Missouri academy of physician assistants

President's Corner

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  • July 14, 2014 9:48 AM | Deleted user

    I wanted to take a few minutes to update everyone on events that occurred yesterday in Jefferson City that effect the PAs of Missouri. Yesterday Governor Nixon signed into law several pieces of legislation that were passed during the 2014 legislative session. For PAs, this signing was a good news/not so good news event.

    Governor Nixon signed into law Senate Bill 808 which included language that clears the path for PAs to be enrolled as Missouri Medicaid providers. We will be meeting with leaders from MO Medicaid next week to discuss the process by which they will begin enrolling PAs as Medicaid providers. This is very good news for those of us who see Medicaid patients as well as for employers who have clinics with a significant Medicaid population as we have identified this issue as one that has proved to be a barrier to PA hiring in certain settings. As we receive more information regarding the enrollment process, it will be distributed to all of you.

    On a not so positive note, Governor Nixon also signed into law Senate Bill 754 which contained language calling for the Board of Healing Arts to license “assistant physicians”, medical school graduates who have not completed a residency. This has garnered quite a bit of state wide as well as national attention. I will list below the links to responses from AAPA, AAFP and AMA for you to review and possibly share with your physicians. This creation of a new “profession” is certainly not something we are celebrating but however, we will be using the attention and publicity it is getting to continue to promote, inform and work to improve the utilization of PAs in Missouri. We will continue to monitor the rule promulgation process for this new law as well as work to maintain the best, most open and productive communication between our organization and the Missouri legislature to ensure that we continue to identify better ways that PAs can work to help solve the identified healthcare issue of provider shortages. Please know that I, as well as the entire MOAPA board, will not rest until we feel that the PA profession is being used to its maximum capacity, both in numbers of PA working as well as practice scope to help serve the health care needs of Missouri.

    This new law is somewhat unchartered waters, but as with anything we send out, please feel free to contact me directly with any questions, concerns or comments about what is above or any PA issue. We are here to serve the PAs of Missouri and if you have a need or a question, we are here to provide the necessary answers or resources you require. Hope to see everyone in Branson next weekend, spaces are still available!!
    Again, here are the links to review the responses from some of the national organizations.

    AAPA- http://www.pasconnect.org/aapa-andmoapa-update-for-pas-on-missouri-legisaltion/
    AMA- http://www.aapa.org/twocolumn.aspx?=2765
    AAFP- http://blogs.aafp.org/cfr/leadervoices/

    Paul Winter
    MOAPA President
    314 374-8033

  • February 25, 2014 8:45 AM | Deleted user

    Hope everyone if weathering this brutal Winter season. I know we are all anticipating a warm up. In an effort to better and more frequently communicate events and information pertinent to our profession I wanted to take a few minutes of your time to bring all of you up to speed on some information and items that I feel will be of interest and importance to our profession as well as organization.

    Legislative Updates
    Although we are anticipating having a fairly “quiet” legislative session in 2014, there are a few bills that we are closely monitoring even though they are not bills we introduced.

    HB 1842 - This bill has been introduced by Rep. Fredrick from Rolla, who sponsored our legislation last year. This bill is called the “assistant physician” bill. He has introduced a bill that would give people who graduated medical school, but have not matched for a residency, standing as an “assistant physician” and would give them the ability to practice under a physician but only in an under-served setting. This bill also would make it so that the Board of Healing Arts would promulgate rules for PAs, NPs and assistant physicians, and that the rules would be the same for all three. This bill has not been scheduled for hearing so not sure what kind of traction it will get, but it is out there in case any of you hear about this.

    HB 1491 - A bill introduced by the nurses which really seems to define each level of nurse out there. LPN, RN, clinical nurse specialist, APRN, etc. There does not seem to be mention of collaborating agreements in this bill.

