Anesthesia Assistants want to license through our practice act.

[sas5814]

There is a piece of legislation that going to be presented in the House Licensing and Administrative Procedures Committee on Monday (Apr 3 @ 2:00 pm in E2.026) that has potential to dramatically effect the PA Practice Act in Texas.  The backstory behind this legislation is lengthy with many political twists and turns.  It is being supported by TAPA and I am told back channel it is to appease some physicians who want them on our practice act. This diminishes our profession and will make changes to the practice act even more difficult because the AAs will have to be culled out somehow. There is stated worry that opposing this will harm relationships with physician groups TAPA is cordial with. So once again we are selling out our profession to appease some physician special interests.

 

The issue with the bill relates to Anesthesia Assistants being licensed through our practice act, crazy right?  Not so much.  Opposition to this bill does not mean that the Anesthesia Assistant profession is shady or that they do not deserve to be licensed.  Opposition simply protects our practice act as a PA practice act, not a PA and AA practice act. 

 

Please read the bill below and form your own opinion.  If this alarms you, as it does me, please forward to other PA's that you know, encourage them to call the members of the House committee to voice their concerns, call a member of the Legislative Affairs committee for TAPA, or better yet, attend the hearing in Austin on Monday and speak against the bill.  Unfortunately, due to my work schedule, I am unable to attend the committee meeting.  

 

This is a grassroots effort to defeat this pending piece of legislation.  These grassroots efforts are even being coordinated with the CRNA group to defeat this bill.  Obviously the reasons are different but the end result is the same. 

 

Below is HB 2525 and I am also including the list of the House Licensing and Administrative Procedures committee members.  Contacting the committee members is especially powerful when done by a constituent in the district the member is from...if you know anyone who practices in these districts, please reach out to them...

 

 

85th Legislative Session House Licensing and Administrative Procedures Committee Roster:

 

John Kuempel, Chair (District 44), E2.422 512‐463.0602    john.kuempel@house.texas.gov  

Ryan Guillen, Vice‐Chair (District 31), 1W.3 512‐463‐0416    ryan.guillen@house.texas.gov

John Frullo (District 84), 4N.6     512‐464‐0676    john.frullo@house.texas.gov

Charlie Geren (District 99), GW.15    512‐463‐0610    charlie.geren@house.texas.gov

Craig Goldman (District 97), E2.606    512‐463‐0608    craig.goldman@house.texas.gov

Ana Hernandez (District 143),4S.3    512‐463‐0614    ana.hernandex@house.texas.gov

Abel Herrero (District 34),4S.6     512‐463‐0462    abel.herrero@house.texas.gov

Chris Paddie (District 9), E2.502     512‐463‐0556    chris.paddie@house.texas.gov

Senfronia Thompson (District 141)    512‐463‐0720    senfronia.thompson@house.texas.gov  

 

 

 

