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Governor Ducey Issues New Guidance On Elective Surgeries

Posted By Administration, Thursday, April 23, 2020

Governor Ducey Issues New Guidance On Elective Surgeries

Elective Surgeries To Resume May 1 For Health Care Facilities That Meet Preparedness Standards

PHOENIX⁠ — With hospitals reporting increased availability of personal protective equipment (PPE) and bed capacity, Governor Ducey today issued an Executive Order removing restrictions on conducting elective surgeries for hospitals, health care facilities and providers that meet certain preparedness criteria.

Under the new order, hospitals, dental offices and other health facilities can resume conducting elective surgeries on May 1 if they can show they have implemented measures intended to keep health care workers and patients safe. These include:

  • Demonstrating greater than a 14 day supply of PPE;
  • Ensuring adequate staffing and beds;
  • Testing patients prior to surgery and all at-risk health care workers;
  • Ensuring appropriate discharge plans for patients being transferred to nursing care facilities, including diagnostic testing for COVID-19;
  • Implementing a universal symptom screening process for staff, patients, and visitors;
  • Establishing an enhanced cleaning process for waiting areas;
  • And prioritizing the restart of elective surgeries based on urgency.

Facilities that meet the specified standards will need to receive approval from the Department of Health Services before resuming elective surgeries. The order shall be considered for repeal or revision every two weeks.

“Hospitals around the state have stepped up to provide additional protections for their staff and patients and increased bed capacity to prepare for a possible COVID-19 surge,” said Governor Ducey. “Because of these preparations, and the responsible actions of Arizonans across our state, data shows our health system continues to remain ahead of the curve. Today’s order continues to prioritize public health while improving access to care for Arizonans and the overall viability of our health care system.”

“The Arizona Department of Health Services has worked closely with our health care providers as they’ve expanded capacity and overall preparedness to prepare for a potential surge in COVID-19 cases,” said Dr. Cara Christ, Director of the Department of Health Services. “Today’s order ensures that adequate protections remain in place as health care facilities expand operations and that public health remains our top priority.”

On March 19, Governor Ducey announced new actions to help preserve hospital equipment and protective gear, including suspending elective surgeries. A week later, the Governor issued an Executive Order requiring hospitals to increase the amount of hospital bed capacity in the state, take steps to optimize staffing levels and maximize critical resources. Expanded reporting requirements have helped the Department of Health Services track capacity and availability of resources.

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Tags:  Legislative 

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Governor Ducey Announces Antibody Tests For Health Professionals, First Responders

Posted By Administration, Wednesday, April 15, 2020
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Ambulance Transport and Referrals to Alternate Care Sites

Posted By Administration, Tuesday, April 14, 2020

Society PA,

As hospitals and emergency departments hit a critical surge of ill patients, Emergency Medical Services (EMS) can keep medically appropriate patients at home or refer patients to alternative destinations to decrease the burden on acute care settings. On April 4, 2020, the State Disaster Medical Advisory Committee approved the implementation of the Treat and Keep Home and Treat and Refer guidelines. These strategies will reduce the number of patients seeking medical care at hospitals when hospitalization is not clinically necessary.  

The Arizona Department of Health Services recommends that healthcare providers and healthcare facilities do the following: 

  • Familiarize yourself with the guidelines available under Treat & Refer Resources on the EMS and 9-1-1 Resources
  • Share this HAN with healthcare partners across the healthcare spectrum, including hospitals, urgent care facilities, doctors’ offices, and all levels of long term care facilities.
  • Partner with your local EMS agencies in implementing these guidelines, as they will help decrease the burden on the acute care settings, conserve PPE, and limit further risk of spread of COVID-19.

Please contact the Bureau of EMS & Trauma System at EMSCOVID@azdhs.gov with questions regarding Treat & Refer.

Thank you,
Arizona Health Alert Network

Tags:  Legislative 

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Arizona PA Board Declaration

Posted By Administration, Sunday, April 12, 2020
Updated: Saturday, April 11, 2020

April 10, 2020

Arizona PAs,

As a follow-up to our last communication (3/31/20), we would like to update you on the Association’s activities as it relates to the COVID-19 public health emergency.  As previously cited, prior to COVID-19, Arizona was one of only 14 states that waived physician supervision requirements for PAs during emergencies or disasters (Arizona Revised Statues 32-2535).  ASAPA leadership has been working closely with our lobbyist team and the Arizona Regulatory Board of PAs (ARBoPA) for clarification of this statute to determine if any process needed to be followed in order for it to be enacted. 

ASAPA provided public comments during the ARBoPA teleconference meeting on April 2, as they considered recommendations to submit to the Arizona Department of Health Services (ADHS) regarding PA licensing as it relates to responding to the current COVID-19 crisis. 

