CAPA News March/April 2014

News

Official Publication of the California Academy of Physician Assistants

March/April 2014

\The Magazine

CAPA Sponsors SB 1083 – Legislation to Permit PAs to Certify Disability

by Teresa Anderson, MPH, Public Policy Director

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here is no doubt that Senator Pavley is a strong advocate and champion for the PA profession.

We are fortunate that she is taking on yet another important practice issue for the profession by authoring SB 1083: Physician Assistant Disability Certification. Currently, physician assistants are not authorized to certify claims for Disability Insurance (DI) with the Employment Development Department (EDD).

The restrictions related to EDD forms are inconsistent with the scope-of-practice of a PA and result in “The restrictions a significant barrier to practice.

related to EDD forms are

Though certifying inconsistent with the disability has been a barrier in PA practice scope-of-practice of a PA for quite some time, recent changes within and result in a significant the EDD have created an additional barrier barrier to practice. ” as some key State Disability Insurance services have been automated via an online version. The online system only allows for a single physician/practitioner electronic signature thereby eliminating the only mechanism for the supervising physician to sign the actual EDD form after the PA has performed the exam. The new version of the

Claim for Disability Insurance Benefits, including the Physician/ Practitioner’s Supplementary Certificate DE 2525XX, is designed with Optical Character Recognition (OCR) functionality and must be submitted in this format in order to expedite forms processing in the SDI online system. Although a hard copy version remains available, it takes significantly longer and must still be completed on OCR forms that use special ink that can be scanned and matched to an on-line data system for processing. According to the EDD, this new online system is being implemented to promote efficiency and reduce cost while following the HIPAA regulations and guidelines.

Current law recognizes licensed medical or osteopathic physicians, an authorized medical officer of a U.S. Government facility, chiropractor, podiatrist, optometrist, dentist, psychologist, nurse practitioner

(after examination and collaboration with a physician and/or surgeon), licensed mid-wife, nurse-midwife, or nurse practitioner (for normal pregnancy or child-birth), or an accredited religious practitioner as practitioners who are authorized to certify claims for Disability Insurance (DI). Including physician assistants as a recognized practitioner, acting as an agent of the supervising physician under a delegation of services agreement, who may certify DI would clarify the inconsistency and omissions in existing law and remove barriers in PA practice.

We are so fortunate to have Senator Pavley as a strong advocate in the Legislature and an incredibly active and strong CAPA membership that is ready, willing and able to respond to the CALL TO ACTION. Be on the lookout for the Call to Action requests as they will be coming soon! 

Gaye Breyman, Executive Director; Senator Fran Pavley, (27th District); Teresa Anderson, Public Policy Director and Kathyrn Scott, Lobbyist

News

At The Table

Editor Gaye Breyman, CAE Managing Editor Denise Werner Proofreaders Kimberly Dickerson Coryn Kulesza

Editorial Board Jeremy A. Adler, MS, PA-C Roy Guizado, MS, PA-C Adam Marks, MPA, PA-C Bob Miller, PA Michael Scarano, Jr., Esq.

Adam Marks, MPA, PA-C and Jed Grant, PA-C at the State Capitol visiting all of the Central Valley legislators to advocate for the SJVC PA Program.

CAPA Board Of Directors

Assemblymember Tom Daly and Andrew Bernal, PA-C at CAPP Reception on December 4, 2013

President Adam Marks, MPA, PA-C president@capanet.org President Elect Jeremy A. Adler, MS, PA-C presidentelect@capanet.org Vice President Roy Guizado, MS, PA-C vicepresident@capanet.org Secretary Joy Dugan, MPH, PA-C secretary@capanet.org Treasurer Bob Miller, PA treasurer@capanet.org Directors-At-Large Ana Maldonado, MPH, DHSc, PA-C dirana@capanet.org

Jeremy Adler, MS, PA-C and Sue Gilroy, PA-C share information about PAs at the CAPA booth at the Osteopathic Physicians & Surgeons of California (OSPC) Conference February 6-8, 2014 in San Diego.

CAPA Attends Press Conference

Cherri L. Penne-Myers, PA-C dircherri@capanet.org Kevin Robertson, MPH, PA-C dirkevin@capanet.org Jay Williamson, MS, PA-C dirwilliamson@capanet.org Student Representative Chelsea Hemming, PA-S studentrep@capanet.org

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: 2318 S. Fairview St. Santa Ana, CA 92704-4938 Office: (714) 427-0321 Fax: (714) 427-0324 Email: CAPA@capanet.org Internet: www.capanet.org ©2014 California Academy of Physician Assistants

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ssembly Budget Chair Nancy Skinner and Assembly Health Chair Richard Pan, M.D., introduced two bills, one that would restore the 10 percent Medi-Cal physician payment cut that went into effect this year and another that would extend the temporary Medi-Cal primary care rate increases called for under the Affordable Care Act (ACA).

Richard Thorp, M.D., California Medical Association (CMA) president highlighted the importance of restoring Medi-Cal rates and extending the temporary rate increase in primary

care when he said “Patients in our communities are already having a difficult time finding access to care. The legislation being introduced today will help to ensure that patients have real access to care as millions of new patients are enrolled in Medi-Cal.” CAPA, along with many other provider advocates attended the Press Conference held on February 19, 2014 to advocate for provider rate restoration along with extending the temporary primary care rate increase. 

CAPA Continues To Collaborate With The PAB – At Arms Length

by Bob Miller, PA; Professional Practice Committee Chair

T California’s Physician Assistant Board (PAB): Rosalee Shorter; Michael Bishop, M.D.; Robert Sachs, PA-C, President; A. Cristina Gomez-Vidal; Catherine Hazelton; Sonya Earley; Charles Alexander, Ph.D. and Jed Grant, PA-C (from the PAB website)

Teresa Anderson, MPH and Bob Miller, PA providing public comment at the Physician Assistant Board meeting on February 24, 2014

he Physician Assistant Board (PAB) has a Legislative Committee to review legislation which is a topic listed on the agenda at most PAB meetings. The Committee evaluates and monitors current or proposed legislation to determine if there is a need for PAB action. The Committee reports their findings and recommendations to the Board.

high level of surveillance on those concerns and the PAB can count on CAPA to provide the PAB with any identified issues. It was decided that there was no need for the ad hoc Legislative Sub-Committee. Gaye Breyman, CAE, CAPA’s Executive Director, addressed the Board to thank them for their trust in CAPA to perform this important activity.

The PAB also has appointed an ad hoc Legislative Sub-Committee.

The ad hoc Sub-Committee was to provide ongoing surveillance and evaluation of regulations and/or laws affecting PAs or PA practice, which might need changing or modification. That ad-hoc committee would bring possible concerns to the Board for potential action.

CAPA has always had a respectful relationship with the PAB going back almost three decades. We always have a CAPA leader at every PAB meeting.

Although we may work together on certain issues, we do so with the realization and respect that the mission of the PAB is to protect the public and provide for licensing and enforcement while CAPA’s mission is to advocate for the practicing PA and the profession. That explains the above – “At Arms Length.” Both organizations share a same goal – to do this work for the ultimate benefit of our patients. 