The Bill is below:
By: Zerwas H.B. No. 2525       A BILL TO BE ENTITLED   AN ACT   relating to the licensing and regulation of physician assistants.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Section 204.153(a), Occupations Code, is amended   to read as follows:          (a)  To be eligible for a license under this chapter, an   applicant must:                (1)  successfully complete an educational program for   physician assistants, anesthesiologist assistants, or surgeon   assistants accredited by the Accreditation Review Commission on   Education for the Physician Assistant or the Commission on   Accreditation of [Committee on] Allied Health Education Programs   [and Accreditation] or by those commissions' [that committee's]   predecessor or successor entities;                (2)  pass the Physician Assistant National Certifying   Exam [Examination] administered by the National Commission on   Certification of Physician Assistants or the Certifying   Examination for Anesthesiologist Assistants administered by the   National Commission for Certification of Anesthesiologist   Assistants;                (3)  hold a certificate issued by the National   Commission on Certification of Physician Assistants or the National   Commission for Certification of Anesthesiologist Assistants;                (4)  be of good moral character;                (5)  meet any other requirement established by   physician assistant board rule; and                (6)  pass a jurisprudence examination approved by the   physician assistant board as provided by Subsection (a-1).          SECTION 2.  Section 204.154, Occupations Code, is amended to   read as follows:          Sec. 204.154.  EXEMPTIONS FROM LICENSING REQUIREMENT FOR   CERTAIN PHYSICIAN ASSISTANTS. A person is not required to hold a   license issued under this chapter to practice as:                (1)  a physician assistant student enrolled in a   physician assistant, anesthesiologist assistant, or surgeon   assistant educational program accredited by the Accreditation   Review Commission on Education for the Physician Assistant or the   Commission on Accreditation of [Committee on] Allied Health   Education Programs [and Accreditation of the   American Medical   Association] or by successor entities as approved and designated by   physician assistant board rule; or                (2)  a physician assistant employed in the service of   the federal government while performing duties related to that   employment.          SECTION 3.  Section 204.155(a), Occupations Code, is amended   to read as follows:          (a)  The physician assistant board may issue a temporary   license to an applicant who:                (1)  meets all the qualifications for a license under   this chapter but is waiting for the license to be issued at the next   scheduled meeting of the board;                (2)  seeks to temporarily substitute for a licensed   physician assistant during the license holder's absence, if the   applicant:                      (A)  is licensed or registered in good standing in   another state;                      (B)  submits an application on a form prescribed   by the board; and                      ©  pays the appropriate fee prescribed by the   board; or                (3)  has graduated from an educational program for   physician assistants, anesthesiologist assistants, or surgeon   assistants described by Section 204.153(a)(1) not later than six   months before applying for a temporary license and is waiting for   examination results from the National Commission on Certification   of Physician Assistants or the National Commission for   Certification of Anesthesiologist Assistants.          SECTION 4.  Section 204.204, Occupations Code, is amended by   adding Subsection (b-1) to read as follows:          (b-1)  Notwithstanding Subsection (b), an anesthesiologist   assistant must be supervised by a physician who is an   anethesiologist and maintains a physical proximity that enables the   supervising physician anesthesiologist to be immediately available   if needed.          SECTION 5.  (a) Sections 204.153 and 204.155, Occupations   Code, as amended by this Act, apply only to an application for a   license submitted to the Texas Physician Assistant Board on or   after the effective date of this Act. An application submitted   before the effective date of this Act is governed by the law in   effect on the date the application was submitted, and the former law   is continued in effect for that purpose.          (b)  As soon as practicable after the effective date of this   Act, the Texas Physician Assistant Board or Texas Medical Board, as   appropriate, shall adopt rules necessary to implement the changes   in law made by this Act to Chapter 204, Occupations Code.          SECTION 6.  This Act takes effect September 1, 2017.

 

 

 

If your representative organization isn't looking after your interests maybe it is time to put your time and money with an organization that is.

[sas5814]

Quick follow up. As of today the bill is in committee but no action has been taken. Further discussion with folks who know tell me this is being ramrodded by anesthesiologists who seem to be swinging a big stick in TMA, the medical board, and the legislature this year. It has support from our state society, essentially, because of fear of having the physicians resist future legislative activities on behalf of PAs.

This is one man's opinion. I understand there is a quid pro quo in politics but to allow our practice act to be bastardized by non providers under duress from a physician group is just wrong. Future political support either will or won't come and health care is evolving. We are at a tipping point in this profession and it is past time to stand up and do what is right for the profession even if it means *gasp* just saying no to the physicians.

If you haven't reached out to the committee members please do. If this dies in committee then it is dead. If you have reached out please do again. Contact information is listed above. Phone calls are best followed by paper letters followed by faxes and emails.

 

If your representative society isn't representing your interests then maybe it is time to put your money and efforts into an organization that does.

[rpackelly]

Actually, in Georgia they are licensed as PAs as well and it did not cause any problems in that state. You might want to speak with someone in GAPA.

[sas5814]

Its a little about it being a problem and more about the formalization that everyone who assists a physician is a PA. They aren't and they need their own enabling legislation. They have a legit place in the medical community but being a PA isn't it.

[rpackelly]

I agree that it would be ideal to have separate legislation. They are a small community and have the staunch support of the anesthesiologists which is another point to consider in terms of the political environment with organized medicine in the state. As I recall their status as PAs in Georgia goes back to the earliest part of the 1970s. The CAA relationship with CRNAs on a national level is quite akin to PAs and NPs and it might be more useful to create allies especially in large and powerful states. I do not think that an AA would or could take jobs from PAs or would want to given the salary differentials.....they work with a physician anesthesiologist immediately available in the suite. first job out of school is typically at 150k plus. Same 27 month masters prep but completely devoted to anesthesia within the OR itself with an anesthesiologist physically present.

 

I am sure this is a product of political necessity but I hear your concern and see its philosophical merit.....just do not think it will end up having any real adverse impact.

