Missouri academy of physician assistants

President's Corner

  • April 04, 2013 2:59 PM | Deleted user


    I want to share the latest legislative information that I received today in order to keep everyone up to date.


    1) Our bill was voted out of the Senate Finance Committee with a vote of 6-0!! I do not know when the bill will be on the Senate floor for a vote but will let you know when it’s time to contact your Senators. 


    2) Our House of Representatives version was not brought up for a vote this week as we anticipated. Still, everyone reaching out to their Representatives is effective as we anticipate a vote on the floor of the House next week. If you have not reached out to your State Representative, please do so as soon as possible. Encourage your families, patients, and physicians to do the same.


    Jorgen told me today we are still in a very good position but let’s not ease up yet as there is still work to be done. Thanks.


    Paul Winter

    MOAPA President


  • April 02, 2013 9:11 AM | Deleted user



    I have been informed by Jorgen Schlemeier that our bill could be voted on the floor of the House of Representatives as early as this week. So now is the time for EVERYONE to contact their State Representative and urge them to vote in favor of HB387. Keep in mind that this bill will change the amount of required onsite supervision from 66% to 4 hours every 2 weeks. This will allow us much greater flexibility to provide patient care in our practices. This will also be paramount in improving our job market to allow more PAs to provide care to the citizens of Missouri.


    If you do not know who your Missouri State Representative currently is, please use the legislator lookup link, House Lookup, to help you identify your State Representative. Remember to have your 9 digit zip code available when using this look-up process as it will make identifying all of your legislators very simple. Reach out to your Representative today either by direct phone call or email. Encourage your families, patients, physicians, friends, and colleagues to do the same thing as volume of calls and emails matters. Let your Representative know that if they have any questions about the bill, they can contact Jorgen Schlemeier, our lobbyist, as he is in the capitol every day.


    As always, if you have any questions, please do not hesitate to reach out to myself or any board member. Thank you for your help with this imperative process.


    Paul Winter

    MOAPA President


  • March 07, 2013 12:25 PM | Deleted user

    HB387 was successfully voted out of the House Professional Registration Committee yesterday by a vote of 19-2!!! This bill is now on its way to the floor of the House for a vote. When we receive more information about when this will be brought up for a vote on the floor of the House, we will pass that information along to all of you. This is definite progress in what we are trying to achieve this legislative session.


    Our senate version, SB219 is still scheduled for a hearing in the Senate Finance committee on Mon March 11. Information on that hearing will also be provided as it becomes available.


    Please pass the word about all of this information to your colleagues who may not be up to date on all of this. Thank you for your efforts and commitment to helping get this passed!!


    Paul Winter

    MOAPA President

  • February 28, 2013 9:40 AM | Deleted user



    Yesterday, February 27th, I testified in favor of HB387 at the House Professional Registration Committee hearing. I am pleased to report that the hearing went extremely well!! In addition to MOAPA testifying in support of this bill, the Missouri State Medical Association, Missouri Anesthesia Association, Missouri Family Practice Association, as well as the Missouri Osteopathic Physician Association (MAOPS) all testified in support!! Yes, you read that correctly, MAOPS testified in favor of our bill!! Wow…have things changed!! That should really warm the hearts of the many people who have waged battle on behalf of the profession in the Missouri legislative arena in years past. In addition to those groups who testified in favor of our bill, no one testified in opposition. We now wait for the Committee to vote on this bill and hopefully vote it out of committee and then it will go to the general floor of the House of Representatives. Again, if your State Representative is on the House Professional Registration Committee, now is the time to reach out to them and urge their support.


    On Monday, March 4th we are still set to have our Senate version of the bill, SB219, heard in the Senate Finance Committee. So, as we have done with this brief update, more information will be sent out as things develop. Please feel free to reach out with any questions that you may have. We need everyone to be clear on this process so don't hesitate to ask whatever questions you may have.

    Thank you for your help with this process,


    Paul Winter

    MOAPA President


  • February 25, 2013 10:06 AM | Deleted user

    Our 2013 legislative efforts have now progressed from introduced pieces of legislation to scheduled hearings in Congressional committees. Tentatively, HB387 is scheduled for hearing on Wednesday, February 27th in the House Professional Registration and Licensing Committee and SB219 for Monday, March 4th in the Senate Financial and Governmental Organizations and Elections Committee. Again, these dates are tentative and are subject to change based on the schedules of each particular committee, however, it is important for all PAs who may live in these committee members’ districts to contact them and ask for their support of our legislation. Letters were sent to specific PAs identified as living in these districts but in case you were missed in this correspondence, a list of the committee members is below for your reference. Please review this list to see if your legislators are on either of these committees. Remember that our bills must be favorably voted out of the committees in order to then go to the House or Senate floor for continuation of the approval process. If we are not successful at the committee stage, our legislation could die right here and we would have to begin the whole process again in 2014. This is why each stage of the process is so very vital to the success of our legislation.