At its most recent meeting, the PAB passed a motion to disband the ad-hoc Legislative Sub-Committee because they stated officially that CAPA continues to provide such a

Inside This Issue At the Table............................................................................................................. 2

CAPA at Napa........................................................................................................ 10

CAPA Attends Press Conference................................................................................. 2

CAPA’s 2013 Yearbook Receives Rave Reviews........................................................ 11

CAPA Continues To Collaborate With The PAB – At Arms Length................................. 3

PAcing Yourself: Keeping Interest in Your Clinical Practice........................................ 13

Workers’ Compensation Provider Fee Schedule Change............................................. 4

Mentoring Future PA Students................................................................................ 14

Song-Brown Commission Awards Grants to Local PA Programs................................... 4

8th Annual Neuropathy Awareness Day.................................................................. 14

CAPA Leaders and Legislation…How It Works! Why It Works!................................... 5

Help Me Help You.................................................................................................. 15

Physician Assistant Professional Organizations: Roles and Responsibilities.................. 6

Meet the New PA Programs!................................................................................... 16

Interprofessional Collaborative Practice:

Knowledge is Power............................................................................................... 18

CURES 2.0 – CAPA Attends Stakeholder Meeting....................................................... 7

Congratulations to the 2014 CAPA Scholarship Winners!!!....................................... 18

New Laws In The New Year....................................................................................... 8

Welcome New Members......................................................................................... 19

Controlled Substances Education Courses for PAs....................................................... 9

Local Groups......................................................................................................... 19

CAPA’s Executive Committee Is Charged With Reviewing and Recommending Positions on Legislation.................................................................. 10 MARCH/APRIL 2014

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Workers’ Compensation Provider Fee Schedule Change

by Bob Miller, PA; Treasurer and Professional Practice Committee Chair

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he California Department of Industrial Relations (DIR) has recently adopted the Resource Based Relative Value Scale (RBRVS) for provider reimbursement effective January 1, 2014. The RBRVS Physician Fee Schedule has been used

by Medicare and will now replace the Official Medical Fee Schedule (OMFS) that has been used by Workers’ Compensation for many years but not updated since 1999.

The move was a result of SB 863 (deLeón) – legislation enacting major reforms to the Workers’ Comp system in California. The legislation and rulemaking had tremendous support and although we were following the bill and speaking with stakeholders,

there was no stopping this drive to improve upon the problematic OMFS. Christine Baker, the Director of the DIR had the following comment in a recent newsletter: “These regulations will provide a more responsive framework for appropriate medical care and returning injured employees to work.”

So what does this mean for PAs? The Physician Fee Schedule will use similar rules as Medicare with regard to non-physician providers (NPPs).

Like Medicare, when PAs submit a bill under their name and identifier it will now be reimbursed at 85% of the physician fee when providing covered services for injured workers.

And, when PA services are performed under direct supervision, their services may be covered as incident-to services, in which case incident-to requirements would apply. Incidentto services are submitted under the physician’s name and identifier and are reimbursed at 100%. Direct supervision means the physician must be present in the office suite and immediately available. You can read the three pages describing the incident-to rules and requirements in Chapter 4.5. Division of Workers’ Compensation (DWC) in Section 9789.15.2 at http://www.dir.ca.gov/ t8/9789_15_2.html. 

Song-Brown Commission Awards Grants to Local PA Programs

by Roy Guizado, MS, PA-C, CAPA Vice President and Student Affairs Committee Chair

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n 1973, the State of California established the Song-Brown Health Care Workforce Training Act (Song-Brown Program) to increase the number of family physicians providing services to the California population. The program encourages universities and primary care health professionals to provide their health care in medically underserved areas.

Also, the program provides financial resources to support family practice residency, family nurse practitioner, physician assistant, and registered nurse education programs throughout California. (State of California Office of Statewide Health Planning & Development) The Commission annually requests PA, NP and family residency programs to apply for grant funding. This year the Song-Brown Commission offered $1.35 million for training 4

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program support. The California Endowment added an additional $1.75 million to the funding pot for a total of $3.10 million available for grant funding. The Commission has set forth formal requirements to be eligible to request grant funding. For physician assistant programs, there must be some training in medically underserved areas, lower socioeconomic neighborhoods, or rural communities. PA Programs must also identify, recruit and admit primary care PA students who would serve in areas of need.

This year the Song-Brown Commission considered fourteen grant applications; seven applications from Nurse Practitioner Programs and seven applications from Physician Assistant Programs.

Full funding was provided to all programs that applied. The PA Programs

receiving funds include Moreno Valley College PA Program, Betty Irene Moore School of Nursing, FNP/PA Program (UC Davis), Western University PA Program, University of Southern CaliforniaKeck PA Program, Loma Linda PA Program, Touro University PA Program and Stanford University PA Program.

Congratulations to all the PA Programs as they continue to promote practice in primary care to medically underserved and lower socioeconomic communities.

Works Cited “State of California Office of Statewide Health Planning & Development.” 15 January 2014.

Healthcare Workforce Development Division. Document. January 2014. 

CAPA Leaders and Legislation…How It Works! Why It Works!

by Adam Marks, MPA, PA-C, President and Teresa Anderson, MPH, Public Policy Director

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ach year hundreds of new bills get introduced in the California State Legislature. As the 2014 legislative year moves along we are very busy reading proposed bills and preparing a legislative agenda that is as reflective and diverse as the PA profession in California. The Executive Committee along with the Public Policy Director reviews all the proposed bills, literally thousands of pages, that are relevant to the PA profession and then makes recommendations to the full CAPA Board of Directors. The recommendations are based on sound policy that furthers the mission and vision of CAPA. The CAPA Board discusses proposed legislative positions and decides on what position (i.e, Support or Oppose or Watch) we want to take on bills in what we fondly refer to as the CAPA Bill File.

Once the legislative agenda is approved, we get to work tracking the bills, attending hearings, giving testimony and diligently watching for amendments that might change the original intent of the bill, or which impact PAs negatively or positively. If there is a change that is significant enough to warrant a formal position or a position change,

the Executive Committee along with the Public Policy Director and often with our Lobbyist advises the Board of the changes and provides detailed information for them to determine if a position change is prudent. When dealing with legislation and the politics that go with it, sometimes a quick decision must be made. In that instance, the Executive Committee makes the decision and directs the Public Policy Director and Lobbyist. The Board of Directors is informed of those actions and provided with justification for the urgency.

Sponsored bills are decided in much the same way. The CAPA office frequently hears from members about issues or barriers they experience in day-to-day practice. Those issues are brought before the Board of Directors and discussed, and we identify whether they are regulatory or legislative issues. CAPA addresses both regulatory and legislative proposals.

That was the how it works…now for the WHY it works! The process CAPA has in place for deciding positions and the legislative agenda is based on the principles of democracy

whereby a Board of Directors, elected by the membership, participates in discussing the issues with equality, all due political tolerance and respect for differing views. Some of the policy issues require very little debate while others give way to spirited discussions that reflect the interests and diversity of the membership. All of the bills are voted on and the majority of the time, after all members of the board hear each other, the result is a unanimous decision. When an agreed upon position cannot be reached, the majority rule applies to the final decision. Above all, there is a fundamental respect for the fact that CAPA is responsible for transparently representing an entire profession and is accountable to its members.

CAPA has a long history of leaders advancing, protecting and safeguarding the PA profession through the legislative and regulatory process. We continue to build upon the successes of the leaders of the past and take great pride in the trust our membership had placed in CAPA. For more information about our legislative milestones please visit the CAPA website at www.capanet.org/CAPA_ Legislative_Milestones.aspx. 

2013-2014 CAPA Leaders: Front Row, L-R: Saloni Swarup, PA, Public Education Committee Chair; Chelsea Hemming, PA-S, Student Representative; Ana Maldonado, MPH, DHSc, PA-C, Director-At-Large; Cherri L. Penne-Myers, PA-C, Director-At-Large; Mike Estrada, MS, DHSc, PA-C, Committee on Diversity Chair; Gaye Breyman, CAE, Executive Director; Teresa Anderson, MPH, Public Policy Director; Adam Marks, PA-C, MPA, President; Jeremy A. Adler, MS, PA-C, President-Elect; Roy Guizado, MS, PA-C, Vice President Back Row, L-R: Eric Glassman, MHS, PA-C, CME Committee Chair; Joy Dugan, MSPH, PAC,Secretary; Jay Williamson, MS, PA-C, DirectorAt-Large; Christy Eskes, DHSc, MPA, PA-C, PA Program Relations Chair and Bob Miller, PA, Treasurer

MARCH/APRIL 2014

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Physician Assistant Professional Organizations: Roles and Responsibilities

by Ana Maldonado MPH, DHSc, PA-C, Director-At-Large

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here are currently over 20 professional organizations that represent physician assistants in the United States. These include and are not limited to the National Commission on Certification of Physician Assistants (NCCPA), the American Academy of Physician Assistants (AAPA), the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) as well as many specialty PA representative groups. This number does not include the 56 state academies and/or associations that represent our profession locally. Many of us have representation in our specialties, in our practices, in our individual communities, in our states and nationally.