[sugars95]

Obviously there is a disconnect at worst or a lack of information at best that is causing sas5814 to fail to understand the benefits of this Texas legislation.  

 

The existing PA laws in Texas already include surgeon assistants, (which may be just as contentious) but overall hasn't impacted current Texas PA practice.  This legislation doesn't bastardize the laws any more than they already have been.  Texas PA legislation isn't owned by PAs.  It's for patients and the public good.  If this is helps ensure patients get safe care from a safe provider, then maybe one should reconsider the misplaced and inappropriate self-ownership of "our practice act"?

 

Also, if sas5814 knew the political climate in Texas, it would be shared that there is a Texas legislative rule that directly prevents any increase of any state governmental agency.  Even if the AAs wanted a different board, with all the benefits of provider oversight and license provisions, it would be impossible.  They have already tried this route, despite the rule, the past three sessions.  Realistically, this is the only way in Texas to make sure an AA in Texas isn't compromised by addictions, predators, etc.  The medical board does not have the authority to police them, and hospital credentialing information can't prevent bad apples from practicing because information isn't shared for liability reasons. 

 

This also has the potential of gaining a profession as an ally.  Why limit and shut out a potential political ally in this current health care climate?

The APRNs are successful in their strategies and to kick this to the curb is not only myopic, but it may be detrimental to PAs in the long run.  Seriously, aligning with CRNAs?  Do you not remember what the NPs did?  Because the same thing is happening to the AAs, maybe worse.

[sas5814]

Obviously there is a disconnect at worst or a lack of information at best that is causing sas5814 to fail to understand the benefits of this Texas legislation.  

 

The existing PA laws in Texas already include surgeon assistants, (which may be just as contentious) but overall hasn't impacted current Texas PA practice.  This legislation doesn't bastardize the laws any more than they already have been.  Texas PA legislation isn't owned by PAs.  It's for patients and the public good.  If this is helps ensure patients get safe care from a safe provider, then maybe one should reconsider the misplaced and inappropriate self-ownership of "our practice act"?

 

Also, if sas5814 knew the political climate in Texas, it would be shared that there is a Texas legislative rule that directly prevents any increase of any state governmental agency.  Even if the AAs wanted a different board, with all the benefits of provider oversight and license provisions, it would be impossible.  They have already tried this route, despite the rule, the past three sessions.  Realistically, this is the only way in Texas to make sure an AA in Texas isn't compromised by addictions, predators, etc.  The medical board does not have the authority to police them, and hospital credentialing information can't prevent bad apples from practicing because information isn't shared for liability reasons. 

 

This also has the potential of gaining a profession as an ally.  Why limit and shut out a potential political ally in this current health care climate?

The APRNs are successful in their strategies and to kick this to the curb is not only myopic, but it may be detrimental to PAs in the long run.  Seriously, aligning with CRNAs?  Do you not remember what the NPs did?  Because the same thing is happening to the AAs, maybe worse.

I have been working health care policy and politics in Texas for 25 years. I understand the system pretty well and the personalities. The NPs have ridden out coat tails when it suited them and screwed us when it suited them and they are light years ahead of us in organization and political will and planning. It is past time to stop crying about the evil NPs. 

It is indeed our practice act and to say it belongs to the patients and the people is just posturing and trying to look like you are on some kind of high moral ground.

The AAs are not our issue. We have plenty of our own. This is a further attempt by TMA to lump all non physician providers as PAs. It dilutes our "brand" and reinforces the idea that your are either a physician or an assistant. The political climate in Texas is increased access to care and lower costs while maintaining patient safety...period. The players are mostly looking out for themselves except for us, it seems, who are trying to curry favor with non PA groups. Mostly we are still bowing the TMA in an attempt to not anger them. We are politically feckless.

The AA legislation is supported by TAPA. I have had converstaion with a number of current and past leaders who state TAPA is afraid if they don't support this TMA will interfere with other legislative efforts. They don't like it but feel powerles to do anything about it. I get it...quid pro quo. That is politics. But sometimes you have to say no and take whatever comes after.

[sugars95]

Ok, I hear you.  To be clear, I completely agree that NPs (and maybe all APRNs) are strategically-well positioned; I don't think NPs are evil.  They are a great example of the power of coalitions.  They are strong because of this and I don't see the point of killing any to future potential of alignment with another profession or organization.  I hate to ask it but why can't we emulate the APRN strategy (see compacts and consensus models) with one based on practice of medicine.  To be clear: not physician. But with others that are medically trained?  Imagine the potential.   