    HB 1481 - Also introduced from the nurses and more specifically APRNs, this bill maintains the requirement to have a collaborative agreement but changes the requirements of the agreement. No mention of any onsite requirement but rather that the amount of collaboration will be determined by the physician and APRN. The bill mentions that the physician must be available via reliable electronic means. There are also chart review specifications listed. This bill was heard in Senate committee on Feb. 17 and there were 5-6 state physician organizations testifying against this bill. I believe the nurses and MO Hospital Assoc testified in favor. No mention of a committee vote scheduled at this time

    MOAPA will closely monitor these bills and will communicate further information as it becomes available.

    Lastly on the legislative front, we will be introducing language to remove the wording in our current law regarding “billing patients directly.” Language in our current law has caused some delay in progressing our MO Medicaid provider status. We tried to work this out through MO Medicaid but have not been successful, so we will work with the legislature to have this wording removed from our law which we hope will help facilitate this process. Our lobbyist, Jorgen Schlemeier, has indicated that he will introduce this language change to a bill that is showing movement during the session. This will probably not require a big push from us at this point as we are allowing Jorgen to do what he does which is navigate through the legislative process. This too will be information that will be passed along to all of you as things develop.

    Organization Updates
    PR Update - This past week MOAPA signed an agreement with The Vandiver Group to provide a public relations push for The PA profession in Missouri. This idea was approved by the board and has been communicated to the membership and was met with overwhelming support. We will be working with this group very soon to begin implementing the campaign to help promote the profession in an effort to hopefully improve in the following areas: public awareness, improved job market, and promotion of MOAPA to all of the PAs in the state to help increase membership and involvement. We are very excited about this endeavor and are confident that this will help continue to move the profession forward.

    Board of Director Changes - Ashley Schnell resigned from the MOAPA Board of Directors as the SW Director at Large as her family responsibilities have increased and she was concerned about being able to adequately meet the needs of the position. We first want to thank Ashley for all of the time and effort she put into the SW region and secondly, thank Melanie Chisam for accepting my request to be appointed to that position in the interim until elections in July. The SW region is so vibrant and active so thanks to Melanie, there will not be a lapse in leadership in that region. If anyone lives in the SW region and has not heard from Melanie, please reach out to her at melaniechisam@gmail.com and give her your contact info.

    In addition, Joe Grassino served as our VP for the past few years and has also felt the strong family and job pull and made the difficult decision to resign from the MOAPA board. We want to extend sincere thanks to Joe for the time and effort he also donated to the organization and to the progression of the profession. Johanna Scheussler from the St. Louis area has been gracious enough to accept the appointment as interim VP pending July elections. The VP position is very important to MOAPA as this position is vital in membership retention and growth. If anyone would like to contact Johanna, her email is jschuess@gmail.com.

    CME Reminder
    Mark your calendars now for the MOAPA Summer CME in Branson. The dates of the conference are July 17-20, 2014. Registration information will be coming out soon but please make plans to attend as this is a great CME as well as a great chance to support your organization. In addition, if any of you have contacts with individuals willing to give talks or if you have a topic that you are willing to speak on, please reach out to Melanie Chisam and let her know. In addition, if you know anyone who would like to display at the conference, such as a medical device company, pharmaceutical company or any company interested in doing direct person-to-person advertising, again, let Melanie know as this is another great way to support MOAPA. Also, elections will be held during the conference and any current fellow member can run for a board position. Please email Johanna Schuessler with any nominations.

    Pre PA Club - I have recently been introduced to a trend that seems to be gaining popularity around the country and that is colleges having “Pre PA” clubs. The University of MO in Columbia has such a club that meets monthly and at times can have 100 people attending. I spoke at their meeting on Feb. 20 and was amazed at the energy these people are putting into pursuing the PA profession. I'm not sure if any other Universities in MO have such an organization but if so, please let us know as we need to do what we can to support and help these people in their pursuit. One of the main items that they expressed to me where they need help is with shadowing opportunities. Now I know all of us get blasted with these but please keep in mind that almost all of the PA schools require shadow hours from these applicants. And in some cases, ridiculous amounts of shadow hours are a requirement. So here is my request, everyone really open your job and your day to allowing someone to shadow, even two times a year!! If everyone participated then the few who do currently will not get blasted with requests. I fully understand the time constraints we all have, the HIPAA hoops out there, etc. But keep in mind, we were all in their position at one time and it may have been a PA who was willing to give you an extra few minutes of their time that helped motivate you or even directly helped you get into PA school. So guess what, PAY BACK TIME!! I gave the group I spoke to last night my word that we would promote the importance of PAs allowing perspective PA students to shadow, so please carefully consider. I encourage all of your to register with www.pashadowonline.com, as this is a great tool that you can use to help schedule shadow time that works best for you as well as put a cap on how many you are willing and able to accommodate. There is a link to this site on the MOAPA website as well.

