HB487/Schedule II Authority

[DizzyJ]

[h=3]PA SCHEDULE II PRESCRIPTIVE AUTHORITY IN JEOPARDY - IMMEDIATE ACTION NEEDED![/h]Ohio PAs:

Language that would grant PAs Schedule II prescriptive authority was in HB487 when it passed the House. The language was removed before it was passed by the Senate. HB487 will now go to conference committee where our only chance to have the language reinstated will occur. Conference committee hearings will begin on Tuesday. If we do not get the language put back in, Ohio PAs will probably not get Schedule II until late in 2013.

It is critical that you contact both your Senator and Representative immediately and explain why the Schedule II language is so important to PAs in Ohio.

Ask your Senator to contact the Senate members of the conference committee (Jones, Sawyer, Widener) and urge them to support reinstatement of the language in conference committee.

Thank your Representative for supporting Schedule II language in the House version of HB487 and encourage him or her to contact the House members of the conference committee (Amstutz, McClain, Sykes) and urge them to support reinstatement of the language in conference committee.

Click Here to Find and Contact Your Senator (enter your zip + 4, click on the Senator’s picture)

Click Here to Find and Contact Your Representative (enter your zip + 4, click on the Representative’s name)

When you call, identify yourself as a constituent of the Senator or Representative and ask to speak to him or her. If he or she is not there tell his or her Aide exactly what you would have told the Senator or Representative. It will be passed on to him or her. If nobody answers, leave a detailed message.

If you email, identify yourself as a constituent of the Senator or Representative's and try to keep it as brief as possible when making your request.

Detailed rationale for reinstatement of the language can be found below, but in brief:

APNs currently have Schedule II authority and PAs do not.

Critical care jobs that were posted for either a PA or APN will now exclude PAs limiting jobs open to PAs.

PA jobs will be lost and patient access to critical care will be reduced.

Please put the Schedule II language back in as not having it will hurt my practice.

PLEASE DO NOT ASSUME SOMEONE ELSE WILL MAKE THE CALL OR SEND AN EMAIL. AGAIN, IF WE DO NOT GET SCHEDULE II BACK IN HB487, IT WILL NOT HAPPEN UNTIL LATE 2013.

If possible, please encourage your supervising physician(s) to contact their Senator or Representative, too.

Any feedback you can give OAPA on your interaction withyour Senator and Representative will be greatly appreciated (oapa@ohiopa.com).

Thank you very much.

OAPA

800/292-4997

2012 Talking Points for HB487 with PA Schedule II Language

A Work Force issue

• APN Schedule II bill passed and signed by Governor last month Within a few months APN’s will be writing Schedule II RX’s PAs work side by side with APN’s in all aspects of medicine and surgery All existing job postings are posted for EITHER APN or PA If PAs cannot write schedule II RX’s, they will not be considered qualified for any critical care positions: ED, ICU, Hospital medicine, Pain Management, surgical specialties, etc. These areas of critical care are the majority of where PAs work in Ohio (second area is primary care) Once again PAs will no longer be able to apply for any position that requires schedule II authority. Joint Commission (JC) standards mandate that no verbal orders should be used unless it is an emergent or urgent issue. If PAs do not have schedule II authority, their only recourse is to write verbal orders for any schedule II. This is a catch 22 as they should not be writing verbal orders per JC. CMS mandates that a patients’ pain be controlled always. Schedule II medications are the number one medication for alleeving a patients’ pain. If PAs do not have schedule II authority, they will not successfully and quickly be able to order the appropriate medications to alleve the patients’ pain. PAs not having full schedule II authority will decrease the number of jobs available to PAs and will promote PAs to once again leave Ohio for other states with better PA practice laws.
  
• Presently, the supply of PAs does not meet the demand for PAs in the workforce. If PAs do not immediately obtain schedule II authority to be on parity with the APN scope of practice, the supply of PAs within Ohio will drastically shrink and patient care will suffer.
  

(copied and pasted from an email OAPA sent out today)

[myerardi]

Done. Thanks for the heads up! Frustrating that this is always happens in Ohio. I have worked with NPs for years and enjoy the interaction but have always wondered why we don't get much support from them. I believe I know the answer to that question. Every time you help one of them you may be preparing them to take your position!

[mcneesejd]

I completed this as well. I have worked a total of 5 years in pain management and see no reason why this should not be allowed. We are losing a lot of ground to NP's. Hirability will be affected, particularly to a pain management physician. I am fully comfortable having my name on this rx because we write them responsibly and limited and short term.

[DizzyJ]

Here is another e-mail OAPA sent out today:

Ohio PAs:

Many thanks to those of you that contacted your Senators and Representatives asking for the Schedule II language to be reinstated in HB487.

The Schedule II language was removed by Senator Burke and he needs to be encouraged to allow its reinstatement.

We need all PAs in Ohio to contact him today! Conference committee will convene tomorrow (Tuesday). It doesn’t matter if he is your Senator or not.

Call him at 614/466-8049

Email him at sd26@mailr.sen.state.oh.us

Tell him to please reinstate the Schedule II language in HB487 because:

PA jobs will be lost and patient access to critical care will be reduced.

APNs currently have Schedule II authority and PAs do not.

Critical care jobs that were posted for either a PA or APN will now exclude PAs limiting jobs open to PAs.

Please put the Schedule II language back in as not having it will hurt my practice.

If we fail to get the Schedule II language reinstated, PAs will probably not get Schedule II authority until late 2013.

Please contact him now!

Thank you.

Beth Adamson

OAPA

800/292-4997

[Hemegroup]

Frightening. Would a letter from an out of state PA make any difference? If so, I'm happy to send one.

[DizzyJ]

Frightening. Would a letter from an out of state PA make any difference? If so, I'm happy to send one.

 

Well...you wouldn't have to point out where you do or don't live ;-)

[mcneesejd]

So the bill passes. Great! However, working in a pain management clinic it does nothing for me. Based on the outline pain management offices (freestanding) are not included in this bill. Therefore I cannot prescribe CII's.

The bill would permit physician assistants to prescribe schedule II medications in particular sites, to their patients. However, it would prohibit the physician assistant from prescribing those medications in a convenience care clinic.

The bill restricts the prescribing to patients with terminal conditions, in a 24-hour supply and after the physician assistant’s supervisory physician initiates the prescription. These three requirements would not be necessary if the physician assistant is prescribing the medication while practicing in the following sites:

(1) A hospital registered with the Department of Health;

(2) A health care facility operated by the Department of Mental Health or the Department of Developmental Disabilities;

(3) A nursing home licensed by the Department of Health or a political subdivision;

(4) A county home or district home that participates in Medicare or Medicaid;

(5) A hospice care program;

(6) A community mental health facility;

(7) An ambulatory surgical facility;

(8) A freestanding birthing center;

(9) A federally qualified health care center;

(10) A health care office or facility operated by a board of health of a city or general health district or an authority having those duties.

 

Whats awkward is that practioner's in these facilities may not have extensive experience but they can prescribe an entire month of CII opioids. However, I have working in pain management for 5 years and work in an independent solo physician office seeing 120 patients per week but cannot write CII's. Seems like providing the indepence to prescribe opioids to those that ARE NOT very experienced would lead to possibly more detrimental effects. I realize there are may patients and providers abusing them. However, we are a certified pain clinic in Ohio and practice this thing called RESPONSIBLE prescribing. Another law that does not make sense.

[KMD16]

I feel your pain!