Using the nuclear option against this bill destroys any future PA legislation, maybe now and in the foreseeable future..  Check out the sponsor of the PA schedule II bill.  Check out who the Chair of Appropriations...TMB president, TMA leadership.  I'm not fear mongering: it is what it is.  Sure, let's sit back for the next few years and watch policy and legislation being made during the era of MACRA, MIPS, and the APMs without a respectable seat at the political table. 

If you are aware of all this, then I will respect your position but I completely disagree with your strategy.  I'm not sure how to expect any forward movement in the future.  APRNs are already going to get independent practice.  Why?  They carved out the CRNAs so the existing legislation would pass in this contentious environment.  Again, a strategy that's moving forward and not shooting itself in the foot.

 

But I will go ahead and take the moral high ground on this one.  "Our practice" has to be altruistic and based on patient safety.  It's not owned by anyone

[sas5814]

We both agree and disagree and I think that is a healthy thing. I think the problem is we are aligning ourselves with someone who really isn't our friend politically and whose main goal is to stop any advancement of scope by any non-physicians. That would be the physicians. They will hold us back and cast us aside when they have no use for us. They also don't have the power of health care legislation they and everyone else thinks they do. I spend a fair amount of time walking the halls in Austin, visiting my local reps offices, and on the phone with legislators. Many (most) are tired of the physicians arguments that basically protect their power and money and attempt to discredit non-physician providers with nonsense like "people are going to die" when not only is there no data to support their claims the data says the exact opposite. We proved that 20 years ago when myself and 2 other PAs basically secured scheduled drug privileges by spending months visiting key legislators and giving hard data to support our request. By the time the physicians even knew what was happening there was no real counter argument to be made except "people are going to die" which of course didn't happen.Our fear keeps us from standing up to them and for ourselves when we should. Aligned with the right people we would have more votes and money to put into the political process and that gets attention in Austin.

Aligning with the NPs won't be terribly different with the exception of we would be working to advance both professions and when they decide to part company we will have made some progress on key issues that benefit us and the people we serve. I have already lent support via a PA organization I was a founding member of to a coalition that includes the NPs and several others that want to advance full practice authority and keep the AAs out of our practice act. You want me to support it? Get your friends the physicians to support full practice authority for PAs. That is politics and quid pro quo. Some vague promise of future support on undefined issues that may never materialize doesn't warm my cockles. 

[sugars95]

Wait...did you just...no.

Please let's just agree to remove "cockles", whether warmed or not, from the lexicon of this healthy discussion.  That's for a different forum altogether.  I hope.

 

Moving on, you misrepresent me: I'm not saying aligning with physicians.  I'm saying aligning with AAs.  Despite what TAPA has circulated, I don't believe this is a physician-led effort, it's heavily physician supported, but physicians were not the impetus behind the legislation.  My understanding is the AAs approached the sponsor, who obviously was friendly.  TMA came in late as a supporter too for that matter. 

 

I really have to believe you have not seen current legislation...you want to quid pro quo for independence before getting schedule II?  At the price of losing the opportunity to rx schedule II?  Nothing vague about that. 

 

I can see how important this is to you and all the work you have done and I understand your ownership of it.  I just think you are misinformed about current events and potentially detrimental to future PA practice.

But I am open to listen.

 

But seriously, no more cockles

[sas5814]

My understanding some anesthesiologists who are in TMA leadership and the medical board quietly strong armed TAPA into supporting this.  That is based on some talks with a few folks in the inner circle.

 

My quid pro quo was support the AAs for FPAR. That is a quid pro quo. Scedule II will make things easier for a small percentage of our brethren. If you want an action that is in the collective groups practice act give something back that helps the whole of us.

 

I'm not sure I understand the detriment you are referring to. By displeasing the physicians or the AAs? Allegiences in p matters relating to policy shifts constantly based on the issue. Today's friend is tomorrow's enemy. It is cognative dissonance to assume if you do something for group A today they will be your friend on issue B in 2 years.

 

The NPs have been aggresively pushing their agenda nationally in open and direct defiance of the physicians and they are running circles around us legislatively. I think it is time to learn a few lessions from their successes.

 

Cockles. (had to...you knew that)

[sas5814]

A cross post from the AAPA Huddle:

 

Posted yesterday

REPLY TO DISCUSSIONOPTIONS DROPDOWN

HOUSE BiLL 2525 UPDATE:

 

TAPA IS NOW SUPPORTING HB 2525  therefore we have no choice but to continue our grassroots effort to KILL THIS BILL.