    Lastly, our next MOAPA Board Meeting will be held Saturday, March 1, 10 a.m., at Missouri Baptist Medical Center in St. Louis. All are welcome to attend.

    I hope you found this information informative as well as pertinent to your practice or interests. As always, I welcome questions, comments, suggestions about how best to deliver information as well as any way we can improve MOAPA or advance our profession. Thanks.

    Paul Winter
    MOAPA President
    314 374-8033

  • December 16, 2013 3:13 PM | Deleted user


    As 2013 comes to a close I felt this was a good opportunity to send out an update on all things MOAPA-related. It has always been my belief that I did not want to overload the membership with endless emails and it is better to wait until there is something significant to report. But, as I compile the items that need to be communicated, I realized it was longer than I had anticipated and I have also received feedback from members requesting more frequent updates. So therefore, I will make every effort in 2014 to do more frequent updates, even if they are very brief, to make sure that the lines of communication are as open as possible within the manpower constraints that we have. My goal will be monthly or every other at the least. Thank you to the members who have expressed this desire for more frequent communication; we will heed your request! Now for the latest activity and updates:

    MO Medicaid Update - This has been a bit slower moving than I had anticipated. If you recall from previous updates, there were questions regarding language in the current PA statute regarding PAs billing patients directly and this was called into question by MO Medicaid. We have submitted a legal opinion and are still waiting for a ruling from their General Counsel. In the meantime, there has been another director change at MO HealthNet which has thrown another monkey wrench/delay into the process. But rest assured, we are diligently working on trying to push this through and I know many of you are carefully monitoring this as it directly impacts your practices as well as future PA employment opportunities. In the next few weeks, Jorgen hopes to be meeting with the new director who is assuming the duties mid-December. More to follow.

    Elections - Elections for MOAPA Board of Directors will be held at the Summer CME Conference in July 2014. Any current fellow member may run for any board position. I will be working on a list of duties for each position to better give anyone considering a board position an idea of what the duties may entail. Having a board position is the best way to be involved in the decisions that help shape the organization and impact the profession throughout the state. Previous knowledge or experience is not required. All that is needed is a desire to be involved and work to move the profession and MOAPA forward. Please consider. If you have questions about any specific position beyond what is defined on the website, please feel free to reach out to me directly and I will try and help clarify. 

    Membership Process Change - In an attempt to make joining and renewing an easier process for the individual members as well as the organization, we now have the option of automatic renewal when joining or renewing. If you choose the recurring dues option, your membership will automatically renew, avoiding the possibility of lapsing without knowing. If you have any questions about this process, email Whitney Bertram at info@moapa.org. We are hoping this is a welcomed addition to the membership process.

    Branson CME - Mark your calendars for the 2014 MOAPA Summer CME which is scheduled for July 17-20, 2014. This is a great, reasonably-priced CME which is also another way to support your state organization. The 2013 conference was a huge success and there were some exciting changes that were implemented so we are hoping to springboard from the 2013 success and make 2014 even more successful. Save the date!

    District Map - Eric Johnson, Mid MO Director at Large (DAL), has created a map of Missouri that divides up the MOAPA regions by county. This is available on the website. If you are not sure what MOAPA region you reside in, this map should help clarify. Anyone is welcome to attend any MOAPA function regardless of region but it is important to know your region to be able to identify who your DAL is and be dialed into the events in your area.