    If you are still unsure who your state legislators are, go to the legislator lookup and enter your 9-digit zip code: House Lookup; Senate Lookup. It is a very fast and easy process. This is information that every PA must have!


    The bills can be looked up and read on the House and Senate web sites under “bill lookup” by their respective bill numbers. The main change we are seeking relates to onsite supervision requirements. Currently, PAs are required to have their supervising physician present 66% of the time they are working. The new law, if passed, requires the physician to be present 4 hours for every 14 days the PA provides patient care. The specifics are in the bills if you would like to read the entire text: HB387; SB219.


    This is both an exciting and stressful time but one that requires everyone’s involvement. This can and should not only include you contacting your legislators, but your family, friends, physicians, patients, and whoever else is willing to contact their members of Congress in Jefferson City to ask for their support. Again, the list of committee members is below for your reference. If your legislators are not on either of these committees, still reach out to them to let them know who you are and what you do for a living. Hopefully, they will have a chance to support our legislation on the floor of their respective chamber of Congress. Once our bills pass through the committee stage (notice positive thinking!), we will send further notice of when they will come to the House and Senate floors for a general vote.

    As always, if you have any questions, please reach out to me or any Board member to make sure that they are answered. Thanks for reading, for your efforts, and for your support of what we are trying to accomplish as well as support of our profession.




    Paul Winter

    MOAPA President




    2013 House Professional Registration and Licensing Committee Members
    Eric Burlison (Chair)

    Kevin Elmer (Vice Chair)

    Sue Allen

    Sonya Anderson

    Wanda Brown

    Jon Carpenter

    Robert Cornejo

    Lyndall Fraker

    Michael Frame

    Diane Franklin

    Keith Fredrick (Physician, HB387 Sponsor)

    Dave Hinson

    Shelly Keeney

    Bart Korman

    Michele Kratky

    Bill Lant

    Donna Lichtenegger

    John Mayfield

    Gail McCann-Beatty

    Dave Muntzel

    Mary Nichols

    Shawn Rhoads

    Jay Swearingen

    Steve Webb


    2013 Senate Financial Organizations and Election Committee Members
    Jay Wassen (Chair)

    Mike Cunningham (Vice Chair)

    Bob Dixon

    Will Krause

    David Pearce

    David Sater (SB219 Sponsor)

    Wayne Wallingford

    Joe Keaveny

    Paul LeVota

    Scott Sifton

  • November 27, 2012 12:26 PM | Deleted user

    Greetings fellow Missouri PAs:


    As we draw near the end of 2012, I feel it’s important to send out some information and updates from MOAPA. After the 2012 Missouri Legislative session ended in May without us successfully passing our legislation, it was time to start preparing for 2013. One of the main areas that we have focused on since the end of the 2012 session was working to garner support from many of the physician groups in Missouri and communicating with them what our goals are as a profession and that we can reach those goals and still maintain a physician-led team approach to patient care. So far, our efforts have been very successful and we are hoping that this will result in a positive outcome in 2013. More details on this are below.


    Also, in review of 2012, our July CME Conference in Branson was again very well attended as well as financially successful for our organization. The CME industry has experienced many changes over the past several years making conferences increasingly difficult to be financially successful due to a decrease in pharmaceutical financial support for speakers, displaying, etc., but with attention paid by our CME Committee to prudent decreases in costs while still maintaining the usual high standards for the event, we were able to make this an income generator for our state organization.


    So again, as 2012 comes to an end I want to give some info on current issues as well as what we are looking forward to in 2013.


    Legislative Plans


    We are introducing a bill, probably in early to mid-January, addressing the current onsite supervision requirements under which we practice. Again, we have been working with several physician groups to draft language that will relax the onsite supervision requirement but still maintain a level of supervision that the physician groups feel are adequate to provide patient safety and responsible practice standards. Specific language has not been fully drafted at this writing but when a bill is filed and given a number, this will be communicated to make sure everyone is aware of what we are attempting to pass this coming session. I cannot express the importance of this legislation to our profession. Even if the current supervision requirements do not impact your current job, this is still extremely important to the progression of our profession and the ability of Missouri to attract PAs to practice in our state and help provide for the healthcare needs of the citizens of Missouri. So this coming legislative session CANNOT be ignored by ANY Missouri PA, MOAPA member or not!!!