Let's join together in our efforts to DEFEAT House Bill 2525 (Zerwas) regarding licensure of Anesthesiologist Assistants (AA)! This bill will likely be heard in the House Licensing and Administrative Procedures Committee on Monday, April 10th. 

 

AAs are trying to gain licensure in Texas by being placed into our PA practice act.

The agreed upon amendments made by TAPA and the Texas Society of Anesthesiologists  do NOT change the fact that if this bill passes  AAs will be in our practice act.

 

Key Points:

 

TX PAs have never opposed the licensure of AAs but the TX PA practice act should not be shared with any other profession.

 

Currently we do NOT share our practice act with any other profession (surgeon assistant in our language is a PA).

 

Only GA has AAs in their PA practice act without the requirement of also being a PA.

KY requires an AA to be a PA.

48 states do NOT have AAs in their PA practice act

 

This is NOT an ANTI-TAPA campaign; this is an ANTI-HB2525 campaign.

 

This is NOT an ANTI-AA campaign; this is an ANTI-HB2525 campaign.

 

If TAPA had decided to OPPOSE this bill we would have supported TAPA's decision.

 

If TAPA had decided to take a NEUTRAL position for political reasons, we would have supported TAPA's decision.

 

Become a TAPA member and vote for leaders who will protect and fight for our profession.

 

What to do:

 

1. Share this email with all fellow PAs and colleagues. 2. Send a handwritten letter to your state representative voicing your opposition to this bill and urge them to vote NO on HB2525 using this form letter as a template.  

3. Call your state representative's Capitol Office to voice opposition to this bill.

      *state your name and the district where you reside

      *state you oppose House Bill 2525

      *Use the talking points below

4.  Visit and Like our Facebook Page: TX PAS AGAINST HB 2525

 

Talking points:

 

1. AAs are NOT PAs and do not belong in our PA statue.

2. Placing AAs into the PA practice act dilutes the PA profession and dilutes the definition of a PA.

3. AAs are not qualified to license, discipline, or regulate PAs and conversely PAs are not qualified to license, discipline or regulate AAs.

4. Placing AAs into the PA practice act will confuse and mislead our patients,  regulators, payers, employers, insurance companies, etc.

5.  We do not want the PA board to become the "assistant board" allowing all other "assistant" professions seeking licensure into our statue. (Orthopedic Physician Assistants, Radiological Assistants, etc.).

If you live in the district of one of these committee members it is imperative that they hear from you by phone, letter, and face-to-face meetings!  House District 44 (Kuempel, John) House District 31 (Guillen, Ryan) House District 84 (Frullo, John) House District 99 (Geren, Charlie) House District 97 (Goldman, Craig) House District 143 (Hernandez, Ana) House District 34 (Herrero, Abel) House District 9 (Paddie, Chris) House District 141 (Thompson, Senfronia)

 

 

It is up to ALL PAs in Texas to fight and defend our profession by protecting our practice act.  Please do so by actively opposing House Bill 2525.

 

Thank you,

 

Linda C. Delaney, MPAS, PAC (lexuslevi@hotmail.com)

Past TAPA President

Past Texas PA Board Member

Past AAPA Director At Large 

------------------------------
Gordon Adams PA-C
San Antonio TX
------------------------------

 

 

 

2.  RE: TEXAS PA PRACTICE ACT (PENDING LEGISLATION)

0 RECOMMEND

Gordon Adams, PA-C

ACTIONS OPTIONS DROPDOWN

Posted yesterday

REPLY TO DISCUSSIONOPTIONS DROPDOWN

Please see the attached communication from another Texas PA colleague regarding HB2525 and the need to stop this bill from getting passed.


Dear PA Friends,

As many of you may have read in the TAPA newsletter, there are many issues that TAPA is tackling on its' legislative agenda this year. There is, however, one piece of legislation that going to be presented in the House Licensing and Administrative Procedures Committee on Monday (Apr 10 @ 2:00 pm in E2.026) that has potential to dramatically effect the PA Practice Act in Texas.  The backstory behind this legislation is lengthy with many political twists and turns.  I have only been made aware of all that has been going on in the past couple of weeks.