    BOHA PA Commission - The Missouri Board of Healing Arts (BOHA) PA Commission is looking for two PAs to serve. To complete an application, a very extensive application, go to boards.mo.gov and search for PA Commission.

    Pre-PA Groups - At the last board meeting, we were introduced to new concept that is popping up on college campuses throughout the state: Pre-PA Groups. We received a presentation from someone who formed one at University of MO-Columbia and at his first meeting he had 50 people show up and the second it grew to greater than 75. Other schools are also forming these. We are looking to work with these groups to provide informational resources, shadowing opportunities and just be a resource to answer any questions they may have. The board found this to be very exciting so if you encounter any of these groups please try and help them in whatever manner you can.

    Public Relations Proposal - Collectively, we are all still very happy with the legislative victories we enjoyed this past Spring/Summer. The bills that we passed were truly profession changing in Missouri. However, it appears that this the communication of these changes to our laws has not really gotten out to the masses, i.e. employers, as we had hoped. Therefore, I don’t believe any of us have seen the “job needle” move appreciably in the direction we would have hoped and quite frankly need. Therefore, the board has investigated hiring a PA firm to professionally and aggressively market our profession to potential employers. This coming right on the heels of this monumental legislation passage. And when we say employers, the goal is to leave no stone unturned. We want to all provide quality patient care but we need to be employed to do that and I am assuming we would all be in agreement on this. The organization does not have the resources to effectively accomplish this, so this is why the concept of hiring a PR firm came to light. We are still in the preliminary stages of this proposal as this will NOT be an inexpensive undertaking. We must therefore really examine the finances of MOAPA, see what we are able to afford, and then evaluate if we have enough financial resources to go ahead with this. The frustrating thing is that we have more than enough “people” resources in the state to afford this but we are trying to do this by having 225 people carry the water for nearly 900! The board members that attended the strategy planning session with the PR firm left very motivated and excited to want to move forward with this as it is not a "want" but really a "need." Between SLU and MSU, they are graduating over 60 PAs this week. If even half of them want to stay in Missouri, does anyone know of 30+ jobs out there? We must do something different as we are all familiar with the definition of insanity. Take this as another call to action to seek out, dialogue and encourage your friends and colleagues who are not members to join and help this organization continue to move the PA profession forward. We have great momentum but we need resources to keep it going.

    Membership - This was mentioned above, but to add on to that, a membership drive will be commencing in the early part of 2014 as we are compiling lists to try and identify who and where the PAs are located who are not members so we can reach out to them and encourage their membership. Maybe they just don’t know how to access us so we will take the message to them. If you know of any PAs that are not members, please invite them to a regional event, encourage them to contact a board member if they are unsure of why they should join or if they have any questions at all. We need all hands on deck to truly experience maximum success.

    Thank you for talking the time to read though this extensive but important list of updates. I hope you find the information useful and as always, if you have any questions about something you read or have suggestions, please feel free to contact me directly either by email or call me. The MOAPA Board of Directors want to wish everyone a happy Holiday Season!

    Paul Winter
    MOAPA President

  • September 09, 2013 1:30 PM | Deleted user

    As the Labor Day holiday is now behind us, this signals the end of the summer 2013. This seemed like an appropriate time to send out from MOAPA. This is a bit overdue, and I apologize, as the rigors of the summer piled up on me a bit so therefore this update is getting to you a little later than I had planned. Never the less, I will try and bring everyone up to speed on the most current information that impacts the PAs of Missouri.