The purpose of this article is to pose the question, what are the roles and responsibilities of the professional organizations that govern our profession that we choose or in which we are mandated to participate? More importantly, what is our individual, professional role and responsibility to these representative organizations?

The question we need to ask ourselves is how do we pick and choose which PA professional organization memberships to initiate, maintain, and support? For those who govern our ability to practice, we are all aware of the timely requirements we must attend to. For those of us practicing medicine, we dutifully adhere in our attention and documentation of continuing medical education and certification requirements. For additional voluntary representation, one presumes we assess our individual PA professional goals and objectives and join one or more of the many professional organizations that represent them.

One has found in exploring the publicized information available from

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these organizations that the role of most of them encompasses many of the same tenets in their missions, responding to the issues that benefit and threaten our profession. Most of these include the following: • Workforce management, additional training and attending to medical education issues • Reimbursement, risk and gain sharing, and valuation of PA professional services • The enhancement and maintenance of the physician assistant profession’s relationships with hospitals and other major elements of the health care system • Updating PAs on issues related to information technology, health care data and quality measurements • Assisting PAs and our employers in adopting reforms in the health care environment • Maintaining PAs’ involvement with community access to medical services and public health issues From our national organization, the American Academy of Physician Assistants (AAPA), we expect: • Representation of the PA profession legislatively in Washington, D.C. • National support working with state PA associations on laws and regulations affecting PA practice We also obtain continuing medical education and networking opportunities from AAPA and the California Academy of Physician Assistants (CAPA).

Now let’s reflect on what our state organization does for the profession.

Most of us who have visited the CAPA website know that the mission of CAPA is, in part, to represent and serve physician assistants statewide, as an advocate of its members for quality health care and for their valued, unique alliance with supervising physicians. But what does this really mean and how does this mission compare, contribute and contrast to the work that our other professional organizations provide?

What one has noted is that CAPA has demonstrated its commitment to enhance, educate and empower physician assistants for the ultimate benefit of our patients in every aspect of California’s health care system. Comparatively, our medical specialty organizations and local practice professional groups represent us in the specific services we provide.

Our national organizations (AAPA, NCCPA, ARC-PA) work collaboratively to maintain a high-standard of education and performance for the profession. One of the unique provisions provided by CAPA has been to effectively sponsor and promote regulatory and legislative changes that have enhanced the ability of the physician assistant to provide safe, cost-effective medical care in the state. CAPA often serves as the hub of the wheel which connects the PA specialty and/or local practice professional groups, particularly when confronted with state regulatory and scope of practice issues.

So I ask, what role and responsibility do we have to our professional organizations? One is to maintain commitment to the shared vision. Two is participatory, ongoing membership. It is what is expected in our profession Continued on page 7

Interprofessional Collaborative Practice: CURES 2.0 – CAPA Attends Stakeholder Meeting

by Jeremy A. Adler, MS, PA-C, President Elect

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n many prior CAPA News publications and at the CAPA Controlled Substances Education Course, I have stressed the importance of registering and routinely incorporating California’s Prescription Drug Monitoring Database (CURES) into clinical practice. The data within CURES is a real, tangible tool that can aid in proper patient selection for controlled substances, and help identify patients potentially suffering from drug abuse or addiction.

Criminal drug diverters and “doctor shoppers” may be identified as well.

As I write this article, there is another tragic celebrity death in the news caused by apparent prescription drug overdose which further highlights the important role the health care community has in the appropriate clinical use of controlled substance medications.

In recent years, the future of the CURES program at California’s Department of Justice was not clear.

Despite having one of the oldest monitoring programs of controlled substances in the country, significant budget cuts resulted in a drastic reduction in manpower and resources.

The whole operation of monitoring California’s controlled substances was basically reduced to the work of one person. CAPA recognized the critical importance of CURES and supported legislation SB 809 which ultimately passed in 2013.

Finally, the CURES program has secured future funds that will allow the system to continue and improve: termed: “CURES 2.0.” Starting April 1, 2014, a CURES fee of $6 will be added to professional license registration to fund the program.

As part of SB 809, upgrades to the CURES system will be planned and

stakeholders will be invited “for the purpose of identifying desirable capabilities and upgrades.” The first meeting of the CURES Stakeholder Meeting occurred January 28, 2014 in Sacramento and was attended by California’s Department of Justice, various boards (Medical, Pharmacy, PA), prescribers, dispensers, Drug Enforcement Administration, nurses, information technology, managed care and others. I was fortunate to represent CAPA members and found the meeting to be productive and exciting. When used properly, the data contained in CURES should improve access to care for those patients who appropriately need controlled substances and significantly reduce access to those with problems of abuse, addiction and diversion.

There was a lot of passion over the ideas about what should be included in the Patient Activity Report and how that information should be displayed. It became apparent that various users of CURES look at the data differently and consensus seemed to revolve around having customizable views and sorting capabilities. All

parties wanted an easier process for accessing registration and want the data available as quickly as possible, yet keeping it accurate. Various ways to have the information available in clinical practice, but not impede work flow were also discussed.

With the many ideas suggested, if even only a small percent make it to the final version, California should have a robust clinical tool to improve patient care. As a part of SB 809, all prescribers registered with the DEA will need to be registered with CURES by January 1, 2016. The Department of Justice is exploring options to work with the licensing boards on automatic enrollment, but this process will take time. The current estimation is that upgrades to the CURES system will take 18-24 months. CAPA continues to recommend all PAs register as soon as possible with CURES, and will continue to plan CURES registering events at our annual conference in Palm Springs.

Please register today with CURES at: https://pmp.doj.ca.gov. 

Physician Assistant Professional Organizations: Roles and Responsibilities Continued from page 6

and therefore must be reflected in our involvement with our self-selected representative professional organizations.

I believe it is not enough to “pay the dues.” Just showing up is not enough.

We must advocate and participate in the organizations we know are looking out for our best interests. Without a collaborative, support system of its

constituency, not one of our professional organizations could continue to effectively represent us.

We need CAPA and CAPA needs us.

Let’s share in the partnership of continued growth and effectiveness in our chosen profession by participating in our state professional organization!.  MARCH/APRIL 2014

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New Laws In The New Year

by Teresa Anderson, MPH, Public Policy Director

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he majority of legislation that passed in 2013 became law on January 1, 2014 with the exception of urgency bills or bills that had a specified date. CAPA sponsors, tracks and monitors a wide range of health care related legislation relevant to the PA profession.

In 2013, one of the most significant pieces of legislation signed, specific to the PA profession, was SB 494 Health Care Providers. This bill makes changes to state law that conTo find out more about forms to the federal Patient Protection these new laws or other and Affordable Care Act definition of prilaws that may be of mary care provider, which includes PAs interest visit: and NPs. This is a significant change in www.leginfo.ca.gov. the law because prior to this change, the state definition was physician specific.

Consistent definitions across insurance codes provide for increased options in care delivery and reduce the likelihood that PA services could be considered out-of-network or specialist services.

Further, this bill authorizes health care service plans (Health & Safety Code 1375.9) to assign an additional 1,000 plan members to a primary care physician/practice based on that physician or practice using a PA or NP. The plans specified are managed care plans, most of which are subject to the Knox-Keene Act and regulated by the Department of Managed Health Care (DMHC), Department of Health Care Services (DHCS) or the Department of Insurance (DOI).

The Knox-Keene Act is the set of laws that govern managed care plans in California. Regulatory guidance 8

CAPA NEWS

for specified plans comes from California Code of Regulations Title 28, Title 22, Title 10 and Title 9.

Current regulations (Title 22) require network adequacy ratios to provide for one primary care physician per 2000 enrollees as well as authorize PAs and NPs to case manage up to 1,000 Medi-Cal beneficiaries in mandatory aid categories.