 The issue with the bill relates to Anesthesia Assistants being licensed through our practice act, crazy right?  Not so much.  Opposition to this bill does not mean that the Anesthesia Assistant profession is shady or that they do not deserve to be licensed.  Opposition simply protects our practice act as a PA practice act, not a PA and AA practice act.  The flip side of the story is that opposing HB 2525 has the potential to upset doctor specialty groups we have worked well with over the years.   Obviously, that could potentially impact TAPA's legislative efforts with other bills this session.

Unfortunately, TAPA has decided to SUPPORT, not oppose or remain neutral but SUPPORT this bill.  therefore we are now undergoing a FULL a grassroots effort to defeat this piece of legislation.

Please be aware of Texas House bBll 2525 and form your own opinion.  If this bill alarms you, as it does me, please forward to other PAs that you know, encourage them to call the members of the House committee to voice their concerns, call a member of the Legislative Affairs committee for TAPA, or better yet, attend the hearing in Austin on Monday and speak against the bill.

I am including the list of the House Licensing and Administrative Procedures committee members.  Contacting the committee members is especially powerful when done by a constituent in the district the member is from...if you know anyone who practices in these districts, please reach out to them...

 

Thank you for your time and attention,

Ann Teal, PA-C

TAPA Past President 2006-2007

 

85th Legislative Session House Licensing and Administrative Procedures Committee Roster:

 

John Kuempel, Chair (District 44), E2.422 512‐463.0602    john.kuempel@house.texas.gov   

Ryan Guillen, Vice‐Chair (District 31), 1W.3 512‐463‐0416    ryan.guillen@house.texas.gov 

John Frullo (District 84), 4N.6     512‐464‐0676    john.frullo@house.texas.

[sas5814]

There is a lot of pressure on the legislators to kill this off in committee. Keep it up! This bill has stalled in committee and hasn't moved to the calandar because of formal objections requiring a hearing.

 

In addition to our legislative efforts, which includes at least a dozen former TAPA presidents, vice presidents, and other board members I am aware of, PAs are calling from their home districts both to Zarwas' office and their home districts asking why Zarwas is abusing his position for the gain of himself and his fellow anesthesiologists (yes he and the co-author are both anesthesiologists). We have also started calling media sources in Austin, Zarwas' home district, and our own districts asking the same questions.

 

Keep in mind we are not opposed to AAs licensing and being regulated just having them attached to our enabling legislation because, and I quote a legislator, "why can't all the assistants be licensed together?" *sigh*

 

We have to keep the pressure on until this dies. Keep calling. Keep writing. talk to your peers. Talk to your representatives in the legislature and your representative organizations. Call your local paper and radio station if you are so inclined. Don't let up.

 

 

If your representative organization isn't representing your interests maybe it is time to put your money and efforts with an organization that is.

[sas5814]

Hands down the most informed, thoughtful reply to this issue I have seen yet. I bow before a master:

 

Interesting discussion to follow.  Perhaps there is a more appropriate way in which to handle the situation.  House Bill 2525 as designed confuses a very important issue.  When Chapter 185 was added to Part 9, under Title 22 of the administrative code it codified the discipline of Physician Assistant in Texas along with the manner in which persons in our profession would be regulated regardless of the specialty or subspecialty in which they practiced.  Over time, modifications established the Texas Physician Assistant Board (TPAB) and defined its relationship to the Texas Medical Board (TMB).  The language contained within HB 2525 alters significantly the intent of the TPAB to one of being an advisory group for licensing other assistants to physicians; which it was never its intent.   The second issue is the title Physician Assistant. The title belongs to the PA profession which is codified in laws and regulations in all states and US territories. The Anesthesiology Assistant (AA) is not a Physician Assistant (PA) and, as such, should not be inserted into the statutes and regulations that govern the practice of PAs in Texas or in any other state. Any effort to recognize and credential the AA in Texas should involve the submission of a separate bill that would establish an appropriate advisory body under the Texas Medical Board. 

 

Under Title 22, Examining Boards, Part 9, Texas Medical Board there are separate chapters that address the role of the TMB in credentialing the Acupuncturists (183), Surgical Assistant (184), Physician Assistant (185), Respiratory Care Practitioner (186) and the Perfusionist (188).  When the credentialing of Medical Radiological Technologists was transferred from DSHS to the TMB a separate section (194) was added to Part 9 that defined who these persons were, their qualifications based upon education and certification and the process for their credentialing.  Based upon the regulatory approach currently used by the TMB, the most appropriate step to the regulation and credentialing of AAs would be to add a new section under Part 9 that establishes an advisory group comprised of anesthesiologists and AAs that would serve in a similar capacity with administrative rules that would define the AA, their education, certification and the process of making an application form TMB credentialing.  Co-opting the administrative rules and regulations of another discipline, no matter how legislatively expedient, is not the way in which to proceed.