    1. As of Aug. 28, 2013, our new onsite supervision laws went into effect. The new requirements state that the physician must be present no less than 4 hours for every 14 day that a PA provides patient services. This will basically null and void the previous waivers that some of you may have had on file with the Missouri Board of Healing Arts.
    2. The law that now identifies PAs as Missouri Medicaid providers has in theory gone into effect but the process has hit some bumps in the road. These bumps in the road are part of the reason for the delay in this update as I was hoping to have more information. Here is the latest: The Missouri Medicaid Audit and Compliance (MMAC) department is the department that will be instrumental in setting up the enrollment process. After this law passed, they identified a line in the current PA statute that states “No PA shall bill a patient independently or directly for any services or procedures”, MO.REV 334.735. This was interpreted by MMAC in a way that called into question whether or not legally they could enroll PAs as Medicaid providers. MOAPA has engaged legal counsel who has drafted an opinion that states that there would not be direct billing by a PA to a patient but rather to a third party payer just like what is done with any other insurance claims process. I have spoken directly with the director of MO Medicaid about this and they have been very cooperative but both MO Medicaid and MMAC, two different departments, just want to be absolutely sure that enrolling PAs as providers will not be a violation of the current statute. I have been told they are scheduled to meet within the next few weeks and will review the legal opinion that MOAPA had prepared and review it with their legal counsel and then make a decision. Worst case scenario would be that they hold their ground on this issue which would force MOAPA next legislative session, to have this section of our current PA law removed through new legislation which would kick us back one year. We did not anticipate this as we never interpreted that section of the law like this so it was basically impossible to foresee this. Never a dull moment is there?
    3. Along the same lines as this, many of you have run into difficulties with having prescriptions written by Pas, and NPs too, for Medicaid patients being refused by several pharmacies especially the Walmart pharmacies. I brought this to the attention of the Medicaid director on a conference call several weeks ago and she was unaware of this. This apparently occurred due to the fact that MO Medicaid identifies providers by DEA numbers and when a mid-level writes a prescription and then places their supervising/collaborating physician’s DEA number on the prescription, as previously done, these were being refused for payment reimbursement because the person writing the prescription and the DEA number needed to match. This was supposed to be clarified with the pharmacies but I am not sure that has occurred or been effective. I have recently been notified by some PAs that Walmart pharmacies are still refusing these prescriptions. I have notified the Medicaid director about this and she has asked that I send her names and addresses of pharmacies that are still refusing PA prescriptions. If any of you have names and addresses of pharmacies that are refusing your prescriptions for Medicaid patients, please email the information to paultwin@aol.com and I will forward it to her. Also, I have asked Jorgen Schlemeier, MOAPA's lobbyist, to reach out again to Walmart corporate in Arkansas to try and deal with this at the corporate level since he represents Walmart as well. We will continue to work to clear this up.
    4. On a much more positive note, our Summer CME Conference in Branson went very well this year. We had a brand new group of PAs organizing the event this year and they hit a home run! Great job to Meredith Cunningham, Melanie Chism, Ashley Schnell and Jeff LeClaire! The event was well-attended, there were great topics and speakers, and the display area was just about full. The group was able to identify ways to decrease some of the costs through educational grants and sponsors which helped defray some of the costs and resulted in a more profitable event. This will directly benefit MOAPA and help us continue to do the work that is needed for the PAs of Missouri.
    5. The MOAPA Board is trying to determine the most efficient and cost-effective way to market the PA profession and the new law changes to prospective employers. I think we have all seen the jobs for mid-levels being opened or at least talked about but PAs are not always included in the hiring plans. Is that due to ignorance about the profession? If so, it is our job to take the information to them and push to get our name into those hiring discussions. This will be high on the priority list.

    All in all, we have a lot to celebrate as we near the last quarter of 2013. Our ship is on a good course from a legislative and organizational standpoint. As discussed above, we still have some hurdles to jump and places where we can improve and progress. Be sure to still take time to celebrate the accomplishments of not only 2013 but the progress that we have made as a profession over the past 5-6 years. For myself and the rest of the board, complacency is not on our agenda and we will continue to move things forward and address the needed issues that impact the PAs of Missouri. We cannot know all of the challenges that you may face so please be a part of the progress of our profession and organization and help the board identify things that need to be addressed, clarified or changed. I guarantee your ideas or questions will be considered, addressed and followed up on but we need to know what they are. Please do not sit on the side lines or your questions to go unanswered. We are available to you, the membership, so reach out.