The important thing to note is that prior to the enactment of SB 494, regulatory guidance limited the increase to case management and mandatory aid categories. Expanding the additional assignment of plan members to include all health service plan members, not just those in mandatory aid categories, will have a significant impact on increasing access to primary care.

The issue referred to as paneling or empanelment is defined as direct: assignment of plan enrollees to a health care provider who is responsible for the coordination of comprehensive health care services for assigned patients. In California, the majority of specified plans assign enrollees to a primary care physician panel. Often those assignments do not take into account the productivity and increase capacity of team-based care. The enrollee provider ratios in the KnoxKeene Act were established in 1975 and SB 494 provides statutory authorization to modify those ratios for a more accurate reflection of the increased capacity of inter-professional team-based care. The new law does not mandate the increase of a physician’s panel rather it allows for it as the primary care team sees fit.

There were literally hundreds of health care related bills introduced in 2013. The special session held bills specific to Medicaid expansion under

the Patient Protection and Affordable Care Act and the regular session saw bills dealing with scope of practice issues, insurance market reforms, budget bills, cancer treatments, primary care issues, healing art licensure, controlled substance issues, mental health issues, medical school financing, HIV testing and many, many more public health issues. As previously mentioned, CAPA tracks and monitors a wide range of bills that are relevant to the PA profession. It goes without saying that there are too many to list. However, below are a few new laws that PAs may encounter in everyday practice. To find out more about these new laws or other laws that may be of interest visit http://www.leginfo.ca.gov.

AB 588 School Athletics: Concussions.

This bill would apply existing law - that requires a school district, if it offers an athletic program, to immediately remove an athlete from an athletic activity for the remainder of the day if the athlete is suspected of sustaining a concussion or head injury, and prohibits the athlete from returning to the athletic activity until the athlete is evaluated by a licensed health care provider, trained in the management of concussions, and acting within the scope of his or her practice, and the athlete receives written clearance from the licensed health care provider to return to the athletic activity - to athletes attending charter schools and private schools.

AB 361 Medi-Cal Health Homes for Medi-Cal Enrollees and Section 1115 Waiver Demonstration Populations with Chronic and Complex Conditions This bill authorizes the Department of Health Care Services (DHCS) to submit

State Plan Amendments (SPAs) or Section 1115 waiver amendments to the federal Centers for Medicare and Medicaid Services for approval to implement a health home program for adults, children, or both, with chronic conditions pursuant to the federal Patient Protection and Affordable Care Act. This bill includes PAs as a health home partner.

AB 154 Abortion Authorizes a nurse practitioner (NP), certified nurse midwife (CNM), and physician assistant (PA) to perform an abortion by aspiration techniques, in addition to medication, in the first trimester of pregnancy upon completion of specified training and validation of clinical competency, as specified.

SB 126 Health Care Coverage: Pervasive Developmental Disorder or Autism This bill extends, until January 1, 2017, the sunset date of an existing state health benefit mandate

that requires health plans and health insurance policies to cover behavioral health treatment (BHT) for pervasive developmental disorder or autism (PDD/A) and requires plans and insurers to maintain adequate networks of PDD/A service providers.

SB 138 Confidentiality of Medical Information This bill requires health care service plans (health plans) and health insurers to take specified steps to protect the confidentiality of an insured individual’s medical information for purposes of sensitive services or if disclosure will endanger an individual, as specified.

SB 352 Medical Assistant Supervision (CAPA Sponsored) This bill allows medical assistants (MAs) to perform technical supportive services, in doctor’s offices and all medical clinics, under the supervision of a physician assistant (PA), nurse practitioner (NP) or certified nurse-midwife

(CNM) without a physician on the premises.

SB 493 Pharmacy Practice This bill updates Pharmacy Law to authorize pharmacists to perform certain functions according to specified requirements; establishes advanced practice pharmacist (APP) recognition.

SB 809 CURES This bill establishes a funding mechanism to update and maintain the Controlled Substance Utilization Review and Evaluation System (CURES) and Prescription Drug Monitoring Program (PDMP), requires all prescribing health care practitioners to apply to access CURES information, and establishes processes and procedures for regulating prescribing licensees through CURES and securing private information. 

Controlled Substances Education Courses for PAs urs 6 Ho I Cat. CME

Saturday, August 23, 2014 UC Davis Education Building 4610 X Street Suite 2128 Lecture Hall 1222 Sacramento, CA 95817

Wednesday, October 8, 2014 Renaissance Palms Springs (preceding the CAPA Conference) 888 E Tahquitz Canyon Way Palm Springs, CA 92262

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CAPA’s Executive Committee Is Charged With Reviewing and Recommending Positions on Legislation

by Gaye Breyman, CAE, Executive Director

Roy Guizado, PA-C, Vice President; Adam Marks, MPH, PA-C, President and Jeremy Adler, MS, PA-C, President Elect

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egislation is a critical function of CAPA. Input from practicing PAs about legislation is integral as we develop and review legislation that affects PAs. To best represent CAPA’s membership, beginning July 1, 2012, the CAPA Board of Directors made an innovative and incredibly successful shift in the body of PAs who are charged with reviewing and monitoring legislation. Prior to July 1, 2012, there was a Legislative Affairs Committee.

The Chair of the Committee (appointed by the president, not elected by the membership) selected the members of their Committee from the general CAPA membership.

With the 2012 shift, CAPA leaders, elected by the majority of CAPA members are the PAs who review legislation and bring recommendations to the full Board of Directors for a majority vote. The group who reviews legislation is comprised of those PAs who hold the top elected positions; the President, President-Elect, Vice President and Immediate Past President (when applicable). They work directly with CAPA’s expert Lobbyist and Public Policy Director.

Legislation sometimes moves quite rapidly through the various committees and sometimes makes it to the Floor of the Senate or Assembly in a matter of hours. Meetings happen in Sacramento all hours of the day and night and sometimes on weekends.

Having a small group of the highest elected leaders, who are always fully up to speed on the issues, makes CAPA very nimble. We are highly regarded in Sacramento for our legislative acumen and action.

We also know this small group cannot possibly know the fine points of all areas of PA practice. We are big proponents of seeking the opinions and expertise of CAPA members-atlarge. You are the ones in the trenches. When we need an expert on the subject matter of a bill, we definitely seek out the advice and opinions of PAs who are working each day in a setting that is impacted by a particular piece of legislation. We do that often and it has served the PAs of California well. We also target PAs with expertise in a particular area to testify for or against legislation in Sacramento. We have a wonderful database and we use it!!

The successes of the past two years speak for themselves. We are Solid and Focused and thoughtfully monitoring legislative actions to both advance our profession in California as well as preserve the current practice environment we enjoy. 

CAPA at Napa

The CAPA at Napa Conference was another huge success. Thank you to all who attended. If you haven’t been to a CAPA at Napa Conference, next year is our 20th. You should attend. We sell out every year so mark your calendar now for the 20th Annual CAPA at Napa Conference on February 21, 2015.

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CAPA NEWS

Joy Dugan, MPH, PA-C was presented with a plaque during the CAPA at Napa Conference to commemorate her service on the CAPA Board of Directors. Joy has been a wonderful addition to CAPA leadership. Her term ends June 30, 2014. Thank you, Joy, you have served the PAs of California well.

CAPA’s 2013 Yearbook Receives Rave Reviews

by Gaye Breyman, CAE, Executive Director Yearbooks. I say it often, but it was really good to hear so many PAs acknowledge and compliment the current group of PA leaders. They are among the best ever assembled and we are doing our best work EVER! You really have an incredible team working for you. And, I appreciated so many of you thanking me for my service to CAPA and California PAs. I love what I do and who I work for. You all make it a labor of love.

All thumbs up for the 2013 CAPA Yearbook!!

H

opefully you received it, read through it and are still enjoying the 2013 CAPA Yearbook.

The positive reaction to the Yearbook has been overwhelming. This special commemorative publication really made a positive impact. And, continues to do so.