ASAPA has also been in communication with both the Governor’s Office and the ADHS requesting their prompt approval of the ARBoPA request to allow PAs to practice without supervision, as provided in A.R.S 32-2535. 

We are pleased to report that as of April 10, ARBoPA has released the following statement which has been approved by the appropriate authorities:

TEMPORARY LICENSURE FOR PHYSICIAN ASSISTANTS DURING THE COVID-19 STATE OF EMERGENCY AND WAIVER OF SUPERVISION REQUIREMENT FOR LICENSED PAs

The Arizona Regulatory Board of Physician Assistants announces the following available temporary emergency licenses for Physician Assistants (PAs) to practice in Arizona and the waiver of certain requirements during the COVID-19 State of Emergency:

  • PAs licensed in another state are eligible to apply for temporary licensure in the State of Arizona using the emergency temporary licensure application. The application fee is waived and, if granted, the PA licensed in another state may practice in Arizona without physician supervision for the duration of the State of Emergency.
  • For PAs currently licensed in the State of Arizona, the requirement to have a written delegation agreement with a supervising physician during the State of Emergency is waived for those PAs wishing to providing care in response to the State of Emergency.
  • Recently graduated PAs, who have not yet taken and passed the PANCE, may apply for a temporary emergency license; however, the requirement to practice pursuant to a signed delegation agreement with an Arizona licensed Supervising Physician remains in effect.

Additionally, we would like to commend Governor Ducey, for proactively including the PA profession in the “Good Samaritan Order” released on April 9.

We would like to thank Arizona PAs for their support and patience as we worked with the appropriate entities to address the need for PAs to practice medicine without administrative barriers during a time of emergency. 

We hope you are all staying healthy as you navigate the many demands of your personal and professional lives during these unprecedented times.  We cannot thank you enough for contributing to the health of Arizona, and the nation, as we know some of you may be redeploying to other states in response to their public health needs.

Sincerely,

Arizona State Association of Physician Assistants Leadership


Tags:  Legislative 

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Legislative Update

Posted By Jen Feirstein, ASAPA Legislative Committee Chair, Tuesday, June 18, 2019
Updated: Monday, June 17, 2019
ASAPA Legislative Update – June 15, 2019

On May 10, 2019, Governor Ducey signed
HB 2519, which increases the physician to PA ratio from 1:4 to 1:6.  Accordingly, as of the general effective date of August 28, 2019, physicians will be able to supervise up to six PAs at any given time.  The original language and intent of HB 2519 was to change the term ‘supervision’ to ‘collaboration’ in Arizona PA legislation.  However, due to multiple stakeholder meetings, which included ASAPA leadership, physician professional organization leadership, malpractice insurance representatives, and legislators, and with the advisement of our association lobbyist, ASAPA opted to support a strike-everything amendment that changed the intent of the bill to that of increased physician to PA ratios.


ASAPA believes that the increased physician to PA ratio demonstrates progress toward the key elements of model PA legislation, which includes unlimited physician to PA ratios.  Additionally, it may decrease barriers to hiring PAs in large hospitals or medical organizations that utilize multiple physicians and PAs that all cross-collaborate.  The process of working on HB 2519 throughout the last Arizona legislative session was critical for the re-introduction of ASAPA and the PA profession to Arizona legislators.  It also allowed for incredible insight into the priorities and goals of our physician colleagues and their professional organizations.  This will be highly important as we start to plan and strategize for future legislative efforts that impact Arizona PAs.

Please reach out to the legislative committee or the Board of Directors of ASAPA with any questions about this legislative update.  We also encourage you to provide any support you can with regard to ASAPA’s future legislative efforts.  One of the most effective ways you can support legislative efforts is through your continued membership in ASAPA, and by promoting membership to your PA colleagues that may not be current members.  Membership applications can be found on the ASAPA
website.

Sincerely,


Jennifer Feirstein, MSPAS, PA-C, DFAAPA
Chair, Legislative Committee
Arizona State Association of Physician Assistants

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PA Prescribing of Schedule II and III Controlled Substances

Posted By Jen Feirstein, ASAPA Legislative Committee Chair, Tuesday, January 22, 2019
Updated: Friday, February 15, 2019

Update – February 15, 2019

 

Many of you likely already saw the announcement sent out yesterday from the Arizona Regulatory Board of PAs (ARBOPA); however, ASAPA also wanted to send official notice to our members that Governor Ducey has signed HB2075 (SB1108).  The bill had an emergency clause so it is immediately effective.  Any disruptions or barriers to the appropriate prescribing of schedule II and III controlled substances by PAs should now be resolved. 

 

If you encounter any difficulty with prescribing these substances, please refer the pharmacy/pharmacist to the final bill signed into law on February 14, 2019.  If you still encounter barriers after referencing HB2075, please reach out to ASAPA so we can communicate with ARBOPA and the Pharmacy Board.