    Our requests of you from the board are consistent. One, we MUST improve our membership numbers. That is how we survive as an organization as well as how we most effectively get information to the PAs in Missouri. Being a member is not enough; you must address this directly with your colleagues, friends and classmates and start the dialogue about where we have been and where we are and how that happened. It happened by having a living, breathing active state chapter. That chapter needs resources to survive and that is where membership is vital to the survival of MOAPA. If there is ever a question of where your membership dollars go, please contact me directly and I will be glad to review what it takes to keep MOAPA running financially. 

    In addition to membership, stay alert to what is happening in the Missouri PA world. We will always try to keep everyone up to date on the latest developments that affect PAs and will specifically inform you of direct actions we may need from you so be sure to read the information we send out. We try to not flood your world with “soft” information and instead spread information out so that you know the message we send will have direct and timely information. 

    We always need to keep our PAC account funded for assistance with our ongoing legislative goals, so again, we ask every PA to donate $100 per year to the PAC fund. This can be done directly on the website. Please carefully consider donating whatever you are able. 

    Lastly, please take an interest in your work place. Get involved in committees at your job and help with ideas that may not be PA related but just global hospital/clinic initiatives. We as PAs need to be part of those processes to make sure that we are part of the decision making processes in our institutions. Tat takes some sacrifice or time and energy but if we don’t, other professional groups will, and that will continue to keep us on the outside looking it. So, take time to represent your profession to the best of YOUR ability.

    Sorry for the lengthiness of this update but I just felt this was important information that needed to be shared. As always, if you have any questions or comments about the above information do not hesitate to contact me directly either by email or phone at 314-374-8033. Remember to send me any contact information of pharmacies that are refusing your prescriptions and I will forward that information. Lastly, our next Board of Directors meeting is scheduled for Saturday, Nov. 9, 2013 at 10 a.m. The meeting will be held at Missouri Baptist Medical Center in St Louis. Everyone is welcome to attend. Thanks for reading and for your hard work in the name of the profession.

    Paul Winter
    MOAPA President

  • June 13, 2013 9:27 AM | Deleted user

    I just received word that Governor Nixon signed HB315 into law! This will change the amount of on-site supervision for PAs from 66% to 4 hours for every 14 days a PA provides clinical services. This is a monumental achievement for the physician assistant profession in Missouri. It has been a long time coming and has a lot of people's blood sweat and tears on it. This will be effective as of Aug. 28, 2013.

    In addition to this news, the bill that identifies PAs as Missouri Medicaid providers will become law on July 1, 2013 since this was part of an appropriations bill. Obviously more information will be forth coming about what the process will be to enroll PAs into the Missouri Medicaid network. We will continue to work with the Department of Social Services during this process and will pass along any information to help with this exciting transition.

    Lastly, work is still being done to address the recent concern regarding prescriptions being written by PA on Missouri Medicaid patients. We are still sorting out the origin of this as well as what can be done to address this to minimize the effect on your practices and the patients you serve. We thank you for your patience and understanding during these recent events.

    As always, any questions, never hesitate to reach out.

    Paul Winter
    MOAPA President
    314 374-8033

  • June 12, 2013 8:29 AM | Deleted user

    It just came to our attention that pharmacies around Missouri have started notifying practices that since PAs are currently not enrolled as Missouri Medicaid providers they will no longer accept prescriptions that are written for Missouri Medicaid patients written by PAs. We were not notified in advance about this situation and therefore, we found out about this just yesterday. I do not have very much information about the origin of this or why this is happening right now especially with the recent legislation we just passed that would recognize PAs as Missouri Medicaid providers. However, since discovering this yesterday I have already been working with Jorgen Schlemeier in Jefferson City as well as multiple people at AAPA and they are working on this situation as well. As soon as I obtain more information about the "whys" and the now "whats," I will pass that along. I find this recent development extremely frustrating but my frustration won't get it resolved but just know that we are working on the problem currently. If anyone receives any written notification from pharmacies about this, please email it to me as the people at AAPA are requesting any written notifications.