 

 

[sas5814]

It seems this grass-roots effort has really gotten some legs. An update about who opposes the issue and why

 

 

HOUSE BILL 2525 UPDATE:
Let's continue in our efforts to DEFEAT House Bill 2525 (Zerwas) regarding licensure of Anesthesiologist Assistants (AA) within the PA Occupations Code! This bill is pending in the House Licensing and Administrative Procedures Committee. If the bill is voted out of committee, it will move on to the floor of the House of Representatives as early as this week.

AAs ARE TRYING TO GAIN LICENSURE IN TEXAS BY BEING PLACED IN OUR PA PRACTICE ACT.

IF THIS BILL PASSES, AAs WILL BE IN OUR PA PRACTICE ACT AND WILL BE LICENSED BY THE TEXAS PA BOARD.

Key Points

• We do NOT share our practice act with any other profession (a surgeon assistant in our language is a PA)
• Only GA has AAs in their PA practice act without the requirement of also being a PA while KY requires an AA to be a PA to be in their PA practice act.
• 48 states do NOT have AAs in their PA practice act.
• This is NOT an ANTI-TAPA campaign; this is an ANTI-HB2525 campaign.
• This is NOT an ANTI-AA campaign; this is an ANTI-HB2525 campaign.

There are 8,400 licensed PAs in Texas. 
TAPA, with approximately 1,800 PA members (non student/physician), is SUPPORTINGHB 2525.
If TAPA was OPPOSING the bill or was taking a NEUTRAL position for political reasons we would not have formed this grassroots movement. 
WHAT CAN YOU DO:
1. Share this email with all fellow PAs and colleagues. 
2. Send a handwritten letter to your state representative voicing your opposition to this bill and urge them to vote NO on HB2525 using this form letter as a template. 
 3. Call your state representative’s Capitol Office to voice opposition to this bill.
*state your name and the district where you reside
*state you oppose House Bill 2525 and use the talking points
4. Visit and Like our Facebook Page: TX PAS AGAINST HB 2525
• TX PAs have never opposed the licensure of AAs. If AAs wish to obtain licensure it should be under their own practice act.

TALKING POINTS
• AAs are NOT PAs and do not belong in our PA statue.
• Placing AAs in the PA practice act misrepresents the PA profession and misrepresents the definition of a PA
• AAs do not have the same training, education, or skillset as PAs and would be inappropriately allowed to practice under PA statue.
• AAs are not qualified to license, discipline, or regulate PAs and conversely PAs are not qualified to license, discipline or regulate AAs.
• Placing AAs into the PA practice act will confuse and mislead our patients, regulators, payers, employers, insurance companies, and the uniformed that a PA and an AA equivocal. Clearly they are not.
• The PA board to is not the “assistant board” and we oppose other “assistant” professions seeking licensure into our statue. (Anesthesiologist Assistants, Orthopedic Physician Assistants, Radiological Assistants, etc.).

If you live in the district of one of these committee members it is imperative that they hear from you by phone, letter, and a face-to-face meeting.
House District 44 (Kuempel, John)
House District 31 (Guillen, Ryan)
House District 84 (Frullo, John)
House District 99 (Geren, Charlie)
House District 97 (Goldman, Craig)
House District 143 (Hernandez, Ana)
House District 34 (Herrero, Abel)
House District 9 (Paddie, Chris)
House District 141 (Thompson, Senfronia)

It is up to ALL PAs in Texas to fight and defend our profession by protecting our practice act. Please do so by actively OPPOSING TX House Bill 2525.

Thank you,

Dwight Deter, PA-C, DFAAPA, TAPA President 1985-1986
Texas PA Board Chair 1994-1998; Texas PA Board Member 1994-2007

Justine Strand De Oliveira, DRPH, PA-C, DFAAPA, TAPA President 1988-1989

Susan Scott, PA-C, TAPA President 1992-1993

Justine Strand De Oliveira, DRPH, PA-C, DFAAPA, TAPA President 1993-1994

Jennifer Jones Fischer, PA-C, TAPA President 1994- 1995

Michael Clark, PhD, PA-C, TAPA President 1997-1998

Tricia Guerra, MPAS, PA-C, TAPA President 1998-1999

Jack Runyan, PhD, PA-C, TAPA President 2000-2001

Robert Smith, PA-C, TAPA President 2001-2002

COL (Ret.) John Drobnica, MPAS, PA-C, TAPA President 2002-2003

Linda Contreras Delaney, MPAS, PA-C, TAPA President 2004-2005
Texas PA Board Member 2012-2015