 

We are proud of the work that went into resolving this issue, and are thankful to our membership for supporting the organization.  Your membership allows for support of our Association lobbyist, an invaluable partner when working on such serious matters affecting PA practice in Arizona.  We urge you to tell your PA colleagues about this situation, and invite them to help make the Association even stronger by becoming members themselves.  Membership applications can be found on the website.

 

Please feel free to reach out with any questions.

 

Sincerely,

 

Jennifer Feirstein, MSPAS, PA-C, DFAAPA

Chair, Legislative Committee

President

Arizona State Association of Physician Assistants


 

Update – February 12, 2019

 

This is an update to prior memos regarding the disruption to schedule II and III controlled substance prescribing. 

 

We are pleased to report that as of February 11, 2019, HB2075 (SB1108) has been passed by both chambers of the Arizona legislature.  The final bill is now ready for review and signature by Governor Ducey, at which time it will be immediately effective.  The Governor has five days to complete this action.

 

We would like to thank the PAs of Arizona for your patience as ASAPA worked with our Association lobbyist and ARBOPA to correct this legislative misinterpretation as expeditiously as possible.  This situation presented a significant barrier to PA practice causing patients to experience unnecessary interruptions in accessing needed medical care.  However, we do feel the resultant legislation is even stronger in identifying and clarifying PA prescriptive authority.

 

Please feel free to reach out with any questions.

 

Sincerely,

Jennifer Feirstein, MSPAS, PA-C, DFAAPA
Chair, Legislative Committee
President
Arizona State Association of Physician Assistants


Update – January 31, 2019

 

This is an update to prior memos regarding the disruption to schedule II and III controlled substance prescribing. 

 

The amendment to SB1108 (corresponding HB2075) was adopted in the Senate Health and Human Services (HHS) committee on January 30th without any discussion or opposition.  The bills are now ready to be voted on by their respective chambers, and if approved, the last step in this process will be Governor Ducey’s signature.  We will continue to provide the membership with updates as they are received.  Please feel free to reach out with any questions.

 

Sincerely,

Jennifer Feirstein, MSPAS, PA-C, DFAAPA
Chair, Legislative Committee
President
Arizona State Association of Physician Assistants



Update – January 25, 2019

This is an update to the prior memos of 1/21/19 and 1/23/19 regarding the disruption to schedule II and III controlled substance prescribing.

The amendment to HB2075 was adopted in the House Health and Human Services (HHS) committee on January 24th without any discussion or opposition. The same amendment will now be introduced to SB1108 at the Senate HHS committee on Wednesday, January 30th. We continue to have consensus around this issue, and are optimistic that the Senate amendment will be adopted as seamlessly as the House amendment. The next step would be for both bills to go to their respective chambers for a vote, and then the bill would be ready for signature by the Governor.

As mentioned previously, ASAPA is working closely with our Association lobbyist, who has assured us this is the fastest possible process for getting this situation resolved. We will continue to provide the membership with updates as they are received. Please feel free to reach out with any questions.

 

Sincerely,

Jennifer Feirstein, MSPAS, PA-C, DFAAPA
Chair, Legislative Committee
President
Arizona State Association of Physician Assistants


Update – January 23, 2019

 

This is an update to the prior memo sent on January 21st.  ASAPA is continuing to work very closely with our Association lobbyist and the Arizona Regulatory Board of Physician Assistants on the controlled substance prescribing issue that is limiting PAs to prescribing a 72-hour supply of schedule II and III controlled substances.

 

As of this morning, an amendment to HB 2075 has been introduced by Senator Nancy Barto.  HB 2075 is a fast-track bill moving through the Legislature to address e-prescribing issues associated with the enactment of the Opioid Act during the 2018 legislative session.  The proposed amendment is attached and addresses the practice barriers PAs have been experiencing in the past week.  Since this is a fast-track bill it would take effect upon signature by Governor Ducey.  There continues to be consensus among physicians and hospitals over the need to correct the interpretation that has created this prescribing limitation so ASAPA continues to be optimistic that this situation will be resolved quickly.

 

ASAPA will continue to communicate updates with you as they are received.  Thank you for your membership in ASAPA; members are vital for supporting advocacy and legislative efforts. If you have colleagues that would like to further support the organization by becoming a member, please direct them to our membership page

 

Sincerely,

Jennifer Feirstein, MSPAS, PA-C, DFAAPA
Chair, Legislative Committee
President
Arizona State Association of Physician Assistants

 


On January 17, 2019, ASAPA was made aware of many practicing PAs in Arizona being told by pharmacies that PAs can only prescribe a 72-hour supply of schedule II and III controlled substances.  The Association has been actively pursuing additional information and working to resolve the problem.