    Thank you for reading this and more information to come.

    Paul Winter
    MOAPA President

  • June 11, 2013 8:43 AM | Deleted user

    Now that we have had a little time to exhale from the legislative session and we await Governor Nixon’s signature on our bills I thought it was a good time to just drop a little note with some organizational updates. A lot of our time on the board is consumed with the legislative issues of the day but we cannot neglect or fail to identify the needs and events that effect the organization as a whole. Please pass any of this information along to your colleagues who may not be on our email list.

    • It with great pleasure that I introduce the newest member to our board, Audrey Massey. She is now our NW Region Director at Large, taking over for Greg Stafford as he needed to resign prior to his term expiring for personal reasons. Audrey is a 2011 graduate from the Pace University PA program and she currently works in Occupational Medicine in the Kansas City area. She is very motivated and we certainly can use the motivation and energy that she possesses as building up the NW region is of paramount importance to MOAPA. If you are living/practicing in this area, please drop Audrey an email with your contact information as she is building her database right now. She may have you on her list already but please do not assume as locating people and having accurate contact information is the biggest challenge the DALs face. Her email is audreymasseypac@gmail.com. She is hoping to have some events in the NW region soon but she needs to know where everyone is located so again, please drop her an email if you live in the NW region.
    • MOAPA is looking for someone to be appointed to the role of Treasurer. Dawn Calabrese is currently the Treasure and has been so for several years but has informed me that she is needing to resign from the board due to needing to meet some changing family needs. Since this is not an election year, a person can be appointed to this position to fill a vacancy until July of 2014 when we will hold general elections. Dawn has agreed to stay in her current role until we are able to secure a replacement. The duties of this position will include a working knowledge of the MOAPA Budget and to maintain adherence to the budget and advise the board of all things related to the MOAPA finances. The day-to-day management, i.e. paying bills, balancing the account, are done by our management company and will not fall on the shoulders of the treasurer so the time commitment is not as burdensome as it may have been in the past. Any current MOAPA and AAPA member who is interested in being a part of the Board of Directors and would like to inquire about the treasurer position, please email or call me directly and I can help answer any questions you may have regarding board responsibilities as well as specific job requirements of the Treasurer. And, on behalf of the board I want to thank Dawn for her many years of service in this role! Her energy and wonderful sense of humor will be missed at our board meetings!
    • Currently we have a vacancy on the board for the President Elect position. The role of this position is to basically work in a training capacity to assume the position of President. There are no specific designated responsibilities other than to be in training under the President to learn the operations of the organization. Again, any current MOAPA/AAPA member is eligible. Basic leadership skills are helpful but not a must but rather a desire to work to continue to move this profession forward in Missouri is what is really needed. Just like the Treasurer’s position, anyone curious about this position please reach out to me and I will be happy to talk with you about the role of President. I will be honest about what it may require but also share with you the huge rewards I have gained through serving as MOAPA President. Keep in mind, if I can learn the position and do it, anybody can!
    • We are very excited about the 2013 Summer CME held in Branson, July 18-21. If you have not registered but need some reasonably priced CME and want to help support your state organization, please go to the website and take a look at the information there about the CME. You can register right on the website. There will be some changes to the format this year that we think will inject some new energy into the event so please consider attending the CME. This is another way to support MOAPA.
    • If you have not already, please check out the MOAPA Facebook page as this has been a great avenue to distribute information as well as a chance for others to ask clinical or practice related questions and stimulate discussion.
    • Last but certainly not least, a recurrent message that needs to always be mentioned is the need to boost membership. If you are unsure about your membership status, whether it is current or when it may expire, please contact Whitney Bertram at info@moapa.org and you can get those questions answered very quick and easy. If you have any colleagues that are not members, please encourage them to join. If there are any issue regarding reasons to join, you can just refer people back to this past legislative session as a quick reference. These bills that contained profession changing language DO NOT PASS without the efforts of this organization! Now the reasons for membership go beyond just this past legislative session but that is just an easy and recent reference point to use if needed. We cannot continue to move this profession forward without having the state organization and we cannot have the organization if we cannot stay financially solvent. Membership is the biggest income source that we have and it will ensure the continued success of the organization as well as the profession here in Missouri. The responsibility of joining as well as encouraging your colleagues to join falls on all of us as individuals! This is not just a board responsibility, this is an individual PA’s responsibility.