    In addition to legislation addressing supervision, we will also introduce legislation requesting that PAs be recognized as Missouri Medicaid providers. I, along with our lobbyist, Jorgen Schlemeier, met with the leaders from MO Medicaid and it was requested that we approach this issue through the legislature so that is our plan. To clear up any confusion, PAs are not currently identified as MO Medicaid providers but that does not mean that PAs cannot be reimbursed for services provided by a PA on a patient who is covered under MO Medicaid. It just needs to be billed under the supervising physician. So therefore, the reimbursement is not different than other non-physician providers. This issue has, however, caused confusion with potential employers so that PAs have been passed over for jobs due to this provider status so we felt this to be something that needed to be addressed and changed. The plan is for this to be in a separate bill than the one I discussed above, but again, bill numbers and specifics will be provided when available.


    In preparation for the legislative session, we are planning something new. We are planning to host a "Legislative Boot Camp" starting in St. Louis first and other areas if possible. We are planning to have this in January 2013, possibly January 26th, but the date is not confirmed yet. This will be a short conference, a few hours. We will have a speaker from AAPA discussing general PA advocacy as well as giving us a national perspective and update with all of the possible healthcare changes and how this could impact us. Also, Jorgen Schlemeier will help us better understand the process that we will encounter in Jefferson City getting our legislation passed. We will have a current state legislator present to speak on effective communication with your legislator. I know I have had people intimidated reaching out to the state members of congress so this talk will be designed to pull the curtain back from that part of the process to help everyone become more comfortable reaching out to communicate directly with legislators. Plans are that this will be held at Missouri Baptist Medical Center and will be free of charge. We will also inquire about the possibility of qualifying for Category II CME. We are planning to lock this in within the next week or two so please, make an effort to attend this very important conference. This has been successful in other states so it seemed like a great idea to bring this to Missouri especially leading into this vital legislative session. More info is coming soon.


    CME 2013 Plans


    As mentioned above, the 2012 conference was again a great success and ran very smoothly as it always has under the great leadership of our "experienced" CME Committee. Well, the 2012 CME marked the last year for the current CME Committee who ran this conference for well more than a decade. They requested this to be their last conference and as much as we would have loved to hold them hostage to continue, we had to thank them infinitely for the service and hard work they provided over the years and move forward to find others who would be willing to step up and keep the tradition going. Spearheading the new CME Committee will be:

    • Meredith Cunningham
    • Ashley Schnell
    • Jeff LeClair

    They are fully committed to maintaining the high standards of this conference along with new ideas that will attempt to freshen the conference to give it a new energy. Please take a few minutes to mark your calendars for the 2013 conference July 18-21, 2013. In an effort to maintain affordability, the conference will still be held at the Radisson Hotel in Branson. If you are willing to give a clinical lecture or know anyone who is willing to speak at the conference, please reach out to Meredith Cunningham and let her know. Finding qualified and affordable speakers is very difficult, so we need to help each other with this task. Please do your part to help make this conference as successful as possible. You can email Meredith at mtc77@me.com with speaker names and topics.




    Membership is something that we continue to work on as a Board. Clearly, the most effective and efficient way to communicate all that we are trying to do in order to progress our profession is to have all 700-plus PAs in Missouri be members of MOAPA. In addition to the communication piece, membership is still one of two sources of income to MOAPA. Membership proceeds in addition to those from the Summer CME are needed in order to keep MOAPA financially solvent and able to work for the continued success and progression of our profession. So, in addition to legislation, membership remains a main piece of this Board’s agenda and we are requesting your help with this as well. Please maintain your membership as well as have direct conversations with your colleagues about membership. If they have questions about membership that you cannot answer, refer them to any Board member and we will be glad to discuss membership benefits with them.


    Board of Directors Updates


    We have had some recent changes to our Board about which I feel it is important to inform everyone. For personal reasons, Meredith Cunningham resigned from her President-Elect position. She will continue to be part of the CME Committee planning the 2013 conference but felt strongly she should place herself in a position which allows her to focus on the conference rather than feel the split between becoming President in July in addition to heading the CME Committee. Therefore, the President-Elect position is currently vacant. If anyone out there is really wanting to jump right into the "deep end" and fill this vacancy, please contact me directly and we can discuss it and I can address duties and responsibilities. Since I have been President for many years now, some new blood and a new voice might be nice for the organization. So if your curiosity about this is at all piqued by this, please drop me a line or call me and we can talk about it.

    In addition to this change, we have also had a change in one of the Director at Large positions. Due to an increase in family responsibilities, Karen Leuenberger found it necessary to resign from her position as Northwest Director at Large. Since her resignation I appointed Greg Stafford to this position. Greg has previous experience on the MOAPA Board from a few years ago and is very motivated to help energize the NW Region.