We sent a copy of the Yearbook to each state chapter of the AAPA and the response is so great. I talked to one Executive Director who said, “Congratulations on your Yearbook.

I can’t wait to show it to my board, but I am afraid to because they will want us to do one!” Many other chapter executives sent emails to let me know what a wonderful idea it was and how incredibly well done it is. It really did turn out beautiful and you all deserve something special to highlight the past year of California successes across so many areas. You made it possible and you made it happen. Thank you for being a CAPA member.

We brought copies of the Yearbook to the CAPA at Napa Conference and had many CAPA leaders sign the Yearbooks for those who came by the Solid and Focused Exhibit Booth. It was so great! People really enjoyed spending time talking to leaders (former and current!) while we “autographed” each of their

We had to share just a few of the comments about the Yearbook we have received from PAs. We are excited that you loved and appreciate it so much.

Solid and Focused

2013 California Academy of Physician Assistants

I was looking through the CAPA Yearbook again last night and all I can say is WOW, how we have grown.

As a California PA for the last 26 years, I have seen CAPA through many changes, but the most recent permutation of Team CAPA has accomplished so many amazing things.

I am proud to be associated with this organization and the current Board allows me to be hopeful for the future of PA practice, not only for me, but for those who will follow. Kudos to all!. Vickie Cranford Lonquich, PA-C

PA profession. I hope we do this every year! Gaye Breyman and CAPA Board, you make us all so proud! Thanks for all of your thoughtful and hard work for all of us and the patients that we serve. – Julie Theriault, PA-C Wow, the Yearbook is fantastic. It is truly ‘coffee table worthy.’ Thank you!

I am really enjoying it and am sharing it with my faculty and students. – Jed Grant, PA-C Enjoyed getting my copy of the Yearbook it is very informative! My congratulations to the Board and staff on all your hard work and another successful year moving our profession forward. – Les Howard, PA Congratulations on the Yearbook!

You know, we needed that. Thank you for giving us such a strong visual, beautifully done representation of all the wonderful things CAPA and California PAs have done. It makes you proud when you see it and read it. It is a real keepsake!” – Sonya Earley, PA-C I can’t tell you how much I enjoyed the CAPA 2013 Yearbook. It made me proud to be a PA and a CAPA member, to see all the incredible work that has been done by the leadership and staff.

Everyone that I know who has seen the Yearbook feels the same way. Thanks CAPA! -- Stephen Hanson, PA-C

Many thanks for the great information about the recent CAPA at Napa Conference. I plan to sign up for next year. I also enjoyed reading the fabulous YEARBOOK, which I intend to share with colleagues at my job place. Congratulations and keep up that great work. - Cristina MaganaAkbari, PA-C 

What incredible CAPA Yearbooks.

Just lovely and what a great relation message promoting our CAPA and the MARCH/APRIL 2014

11

DO YOU REMEMBER THE FIRST TIME YOU GAVE SOMEONE HOPE?

The physician assistant profession is extremely demanding, but it is also filled with uniquely rewarding memories. And your memories could have a huge, positive impact on others.

That’s why we’re building a more connected relationship among the 1,800 UC Davis alumni who share the same mission, passion, and values as you. Your stories could enrich their lives and careers – and their stories could certainly do the same for you.

Reach out. Reconnect. Remember.

Take a look back, so others may move forward. Visit remember.ucdavis.edu and rejoin the alumni network.

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CAPA NEWS

PAcing Yourself: Keeping Interest in Your Clinical Practice

by Joy Dugan, MPH, PA-C, Secretary and Erin Littmann, MPH, PA-C, CAPA Member

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s PAs, avoiding burnout is essential to maintaining a long career and avoiding compassion fatigue. When your medical practice becomes routine and mundane, mental fatigue, stress and provider burnout can set in and can easily lead to medical errors and poor patient outcomes. It is very important to find balance in life and medicine.

According to Maslach & Jackson (1981), burnout syndrome “Symptoms of provider can be described by burnout include three constructs: emotional exhausimpatience, difficult tion, depersonalizaempathizing with patients, tion (negative or very detached feelings tardiness, increased toward patients), and reduced personal absenteeism and for some, accomplishment (negative evaluation somatic problems. ” of oneself and feeling unsatisfied with positive job performance and achievements).1 Symptoms of provider burnout include impatience, difficult empathizing with patients, tardiness, increased absenteeism and for some, somatic problems.

Though PA burnout rates have yet to be studied, nearly half of physicians (n=7288) in a 2012 study had at least one symptom of burnout.2 In this study, burnout rates were highest among physicians practicing in family, general internal medicine and emergency medicine. A shortage of physicians in these specialties, combined with provider burnout can equate to decreased health care access for patients.

Here are some tips we came up with to help avoid burnout: Have Non-Medical Interests.

Taking time outside work to pursue

your (non-medical) interests is vital to your PA career. Use that vacation time to recharge, even if it is a “staycation.” We suggest exercise, find a new hobby or revisit something you used to love to do, or spend time with your family/friends/pets to avoid burnout. The key is not letting your job consume you! We dare you to not talk about work, patients or medicine for 24 hours!

Group Visits.

Many practices are now having group patient care visits to address chronic medical conditions. This can be fun for both the PAs and patients. For PAs, it allows us to step out of our usual clinical routine. We can address one problem with multiple patients in an interactive and non-threatening environment. Patients may become more empowered and appreciate meeting others with similar medical issues.

Consider Precepting.

Students keep medicine fresh and interesting. They bring new ideas and it keeps you on your toes. It reminds you why you pursued a career in medicine. They are also entertaining to watch – you never know what they are going to say or do.

We have worked with students that are so elated to see an erythematous tympanic membrane or to perform their first I&D. Their excitement and enthusiasm can be contagious; it also reminds us of how far we have come as providers. If you are interested in precepting, contact one of our California PA programs.

Meet with a “Super User.”

The electronic health record (EHR) implementation, meeting of meaningful use markers and increased demand for our services contribute more to our workplace stress. Even if your EHR has been implemented for

a few years, every few months meeting with a “super user” can be helpful. This is especially true when there are updates to EHR. Learning timesaving short cuts can save you hours per week, which means having more time to pursue a balanced lifestyle.

Go to Conferences.

Palm Springs? Napa? To give a shameless plug, CAPA really does have great conferences. Attending conferences is a time to reconnect with classmates and colleagues.

Conferences also allow for networking and learning new skills. If burnout is a problem for you, consider taking some continuing education courses based on mindfulness-based stress reduction. Mindfulness-based stress reduction continuing education has been shown to reduce provider burnout.3 References 1Demmer, C. (2004). Burnout: The Health Care Worker as Survivor.

AIDS Read. 14(10).

2 Shanafelt, T.D., Boone, S., Tan, L., Dyrbye, L.N., Sotile, W. Satele, D., West, C.P., Sloan, J., Oreskovich, M.R. (2012). Burnout and Satisfaction With Work-Life Balance Among US Physicians Relative to the General US Population.

Achieve Internal Medicine.

172(18):1377-1385. doi:10.1001/ archinternmed.2012.3199.

3. Goodman, M.J., Schorling, J.B. (2012). A Mindfulness Course Decreases Burnout and Improves Well-bring Among Healthcare Providers. International Journal of Psychiatry Medicine. 43(2):119-28. 

MARCH/APRIL 2014

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Mentoring Future PA Students

by Jasleen Kaur, Pre-PA Member

M

entoring is the progression where an individual can convey his or her knowledge and experiences to another individual and help them by building their skills, giving them direction and aiding them in fulfilling their goals. Quality mentors are an amazing asset to someone building the foundation for their future.

A large part of becoming a physician assistant is giving back to the community. One way to get involved as a practicing physician assistant is to mentor Pre-PAs. There are several tools a Pre-PA mentor can provide.

Helping with the application essay, health care experience, choice of courses and interview behaviors are just a few ways that can ensure the success of the student.

