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Looking at the text of the bill that establishes:

(1) A physician assistant specializing in psychiatric mental health under this section


307     shall:
308          (a) hold a valid license as a physician assistant under this chapter;
309          (b) obtain and maintain a Certification of Added Qualification in psychiatry issued by
310     the National Commission on Certification of Physician Assistants;
311          (c) complete:
312          (i) an accredited doctorate level academic program for physician assistants approved by
313     the division in collaboration with the board; or
314          (ii) a post-graduate residency in psychiatry and additional clinical practice or
315     coursework in accordance with requirements approved by the division in collaboration with the
316     board; and
317          (d) complete the clinical practice requirement established by the division in
318     collaboration with the board.
319          (2) The division, in collaboration with the board, may approve a program under
320     Subsection (1)(c)(i), if the program:
321          (a) is a regionally accredited doctoral level academic program;
322          (b) includes at least 1,600 didactic hours of instruction that results in a doctorate of
323     medical science degree or equivalent; and
324          (c) provides graduate level instruction in:
325          (i) neuroscience;
326          (ii) health care law and ethics;
327          (iii) health care delivery;
328          (iv) evidence-based medicine;
329          (v) evidence-based research;
330          (vi) academic writing and publication;
331          (vii) psychiatric assessment;
332          (viii) crisis intervention;
333          (ix) a comprehensive review of mental disorders

So it's great that Utah is making some legislative moves, however these additional requirements are completely ridiculous. Requiring that PAs meet all these additional requirements after graduating from PA school is admitting that our education is not equivalent to NPs. Also, how many PA residency programs are out there as well as DMS programs that meet the above criteria? Also, what is the point of having separate requirements for Psych PAs. This is not a good bill and certainly not a good precedent to set for other states

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what???

 

so a psych NP can have about 500 clinical hours TOTAL

We have to have 2200!!!

We rotate through all different services, NP - well they do pretty limited - and the whole body is the whole body..... can't just separate psych from everything else....

You need to involve AAPA and PAFT as this is clearly written by someone that has 1) no idea of our education or 2) is siding with NP's

 

Neither one of which is a good thing

 

 

We don't need to ask for the moon, we just need to be treated honestly and our education respected.

 

 

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To be certain UAPA are the ones pushing for this bill:

https://utahapa.mypanetwork.com/page/696-utah-s-b-28-physician-assistant-mental-health-practice-amendments

And it gets much worse than this as their original proposal was for PAs to complete either 10,000 hours of post-PA practice or 4,000 hours plus  DMS/residency. Looks like the PAs pushing for this have significant stake at one of the DMS programs in Utah.

I mean, who needs NP and MD opposition when we have PAs trying to undermine our own profession

 

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What the hell is wrong with them? If they succeed in this they will be holding up a new "standard" that other states will think they need to meet.

I have no desire to obtain a fluff DMsc to enable me to practice. 

Does the remainder of the text in this bill allow complete and utter independent practice with fill reimbursement? If not then it's a terrible idea. 

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22 minutes ago, MediMike said:

What the hell is wrong with them? If they succeed in this they will be holding up a new "standard" that other states will think they need to meet.

I have no desire to obtain a fluff DMsc to enable me to practice. 

Does the remainder of the text in this bill allow complete and utter independent practice with fill reimbursement? If not then it's a terrible idea. 

I read through it, and it doesn't look like it.

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AAPA needs to be advised of this so they can come out against it.....

NCCPA as well

if the two national agencies come out against, and maybe even PAFT then it should die a quick death 

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  • 1 month later...

It appears that the first part that passed is a good thing. Independence after 10,000 hours of supervised work. I'm not so sure that I agree with the mental health bill, but maybe this is an improvement in the current situation in Utah. 

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Weird, I don't see the same text from webpage. 

https://le.utah.gov/~2021/bills/static/SB0027.html

 

307          Section 9. Section 58-70a-503 is amended to read:
308          58-70a-503. Unprofessional conduct.
309          (1) "Unprofessional conduct" includes:
310          (a) violation of a patient confidence to any person who does not have a legal right and a
311     professional need to know the information concerning the patient;
312          (b) knowingly prescribing, selling, giving away, or directly or indirectly administering,
313     or offering to prescribe, sell, furnish, give away, or administer any prescription drug except for
314     a legitimate medical purpose upon a proper diagnosis indicating use of that drug in the amounts
315     prescribed or provided;
316          (c) prescribing prescription drugs for oneself or administering prescription drugs to
317     oneself, except those that have been legally prescribed for the physician assistant by a licensed
318     practitioner and that are used in accordance with the prescription order for the condition
319     diagnosed;
320          [(d) failure to maintain at the practice site a delegation of services agreement that
321     accurately reflects current practices;]
322          [(e) failure to make the delegation of services agreement available to the division for
323     review upon request;]
324          [(f)] (d) in a practice that has physician assistant ownership interests, failure to allow
325     [the supervising] a physician the independent final decision making authority on [patient]
326     treatment decisions[, as set forth in the delegation of services agreement or as defined by rule]
327     for the physician's patient;
328          [(g)] (e) violating the dispensing requirements of Chapter 17b, Part 8, Dispensing
329     Medical Practitioner and Dispensing Medical Practitioner Clinic Pharmacy, if applicable; [or]
330     and
331          [(h)] (f) falsely making an entry in, or altering, a medical record with the intent to
332     conceal:
333          (i) a wrongful or negligent act or omission of an individual licensed under this chapter