 

Here is what we know as of this writing:

 

During the 2018 legislative session, HB 2250 passed, which was intended to certify PAs for 90-day prescription privileges for non-opioid schedule II and III controlled substances.  Unfortunately, the final language that was passed in HB 2250 (attached) is being interpreted to restrict the prescribing of schedule II and III controlled substances to 72-hours.


HB 2250 was intended ONLY to increase the prescribing limits of non-opioid schedule II and III controlled substances to 90 days, and to otherwise leave prescribing privileges unchanged.  Unfortunately, explicit language was not included that indicated the ability to prescribe for up to 30 days was remaining unchanged. 


After HB 2250 passed, ASAPA testified at both the rule-making hearing and at the Arizona Regulatory Board of Physician Assistants (ARBOPA) board meeting expressing concerns about possible misinterpretation. 


ARBOPA now understands our concerns and we are working very closely with ARBOPA and our association lobbyist to identify the most expeditious solution to this problem.  Currently, it appears this will likely occur in the form of amending a fast-track bill moving through the Legislature to address e-prescribing issues associated with the enactment of the Opioid Act during the 2018 legislative session.  There is consensus among physicians and hospitals over the need to correct the interpretation that has created the prescribing limitation.


ASAPA will communicate updates with you as they are received.  Please be ready to reach out to your legislators, if needed.  We are aware of the significant burden this is placing on PAs, especially PAs practicing in pain management and other disciplines that regularly prescribe these medications.  Please know that we are doing everything in our power to resolve this barrier to PA practice and to the health care needs of our patients.


Sincerely,

Jennifer Feirstein, MSPAS, PA-C, DFAAPA
Chair, Legislative Committee
President
Arizona State Association of Physician Assistants

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Voting Guide to the Arizona Ballot Propositions

Posted By Administration, Wednesday, October 3, 2018
Preparing for elections in November?  A Voting Guide to the Arizona Ballot Propositions has been prepared by the ASAPA lobbyist team at Goodman Schwartz Public Affairs.  ASAPA members can access this guide under the Members Only tab.  You must be logged in.

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Impending Opioid E-Prescribing Mandate Guidance

Posted By Administration, Tuesday, September 11, 2018

Action Alert – Impending Opioid E-Prescribing Mandate Guidance

One of the most significant provisions of the Arizona Opioid Epidemic Act, SB 1001, is the prescriber electronic transmission requirements for prescribing opioids. Electronic prescribing of controlled substances (EPCS) mitigates prescription fraud to prevent the occurrence of fake prescriptions, as well as reduces prescribing errors and improves the accuracy of medication dispensing. These new requirements go into effect in 2019.

Opioid E-Prescribing Requirements
Beginning January 1, 2019, each prescription order for a Schedule II opioid in
Maricopa, Mohave, Pima, Pinal, Yavapai, and Yuma counties must be transmitted electronically to the dispensing pharmacy. The only exception is for Medication Assisted Treatment (MAT) for substance use disorder, or if a waiver is granted to a prescriber (see below).

Beginning July 1, 2019, these same requirements go into effect in Greenlee, La Paz, Graham, Santa Cruz, Gila, Apache, Navajo, Cochise and Coconino counties.

Link to E-Prescribing Requirements in SB 1001 Bill Language

Take Action for Compliance
We urge you to assess your clinical practice capacities and determine if you are compliant with these impending opioid e-prescribing requirements to avoid and/or
minimize any disruption to your practice and patients.

It is important to note that e-prescribing controlled substances must satisfy the Drug Enforcement Administration’s Electronic Prescriptions for Controlled Substances (EPCS) system requirements and may cost more than basic e-prescribing. Many of the most common electronic health record vendors have both e-prescribing and EPCS capabilities so contact them for more information. To find out if your EHR vendor is EPCS-certified, you can also check the Surescripts website.

Request a Waiver, if Necessary
Pursuant to
Arizona Revised Statutes 36-2525 Q., the Arizona State Board of Pharmacy is required to grant waivers to medical practitioners who lack adequate access to broadband or face other hardships that prevent implementation of EPCS. The maximum duration for a waiver is up to one year.

If you determine you will be unable to meet the EPCS e-prescribing requirements, please submit a waiver using this link to the Arizona Board of Pharmacy as soon as possible: Waiver Form Link

DO NOT DELAY! The deadline to get a waiver to the Arizona Board of Pharmacy for consideration before 2019 is November 15, 2018. Once the waiver form is completely filled out, email the form to pmp@azpharmacy.gov.

Questions & Feedback?
If you have questions about EPCS, additional information is available on the Health Current website or you may contact them for phone-based support at 602-688-7200.

Tags:  Legislative  Opioid 

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ASAPA Sends Letter to U.S. Congress Regarding Medicaid

Posted By Administration, Friday, January 6, 2017
Download the attached document to view the letter.

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