Building goals with the mentee can help create a pathway that ensures valuable use of time. This can be done by creating lists of short-term and long-term goals allowing a visualization of areas of improvement for the individual to master the skill sets for PA school and beyond. A mentor

can also help with the CASPA application process that can be long and extensive. The student can benefit from guidance with specific tips including creating timelines, deadlines and choosing schools.

As a Pre-PA, I have found having multiple mentors was a tremendous asset in making my career decision.

I have experienced the challenging journey to starting my career, including building direct patient hours, getting experience in various volunteer services and obtaining interview techniques. Throughout this process, I found the most valuable tool was guidance.

One of the most instrumental mentors to me during this process was Cherri Penne-Myers, PA-C. Her leadership allowed me to gain invaluable experience by observing sedation appointments as well as attending the volunteer First Aid booth at a local triathlon. Witnessing the day-to-day routine of a practicing PA gave me a sense of what the occupation includes and responsibilities entailed. This confirmed my aspiration to become

a PA and gave me a knowledgeable base of anticipated trials.

I also had the opportunity to be mentored by a few family members that are practicing PAs. My sister, a PA working in cardiology, has helped with mock interview sessions. These meetings were extremely beneficial and increased my confidence in my interviewing skills. On her suggestion, I began volunteering as a Clinical Care Extender for Hoag Hospital. While at Hoag, I gained hands-on experience with a diverse set of patients. Through networking at the hospital, I was given the opportunity to sit in on surgical procedures while shadowing two PAs working in Gynecologic Oncology.

Each mentor has provided me invaluable knowledge and experience which will serve as stepping stones towards success as a PA. Thank you to all the physician assistants guiding future PAs! Mentoring is a wonderful way to get involved and the profession will benefit as future PAs continue to pay it forward once they are practicing. 

Neuropathy Action Awareness Day Wednesday, June 11, 2014 9:30 a.m. to 4:15 p.m.

Intercontinental Los Angeles/Century City Hotel 2151 Avenue of the Stars, Los Angeles, CA 90067 Neuropathy Action Foundation is offering 20 free registrations to the first 20 PAs who contact them at (877) 512-7262 before June 1 and who mention they are a CAPA Member. They also have complimentary openings if you have a patient who you think would benefit and who a CAPA member recommends. For more information visit their website at: www.neuropathyaction.org. The 8th Annual “Neuropathy Action Awareness Day” provides an exciting opportunity for patients to interact with other patients, providers and exhibitors. Neuropathy patients, caregivers, health care providers and others are encouraged to attend this event to learn about neuropathy, how to cope with neuropathy, policy issues and patient advocacy. This year the morning consists of an Exhibit Area and educational sessions. There will then be a sit down luncheon. The afternoon consists of additional educational sessions and Exhibit Area with refreshments. The event features a celebrity speaker, elected officials and others. There will also be a Silent Auction made up of trips, activities and other fun items! It is a great event!

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CAPA NEWS

Help Me Help You

by Sonny Cline, PA-C, MA, M.Div, Political Action Committee Chair

M

y parents are still alive and for that I am thankful. I talk with them every week by phone or sometimes by FaceTime.

I love that I can call them whenever I want, even if it is to ask my mom a quick question about a recipe or something only a mom would know.

My dad and I commonly talk about financial investments or how our businesses are progressing. I think the biggest change in our relationship has come with my age and realization of what my parents have meant in my life. I am a parent and a husband now. I have a career and many responsibilities. It is only with this experience that I have come to truly understand the significance of my parents in my life. Even now, at 50 years old, the thought of losing my parents brings tears to my eyes.

It’s funny how someone or something so important can go unnoticed for so many years. For so long, I really did not understand how important my parents were to my success. I had no idea the many things they did behind the scenes to ensure that I had every opportunity to achieve my goals.

I will probably never really know what it was like for them in the most

difficult days of managing our family; providing when times were not so good and staying together when they felt like going their own way. They have been the invisible steel beams that have provided an undying support for me throughout my life.

them for advice on a recipe. My guess is that you will get a good answer.

I want you to continue the great work you do in the California health care system. I want you to go on to the highest success that you desire to achieve. It is my hope that you work hard every day in an environment that you love and go home to your life, satisfied and without any worries about your profession or future. That is why we have CAPA and the CAPA PAC. I want you to remember there are people working hard on your behalf every day. As you mature in your practice of medicine and in your lives, it is my hope that you realize this and value it as I have my parents.

I think there are many parallels between my parents and CAPA. I want you to know our Executive Director, Gaye Breyman, CAE; Public Policy Directory, Teresa Anderson, MPH; CAPA leaders and the CAPA staff are constantly at work to ensure your ongoing success. The truth is that most of you have no idea the amount of problem solving they do on a daily and weekly basis to clear the road for all of us. There are a multitude of issues that could bog down the PA profession every year. Most of you never even know what those issues are or what the consequences would have been if they would have come to fruition, and I’m glad you don’t. The truth is the health care system in California needs you focusing on patients and their needs. We don’t need you constantly worried about the many obstacles that are commonly thrown in our path. That is where CAPA serves you and serves you well. You can even call

I want to encourage you to be a part of CAPA and contribute to your CAPA PAC, not because you have to or feel obligated to do so, but out of honest appreciation for the invisible steel beams that support you every day while you are out there in the field, doing what you do best. Together we can have great success both as a profession and as individuals.

Thanks CAPA for all you do. 

Yes, I Want to Do My Part for the PA Profession in California (Donate online at www.capanet.org or mail this form to the CAPA office.)

Name__________________________________________________________________________________________________________________________ Address ______________________________________________________________City___________________________ State______ Zip_______________ Phone _____________________________________________________________ Email ______________________________________________________ Amount of cash/check/credit card donation: $_____________________________________________ If donation is $100 or more, please list employer_________________________________________________________________________________________ Please make checks payable to CAPA PAC. You may also pay by credit card. All contributions are voluntary. PAC ID # 981553 



Exp. Date______________________

Signature______________________________________________________________________________________ CVV#________________________

MARCH/APRIL 2014

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Meet the New PA Programs!

Kimberly Lopipero, MPAS, PA-C, PA Program Relations Committee Member

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here are two new reasons to be excited about being a PA and becoming a PA in Southern California! We are proud to introduce Chapman University and Marshall B. Ketchum University (MBKU) PA programs, both located in Orange County. Each has applied for provisional accreditation through the Accreditation Review Commission on the Education for the Physician Assistant (ARC-PA) (AccreditationProvisional is an accreditation status for a new PA program that has not yet enrolled students, but at the “This is an amazing chance time of its initial accreditation review, has for you to give back by demonstrated its preparedness to initiate a sharing your knowledge program in accordance with the accreditation through providing a guest standards).

lecture, becoming a course

Each program is preparing to offer a Master of Medical Science degree and will provide prospective PA students more opportunities to obtain their PA education in order to meet the current workforce demands within a changing medical climate. Practicing PAs will also have additional opportunities to make a positive impact on the future of our profession by sharing their knowledge through clinical precepting and/or didactic presentations.

Here is a little more information about each program:

director or as a clinical preceptor. ”

Chapman University Chapman University is currently developing a Physician Assistant Studies graduate program with the first entering cohort proposed for January 2015, pending AccreditationProvisional by the ARC-PA. The 16

CAPA NEWS

curriculum will span 24 months, fulltime, divided into 12 months of academic clinical preparatory instruction and 12 months of supervised clinical practice. The program will be housed in the new state-of-the-art Harry and Diane Rinker Health Sciences Campus in Irvine, California, which also houses an existing Physical Therapy program and the new School of Pharmacy. The program plans to accept 25 students for the Spring cohort and 25 students for the Fall cohort.

Michael Estrada, MS, DHSc, PA-C, has been appointed as the founding director. “My vision for the new PA program is three-fold,” explains Dr. Estrada. “First, I want to increase access to health care so that graduates of the program provide health care to medically underserved communities; second I want them to have a strong base in primary care which will enable them to practice in any setting; and lastly, I would like graduates to lead, promote and empower their local and global communities.”