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On 3/4/2021 at 12:22 AM, PACali said:

Weird, I don't see the same text from webpage. 

https://le.utah.gov/~2021/bills/static/SB0027.html

 

307          Section 9. Section 58-70a-503 is amended to read:
308          58-70a-503. Unprofessional conduct.
309          (1) "Unprofessional conduct" includes:
310          (a) violation of a patient confidence to any person who does not have a legal right and a
311     professional need to know the information concerning the patient;
312          (b) knowingly prescribing, selling, giving away, or directly or indirectly administering,
313     or offering to prescribe, sell, furnish, give away, or administer any prescription drug except for
314     a legitimate medical purpose upon a proper diagnosis indicating use of that drug in the amounts
315     prescribed or provided;
316          (c) prescribing prescription drugs for oneself or administering prescription drugs to
317     oneself, except those that have been legally prescribed for the physician assistant by a licensed
318     practitioner and that are used in accordance with the prescription order for the condition
319     diagnosed;
320          [(d) failure to maintain at the practice site a delegation of services agreement that
321     accurately reflects current practices;]
322          [(e) failure to make the delegation of services agreement available to the division for
323     review upon request;]
324          [(f)] (d) in a practice that has physician assistant ownership interests, failure to allow
325     [the supervising] a physician the independent final decision making authority on [patient]
326     treatment decisions[, as set forth in the delegation of services agreement or as defined by rule]
327     for the physician's patient;
328          [(g)] (e) violating the dispensing requirements of Chapter 17b, Part 8, Dispensing
329     Medical Practitioner and Dispensing Medical Practitioner Clinic Pharmacy, if applicable; [or]
330     and
331          [(h)] (f) falsely making an entry in, or altering, a medical record with the intent to
332     conceal:
333          (i) a wrongful or negligent act or omission of an individual licensed under this chapter

Yea you are looking at SB 27; mental health is SB 28. 
 

Both bills do nothing to help new grads. NPs in Utah can practice independently right after graduating from NP school. I guess we need 5 years to catch up to their level. Not only that, but it only applies to one specialty. So if you’ve been a primary care PA for 5 years and you apply for a specialty job, you will still need to be supervised for 4000 hours, meanwhile they can hire a new grad NP who does not need supervision. Both bills are hot garbage and terrible precedent. 

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10 hours ago, iconic said:

Yea you are looking at SB 27; mental health is SB 28. 
 

Both bills do nothing to help new grads. NPs in Utah can practice independently right after graduating from NP school. I guess we need 5 years to catch up to their level. Not only that, but it only applies to one specialty. So if you’ve been a primary care PA for 5 years and you apply for a specialty job, you will still need to be supervised for 4000 hours, meanwhile they can hire a new grad NP who does not need supervision. Both bills are hot garbage and terrible precedent. 

"Assistants"....

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  • 2 weeks later...

And both garbage bills have been signed into law meanwhile NPs got FPA.

PAs can now practice independently after 10,000 hours of experience as well as at least 4,000 hours of specialty-specific experience. The mental health bill is so convoluted, I am going to assume is going to affect a handful of people in total, who clearly have a stake at Rocky Mountain DMSc program.

Whoever sponsored the bill must have forgotten that it's not so much about independence, but removing barriers to hiring PAs. If I was an employer looking to hire an APP, why would I want to deal with the convoluted process of getting a PA? 

Maybe it's not too late to become an NP

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6 hours ago, Cideous said:

LOL, I love this.  

And yet, "we are just fine" according to the old guard of PA's.  They are laying waste to this profession for the new PA's...know it....and don't give a damn.

I don't know its so much that they don't give a damn as its "this has worked for 40 years so why change it." or my favorite "I got mine and its working so don't tamper with it."

A recent Huddle conversation started by an old school PA who wants to stop the title change process until we can have a live HOD meeting rather than virtual because we can't make such a big decision without a live meeting and also wants to start a round of data gathering and voting among PAs that would take years.

It boggles my mind.

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5 minutes ago, deltawave said:

Utah just passed full OTP/autonomous practice. No SP required. Also, direct billing by PAs. 

Do people read these bills?
You need 10,000 hours for independent practice and 4000 of these have to be in the same specialty. So lets say you are a GI PA who is out of work, well you can't just get a job in any specialty without supervision. But guess what, they can hire a new grad NP to work without supervision for perceived less liability. NPs in Utah had full FPA passed right before these 2 bills got passed. Think of the optics - so NPs are so well educated they don't require any post-grad supervision, while PAs need 10,000 hours 

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15 minutes ago, deltawave said:

It’s better than nothing at all.

This is how it works when you are not only behind the 8 ball but behind by 5 games. 
 

 

This.... it is great when we can make a sweeping change but these things are more typically accomplished incrementally and slowly. Next legislative session they can  say "see the world didn't end and nobody died" and move on from there.

Here in Texas everything used to get approved for underserved areas only and then later for everyone. It was like the country folk were expendable guinea pigs.

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Watch the other states adopt this terrible precedent, which btw was still opposed by Utah Medical Association. I am not entirely sure who we are even trying to tiptoe around. Also, I am not aware of nurses starting their legislative push anywhere with 10,000 hours of supervised practice as a requirement. Our profession is loosing ground FAST; if we don't turn it around soon enough, we will become second rate providers which we already are in many places.

The idea of independent practice isn't for PAs to go and open specialty clinics on their own - it is to compete with NPs for jobs; I fail to see how this bill advances that goal 

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