not that great, still tied to a doc, still have a worry that the doc can flake out on you also PA board is under BOM so still not ideal Quote Link to comment Share on other sites More sharing options...
ohiovolffemtp Posted April 24, 2023 Share Posted April 24, 2023 AZ is one of the states where I work. I'll have to ask the hospital and my EM group what difference this will make. I'm way over the hour requirement. 1 Quote Link to comment Share on other sites More sharing options...
SedRate Posted April 24, 2023 Share Posted April 24, 2023 2 hours ago, ohiovolffemtp said: AZ is one of the states where I work. I'll have to ask the hospital and my EM group what difference this will make. I'm way over the hour requirement. It'll likely only change the requirement to have a delegation agreement with SP filed with the the AZ PA board and having a SP on scripts. At the hospital level, NPs are required to have a SP cosigner despite independence so I don't see that changing for PAs, unfortunately. 1 Quote Link to comment Share on other sites More sharing options...
Mayamom Posted April 26, 2023 Share Posted April 26, 2023 So can this PA board deny the hours? If they feel where you were working doesn't satisfy the requirements? So glad I'm done with all this. Quote Link to comment Share on other sites More sharing options...
Joelseff Posted May 9, 2023 Share Posted May 9, 2023 (edited) On 4/24/2023 at 10:34 AM, ohiovolffemtp said: AZ is one of the states where I work. I'll have to ask the hospital and my EM group what difference this will make. I'm way over the hour requirement. When we got "collaboration" here in California in 2016, my company knew nothing about it. Ask your state chapter and your state PA board. Edit: Correction: California got a version of OTP (SB697) effective 2020... I got it mixed up with our reduction of chart note cosignature bill (reduced it to 5% at the time, now with SB697 it's determined at the practice level and can be zero) that passed in 2016. Edited May 13, 2023 by Joelseff Corrected information Quote Link to comment Share on other sites More sharing options...
TeddyRucpin Posted May 9, 2023 Share Posted May 9, 2023 Iowa PA legislation on the governor's desk. They already improved practice laws significantly in March 2020; this is even better. Strong work to all involved. 1 Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted May 9, 2023 Moderator Share Posted May 9, 2023 59 minutes ago, TeddyRucpin said: Iowa PA legislation on the governor's desk. They already improved practice laws significantly in March 2020; this is even better. Strong work to all involved. Independence?? Quote Link to comment Share on other sites More sharing options...
TeddyRucpin Posted May 9, 2023 Share Posted May 9, 2023 Just now, ventana said: Independence?? Iowa-2023-HF424-Enrolled (legiscan.com) Quote Link to comment Share on other sites More sharing options...
iconic Posted May 9, 2023 Share Posted May 9, 2023 1 hour ago, TeddyRucpin said: Iowa-2023-HF424-Enrolled (legiscan.com) The way it reads is collaboration after 2 years Quote Link to comment Share on other sites More sharing options...
bobuddy Posted May 9, 2023 Share Posted May 9, 2023 I believe Colorado just got collaboration signed but I do not know the details Quote Link to comment Share on other sites More sharing options...
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