The goal of the program is to create a viable collaborative, inter-professional learning experience that will attract high quality students and faculty necessary to prepare health care professionals entering the health care workforce and meet the needs of the surrounding and global communities.

“The health care system is changing from its traditional model to an inter-professional, patient-centered team approach,” said Dr. Estrada.

Consistently ranked among the top universities in the West, Chapman University provides a uniquely personalized and interdisciplinary educational experience to highly qualified students. Our programs encourage innovation, creativity, collaboration and focus on developing global citizen-leaders who are distinctively

prepared to improve their community and their world.

Dr. Estrada is searching for highly qualified, motivated and innovative physician assistant educators and content experts. To find out more about partnering with Chapman University’s Physician Assistant Studies Program or how to become a preceptor, please contact Dr. Estrada at (714) 744-7018 or estrada@chapman.edu.

Marshall B. Ketchum University Marshall B. Ketchum University (MBKU), located in Fullerton, is excited to be the first PA program opening in Orange County. The program plans to offer a 27 month, graduate program with a 12 month didactic phase and a 15 month clinical phase. MBKU’s inaugural class size will be 28 students, allowing an ideal opportunity for students to participate in discussions and for professors to provide individualized attention to each student.

The program’s focus is on primary care with special attention to the medically underserved population.

Diverse clinical rotation opportunities within medically underserved populations and communities will focus on improving cultural competence and providing quality care to all. The curriculum is integrated throughout the program to make the information more meaningful and interrelated with the intention of providing a more organized and comprehensive learning experience.

MBKU is dedicated to providing a strong foundation in evidence-based medicine with an interprofessional Evidenced-Based Practice course, a Clinical Decision Making course and a Master’s Capstone research project, all designed to foster lifelong learning.

Community service has played an important role in the education of MBKU students for many years, and the university has spent time building strong professional relationships with the community. PA students will learn the importance of leadership while contributing to the local community as they complete their Master’s Capstone service project.

This project involves identifying a community health or population group need, developing and implementing a project to assist with that community/group need.

MBKU was founded in 1904, and is the third oldest Optometry school with a history of excellence in clinical

education, patient care, research and public service. MBKU is proud to develop an interprofessional educational experience for individual medical professions to promote collaboration in providing high quality patient-centered care.

MBKU’s PA program anticipates matriculating the first class in August 2014, pending AccreditationProvisional from the ARC-PA. The accreditation site visit took place early December 2013 and the decision by the ARC-PA regarding accreditation will be announced in March 2014. MBKU is currently looking for PAs that are experts in their fields of practice to join their team to provide

classroom instruction and/or clinical education. Please contact Kimberly Lopipero MPAS, PA-C, Director of Didactic Education at (714) 8725688 or klopipero@ketchum.edu.

This is an amazing chance for you to give back by sharing your knowledge through providing a guest lecture, becoming a course director or as a clinical preceptor. Make this the year that you join the community of PA educators and help to educate the next generation of PAs! 

CAPA0112_Layout 1 11/29/11 4:08 PM Page 1

You’re “on-call” 24/7. Make sure your malpractice coverage is too.

Individual professional liability coverage at competitive rates.

Physician Assistants Professional Liability Insurance 888.273.4686 | www.hpso.com/oncall This program is underwritten by American Casualty Company of Reading, Pennsylvania, a CNA company, and is offered through the Healthcare Providers Service Organization Purchasing Group. Coverages, rates and limits may differ or may not be available in all states. All products and services are subject to change without notice. This material is for illustrative purposes only and is not a contract. It is intended to provide a general overview of the products and services offered. Only the policy can provide the actual terms, coverages, amounts, conditions and exclusions. CNA is a registered trademark of CNA Financial Corporation. Copyright © 2012 CNA. All rights reserved.

Healthcare Providers Service Organization is a registered trade name of Affinity Insurance Services, Inc.; (AR 244489); in CA, MN & OK, AIS Affinity Insurance Agency, Inc. (CA 0795465); in CA, Aon Affinity Insurance Services, Inc., (0G94493), Aon Direct Insurance Administrator and Berkely Insurance Agency and in NY and NH, AIS Affinity Insurance Agency. ©2012 Affinity Insurance Services, Inc. CAPA112

MARCH/APRIL 2014

17

Students Students Students Students Students Students Knowledge is Power

by Chelsea Hemming, PA-S, Student Representative

I

am a firm believer that the best patients are the most educated patients. Not necessarily a college degree, but well educated in their health. As a student, you have the unique opportunity to actually sit down and explain your diagnosis and treatment plan with your patient while your preceptor is continuing to work. I’m not suggesting you spend hours, but instead of spending five minutes waiting for your preceptor to be ready for you to “Seek out opportunities present, you can use that time talking to to learn from everyone your patient. Even if you’re convinced (including your patient). ” your preceptor is going to go in there and explain it all over again, go ahead and do it yourself first. I sat in on discussions multiple times on how to effectively place a child in “time out” and thought I had it memorized, until I went into the room and actually tried (and failed) to do it myself.

I’ve found that spending a couple of extra moments to explain results and the treatment plan saves the patient from multiple return visits.

I’m currently in my emergency department rotation and have had patients come to me directly from another hospital because they didn’t understand their diagnosis. They are usually extremely grateful that I took the time to actually sit down and care about them as a patient.

How can we expect our patients to take care of themselves if they haven’t had someone to teach them how? This is where we can make an impact on our patient’s lives.

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CAPA NEWS

Not only does this benefit the patient, but it also benefits you as a student. I’ve always operated under the impression that you don’t know a subject until you’re able to teach someone else about it. But it’s different than explaining it to your classmate; you have to explain complex pathophysiological processes to someone who may have dropped out of school at a young age.

I have found that this is one of my biggest difficulties on rotations. I know the pathophysiology of asthma and why a steroid is often needed to suppress acute flares of this chronic disease, but often the patient is prescribed this medication without fully knowing why. Hearing my

pediatrician on my rotation discuss asthma in terms of fire and coals to a newly diagnosed patient was a great experience and it will definitely be added to my handy book of analogies to use when counseling my patients.

Rotations and any clinical experience are all about putting your knowledge into practice, so soak it all up!

Seek out opportunities to learn from everyone (including your patient).

Use this time wisely and enjoy this journey, you only get to experience it once and it’ll be over sooner than you think.

As always, feel free to contact me if you need anything throughout this process. 

Congratulations to the 2014 CAPA Scholarship Winners!!!

Community Outreach Scholarship Brittany Sumerel, PA-S University of Southern California, Keck School of Medicine Ray Dale Memorial Scholarship Whitney Burnett, PA-S University of Southern California, Keck School of Medicine Ruth Webb Minority Scholarship Sheila Lau, PA-S University of Southern California, Keck School of Medicine

Welcome New Members

Local Groups

November 18, 2013 through March 5, 2014 Julie Adams, PA-C Omoniyi Akintola, PA-C Jaclyn Aldana, PA-S Bryan Alford, PA-S Natalie Archambo, PA-C Ronneil Aviles, PA-S Jeff Axten, PA-S Amber Bender, PA-C Julia Bertozzi, PA-C Lindsey Bettisworth, PA-C Michael Boucher, PA-C Scott Bowers, MPA-S Kathryn Bradley, PA-S Megan Branum, PA-C Barbara Brittell, PA-C Tom Brookshire, PA Jennifer Brough Wilson, PA-S Christen Buirley, PA-C Gregory Buttolph, PA-C Michael Cadette, PA-S Collene Camill, PA-S Courtney Campbell, PA-C Michael Cancilla, PA Susan Chan, PA-S Teresa Chen Raia Ivanka Cimatu, PA-S Samantha Cisneros, EMT Lisa Cung, FNP Marvic David, PA-S Richard de Castro, PA-C Michael De Rosa, MPH, Ph.D., PA-C Francis Delos Reyes, EMT-P David DeMattei, EMT Duy Dinh, PA-S Jennifer Dobrinen, PA-C Lori Dreyer, PA-C Jeannie Duong, PA-S Jason Ehrhart, PA-C Gina Erdahl, PA-C Rochell Ermitanio, PA-S Lesley Field, PA-S Lisa Finger, PA-C Audrey Fortezzo Tory Foss, PA Barbara Ganley, MSN, PhD Brooke Garcia, PA Irma Garzon Acosta, PA-C April Gonzalez, PA-C Monica Gralian, PA-C Elizabeth Granados, PA-S Richard Grandquist, PA-S Alexandria Grechko, PA-S Zacharia Greenlee, PA-S George Guido, PA-C Andrew Gutowski, PA-S Michelle Habets, PA-C, MS Bekele Haimanot, PA-C William Hall, PA-C James Hamilton, PA Jessica Hampton, PA-S Lonna Hampton, PA-S Stella Hanadi, PA-S Kathryn Hanks, RN, PA-S Matthew Harrington