Michael Clark, PhD, PA-C, TAPA President 2005-2006

Ann Teal, PA-C, TAPA President 2006-2007

Catherine Judd, MPAS, PA-C, TAPA President 2007-2008

Elias Villarreal, Jr., ADE, MPAS, PA-C, DFAAPA, TAPA President 2009-2010

Allan Boutwell, MPAS, PA-C, TAPA President 2010-2011

Elias Villarreal, Jr., ADE, MPAS, PA-C, DFAAPA TAPA President 2016-2017

James E. Delaney, PA-C, AAPA President 2012-2013

[sas5814]

Another call for action from our CRNA colleagues:  

B 2525 will soon be sent to the House Calendars Committee, the committee that will determine if and when the AA licensing bill will be heard by the full House. While no single member can hold a bill in Calendars indefinitely, if we have enough friendly members on the committee registering their concerns with the bill by “tagging” it, we hope to keep the bill from ever reaching the House floor. Traditionally, only constituents are encouraged to contact his or her representative. However, this bill’s supporters are more organized than ever, and they are contacting all members of this committee, regardless of constituency. Therefore, further action is requested from all PAs and interested parties.

UPDATED ACTION REQUEST: Today, please contact the following members of the House Calendars Committee and voice opposition to HB 2525:

Representative Todd Hunter (Chairman): 512-463-0672

Representative Donna Howard (Vice-Chair): 512-463-0631

Representative Roberto Alonzo: 512-463-0408

Representative Trent Ashby: 512-463-0508

Phone calls only take a few minutes. If you are not a constituent, please state where you reside in the state. If you are a constituent, please state where you reside in the district. When urging representatives to oppose HB 2525, remind them that licensure of such a small group of providers (around 130 Anesthesiologist Assistants) is bad medicine for Texas because:

AAs ARE NOT PAs – and should not be in the PA occupation code.

AAs DO NOT improve patient safety standards— neither will licensure.

AAs DO NOT reduce healthcare costs — neither will licensure.

AAs DO NOT improve access to anesthesia services — neither will licensure.

ONGOING ACTION REQUESTS: Please call and email your state representative TODAY to voice your opposition to HB 2525. Contact information for your representative’s Capitol and regional offices can be found here. Additionally, TxANA will facilitate arrangements for a personal meeting with your representative if you are able to travel to the Capitol.

[loliz]

Obviously there is a disconnect at worst or a lack of information at best that is causing sas5814 to fail to understand the benefits of this Texas legislation.  

 

 

 

Um.. nope. He seems to have reported the situation exactly as I understand it and exactly how it has been discussed in every (dozens) conversation about this that I have had. I agree. This SB should not pass and it is another attempt by a few active physicians and our own state association to marginalize us. What's next TAPA, should we throw the MAs and CNAs on our practice act as well? 

[cg02186]

I agree but FWIW I did all my rotations and schooling in Georgia and worked with plenty of AAs and there really isn't anything weird about it.  I didn't even know it was an issue at all until I saw this post.  The only thing I noticed is when I applied for my license there was a couple of separate forms that you had to fill out weather you were PA or AA and took the NCCPA exam or the NCCAA. I have not seen or heard any of the PAs I've worked with ever mention it in a negative way.  

[loliz]

I agree but FWIW I did all my rotations and schooling in Georgia and worked with plenty of AAs and there really isn't anything weird about it.  I didn't even know it was an issue at all until I saw this post.  The only thing I noticed is when I applied for my license there was a couple of separate forms that you had to fill out weather you were PA or AA and took the NCCPA exam or the NCCAA. I have not seen or heard any of the PAs I've worked with ever mention it in a negative way.  

 

You are completely misunderstanding the issue. The issue is not with AAs. They are fine, they can do their thing. The issue is that there is a bill that will include AAs under the umbrella of PAs within our occupation code. AAs are not PAs. They should not be included in our occupation code, our legislation, our licensing board, etc. 

I can picture it now... in a few years when APNs get independent practice in Texas and PAs try to do the same, our legislation will get kicked to the curb so fast because it will include AAs within our umbrella. Not good. Don't be short sighted.