    As always, I welcome any questions regarding the items I discussed above as well as anything else MOAPA related that you may have on your mind. I appreciate you taking the time to read this as well as all you do in your practices to represent the PA profession. Call or email me anytime.

    Paul Winter
    MOAPA President

  • June 06, 2013 10:07 AM | Deleted user

    On June 5, Fox 4 News aired a news story about PAs and the recent legislation we passed. It was broadcast in the Kansas City area. If you missed it, visit http://fox4kc.com/2013/06/05/legislation-could-improve-access-to-care-by-physician-assistants/ to watch a recording of the news story.

    Paul Winter
    MOAPA President

  • May 10, 2013 4:30 PM | Deleted user


    Again, it is with great pleasure that I am able to share good, or rather, great news. I received word yesterday that HB11 had passed both chambers of the legislature and will be sent to Gov Nixon for his signature. This bill contains language that identifies PAs as Missouri Medicaid providers. This new law will help us be able to fully serve a population who is truly in need as well as will help employers feel more confident with hiring PAs knowing that PA services are recognized as reimbursable. Keep in mind, we have always been able to be reimbursed by Medicaid but under our supervising physicians which has caused confusion and hesitation by employers to employ us due to this. So this new law should eliminate that confusion!!!

    This combined with the recently passed law that will change our on sight supervision requirements makes this current legislative session one to truly be celebrated. Thanks again to everyone who has helped with this process! Please pass the word about this news to anyone who may not be in the loop of all things MOAPA. And also, if anyone in your circle is not in the loop, please encourage membership as through strength of numbers is how we will continue to move forward.

    There will be more information in the coming months on what the process will be to obtain a Medicaid provider number or how the whole process will unfold. We will always pass along information as it becomes available. Again, thank you for your efforts and never hesitate to contact me with any questions or concerns.

    Paul Winter
    MOAPA President

  • May 02, 2013 1:31 PM | Deleted user


    It is with great pleasure that I write to all of you today as I have wonderful news to report.

    I was notified late Tuesday, April 30 that HB315 passed the Missouri Legislature and will be forwarded to Governor Nixon for his signature. Included in this bill are the supervisory language changes that we introduced this session. Our onsite supervision requirements will change from the current 66% onsite supervision to 4 hours for every 14 days a PA works! In addition, the distance requirement has changed from 30 miles to 50 miles at all locations.

    This is a huge change for our profession and will open our job market and help us better serve the healthcare needs in Missouri. Thanks so much to Jorgen Schlemeier, our lobbyist, for his tireless efforts at the capitol; Liz Roe, from AAPA, for her guidance; and Terry Carlise, on whom I rely frequently for his vast legislative experience as well as his ability to keep me calm and grounded in my desires for our profession. Also, thanks to the entire MOAPA Board of Directors for their work at board meetings, setting the association’s goals and agenda as well as getting the word out to the people in their districts, which is of vital importance. And last but certainly not least, thanks to all of you for the calls, emails and letters to your legislators. We had so little if any real opposition with this and that comes through getting our message out to the lawmakers. All of your efforts are now showing the results of your labor!

    We are still waiting to receive final word on our other legislation which will identify PAs as Missouri Medicaid providers. I am hoping to have an update for you on that next week. The bill is in the final stages and we are anticipating positive news.

    Information on when these bills will take place will be forthcoming in the next few months. We will also let everyone know as soon as Governor Nixon signs these into law, but for now please take some time to celebrate this great victory and feel good that we are continuing to move our profession in the right direction!

    Paul Winter
    MOAPA President

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