Wesley Harrington, PA-C Felicity Harris, PA-S Nancy Hejde, PA-C Laci Helmhout, PA-S Brian Hoang Jeffrey Holter Kimberly Hornung, PA-S Melanie Houser, PA-C Jillian Hunter, PA-C Yvonne Jackson, PA Michele Johnson, PA-C Natalie Johnson, PA-S Kaitlin Jones, EMT-B Lindsay Jones, PA-C Natane Jordan, PA-S Ben Kavoussi, PA-S Jacqueline Kenney, PA-S Anita Khachatourian Gina Kim, RT Angela Kinderman, MMS, PA-C Leon Koenck, PA-C Susan Kolp, PA-S Christine Kubeck Jazmine Kwong Lori Lapina, PA-C Judith Lara, PA Ashley Lathrop, PA-C Michael Lay Jessica Le, PA-S Lam Le, MS, PA-S Ellen Lee Jane Lee, PA-S Margaret Leone, PA-S Vincent Lim, PA-C David Liu, PA-C Tammy Liu Tracy Lo, PA-C Pamela Lommen-Midence, PA Hilary Long, PA-C Katherine Loose, PA-S Erin Lopez, PA-C Rosalinda Lopez Michael Louie, PA-S James Luong, RT Tran Luong Pailin Mack Lindsey MacKellar, PA-C David Mackey, PA-C Alyssa Mangabay, PA-S Erik Marchinek, PA-S Roberto Marin, PA Abigail Mark-Ekpendu, PA-S Inna Markiv, PA-C Belinda Martindale-Witcher, PA-C Chuck Mayfield, PA Nathan McCan, PA-S Alyssa Miller, PA-S Graciela Miller, PA-C Rachel Miller, PA-C Kristina Mischler Ethan Morris, PA-S Michael Mote, PA-SII Mai Murray, PA-C Lesley Nakata

Ngoc Dung Nguyen, PA-C Emily Njoroge, PA-S Abram Nunn, PA-C Juanita Ortiz Walker, PA Eliza Oun, PA-S Jason Packer, PA-C Chad Palmer, PA-C Alexandra Parrott, PA-C Cara Paxson, PA-S Christopher Perry, PA-C Sally Pham Jesse Phelps, PA-C Aivi Phung, PA-S Corinne Pogemiller, PA Shirley Powell, PA-C Jason Quicho, PA-S Mary Rankin, PA-C Antonia Reynaga-Rankin, PA-C Eric Reynoso, PA-C Keri Riley Lisa Roberge, PA Sheri Rocha, MPA, PA-S Cristina Rodriguez, PA-S Michael Rodriguez, PA-S Robert Ruiz, PA-C Jessica Rumsey, PA-C Lapa Ruttanasee-Dang, PA-C Caitlin Sacher, PA-C Brenda Saglio, PA-C Karina Salas Graciela Sanabria, PA-C Richard Sanders, PA-C Lindsay Schell, PA-S Eve Schulman, PA-C Jason Schumer, EMT-P, IC Samantha Scigliuto, PA-C Roia Shefayee Arpana Shivdasani, PA-C Chetana Sisodia, PA-C Megan Smith, PA-S Sarun Soon, EMT Laurie Strasburger, PA-C Alan Sunada, PA-S Julie Tankersley, PA-C Samantha Telarroja Charles Telesco, PA-S Sarah Thebarge, PA-C Kenneth Thomas, MD Sean Thomas, MD Jim Thompson, PA-C Allyson Togashi Matthieu Tuahivaatetonohiti, PA-S Katerina Viitala, PA-S Erin Walker, PA Wendy Wallin, PA-C Elaura Webster, PA-S Claire Wilkinson, PA-S Stacy Williams, PA-C Kelly Wong, PA-S Rebecca Wood, PA-S Kelly Zessin, PA-C Tamar Zwick, EMT-P

1. Redding Area PA/NP Alliance P.O. Box 993515, Redding, CA 960-3515 Summer Ross, PA-C; (530) 225-6194 summerlynn712@gmail.com 2. Physician Assistant Society of Sacramento (PASS) Atul Sharma, PA-C, President; (916) 397-6035 pasocietyofsac@yahoo.com; pasocietyofsac@groups.facebook.com 3. Contra Costa Clinicians Association Brian Costello, PA-C; (925) 852-8706 contracostapas.com 4. San Francisco Bay Area Physician Assistants (SFBAPA) www.sfbapa.com, Martin Kramer, PA-C; (415) 433-5359 220 Lombard St., Apt. 118, San Francisco, CA 94111-1155 mkramersf@hotmail.com 5. Bay Area Mid-Level Practitioners Rose Abendroth, PA-C; (650) 697-3583, Fax: (650) 692-6251 rosepard@aol.com Matt Dillon, PA-C; (650) 591-6601, mattdillon42@hotmail.com 6. Bay Area Non-Docs Linda O’Keeffe, PA-C; (650) 366-2050, lindapac@aol.com 7. Northcoast Association of Advanced Practice Clinicians John Coleman, PA-C; (707) 845-6008, streetdrag49@sbcglobal.net 8. Stanislaus County NP/PA Network Brian Cormier, PA-C; (209) 605-4966, briancor@verizon.net www.nppanetwork.org 9. Stockton Midlevels Roy Blanco, PA-C; (209) 623-8580 stocktonmidlevels@gmail.com 10. Journal Club for PAs and NPs (Fresno area) Cristina Lopez, PA-C; (559) 875-4060; Fax: (559) 875-3434 clopez875@aol.com; 2134 10th St, Sanger, CA 93657 11. Central Coast Nurse Practitioners & Physician Assistants Kris Dillworth, NP; ccnppa@yahoo.com Sharon Girard, PA-C; (305) 803-1560; ccnppa@yahoo.com 12. So Cal PAs Linda Aghakhanian, PA-C; want2heal@hotmail.com 13. Orange County Hung Nguyen, PA-C; (714) 846-8178; nhy52@yahoo.com 14. San Gabriel Valley Local Group M. Rachel DuBria, PA-C; (818) 744-6159, racheldca@aol.com 15. San Fernando/Santa Clarita Valley Group Jonah Tan, MPT, PA-C; (818) 634-0007, jotptpa@yahoo.com 16. Coachella Valley Physician Assistant Group Matthew Keane, MS, PA-C; mkeanepas@gmail.com 17. San Diego Area Robin Caballa, PA-C; info@sdpasociety.com www.SDPASOCIETY.com.

MARCH/APRIL 2014

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California Academy of Physician Assistants 2318 S. Fairview St. Santa Ana, CA 92704-4938

Address Service Requested

PRSRT STD US POSTAGE PAID SANTA ANA, CA PERMIT NO 949

CAPA’s 38th Annual Conference October 9-12, 2014

Optional Workshops, October 9 and 11

Controlled Substances Education Course

October 8, 2014 – Prior to the CAPA Conference

T

here is quite simply nothing like the CAPA Conference. The setting: PAlm Springs and the beautiful Renaissance Hotel and Palm Springs Convention Center offer a wonderful, community-building gathering place. And, the group dynamic created by all of you makes the CAPA Conference a one-of-a-kind conference experience.