    On a more general note about being a Board member and what it takes, if you have ever had the feeling that you want to do more for the profession but are not sure how, consider becoming a Board member. Each position has its own responsibilities but you may be surprised that the time it requires may not be at all what you thought it would be. You don't need to have previous Board experience, you don't need legislative experience, what you need is a desire to get involved and work to continually improve this organization and our profession in Missouri. That is it!!! I had no legislative experience but just learned by observation and a desire to work to make things better and not just continue to stand on the sideline and complain about why things are not the way they should be or at least better than they are. It was time for me to get into the game and be a part of the process of making these things that we complain about better. So if you have any of these feelings tugging at you, just reach out to me or any Board member and inquire about it and really see what it is all about. This is an organization for PAs run and surviving by the work of PAs, and again, new blood and new energy for any organization is a good thing. Feel free to contact me by email to paultwin@aol.com or call me at 314-374-8033.


    Well, I think I have taken up enough of your time with this update that I hope you found helpful. I struggle with not doing more frequent newsletters like this but I know in our lives we get so many emails about so many things that I tend to try and save things up and communicate them when I feel there is new or timely information. Please know that the relatively few emails I send out are not a reflection of the work that really is in continual process for the improvement and progression of the climate for PAs in Missouri. I am always available to answer questions or help problem solve for any PA who has specific needs. So, if you find yourself with a specific need or question, never hesitate to reach out to me or any Board member and we will do our best to help answer your question or help solve any issue that you may have. Thanks for reading and know that more information about our legislative plans and bill numbers as well as information about contacting your legislators will be forthcoming.







  • May 15, 2012 9:26 AM | Deleted user

    As promised, here is the latest legislative update. It is with considerable frustration that I report that we were unsuccessful in getting our change of onsite supervision bill passed this session. Although the frustration may be there, we did make some strong and hopefully lasting relationships that will help us in the future. In addition, we did learn a lot from this session which will help us in our strategic planning for the 2013 session when we will pursue this issue again as it is paramount to our profession. We will be spending the “off-season” working to develop other relationships with physician groups as well as legislators and lay the groundwork for their support of our efforts. Rest assured that your Board will not sit idle during this time!!

    What we are asking of the membership are these things:

    1. Please identify if your physician or any physician in your circle is a member of the Missouri State Medical Association and then please have them contact the leadership and implore them to support and NOT oppose our efforts. Let them know that we support the team-based approach to healthcare and they do not support the obstruction that they have put up against our efforts. Other physician groups would be helpful as well including but not limited to the Missouri Association of Osteopathic Physicians and the Missouri Family Practice Association. Have them dialogue with their leadership on our issues.
    2. Please donate to the MOAPA PAC fund. This is an election year and we need to have a presence at campaign fund raisers during this time. We have always asked for each PA to donate at least $100.00 per year to this fund. You can do a monthly donation/debit if that works better for you than a lump sum donation. This process is imperative to us gaining maximum access to legislators in order to deliver our message and garner their support. I know that no one likes to part with their hard-earned money, but this is a major part of the process so please go to the web site and donate today or send a check. Remember that 100% of the funds donated to this will be used for this purpose as there are no administrative costs. All info is on the web site www.moapa.org. Please do this TODAY!!
    3. Identify and contact your state legislators even in the off-season and just introduce yourself as a PA in their district and let them know that we will be pursuing legislation in the coming session. Try and visit them personally in their local office as the off-season is sometimes a better time to actually have a conversation with them about what we will be looking to achieve and why. We can provide any information that you may need so don't hesitate to ask as these visits are very effective. Other things you can do are invite your legislators to visit your clinic/office and see how you function or offer to place a sign in your yard during election time if they are running. You may also consider donating even a small amount to their campaign fund directly. These are all ways to develop relationships as that is what drives much-needed votes.

    As we have always stressed, no matter what legislation we pursue, it is a group effort!! The Board is willing to do as much of the leg work as needed but we need all hands on deck. Can you imagine the effect we would have if we had all 700+ MO PAs working on our issues? We have made great strides the past few years with just a handful of active folks so just imagine if we could have all hands on deck with both the legislative efforts as well as the organizational efforts, whew, what a thought!! So if you have apathetic colleagues, classmates, or friends, please inspire them to get off of the sidelines and get in the game as we will all benefit from these efforts. As always, I welcome any questions, comments, or criticisms so feel free to drop me a line or give me a call.

    Thanks for reading this as well as for all of your efforts.




  • May 03, 2012 12:53 PM | Deleted user



    I want to take a few minutes to update everyone on the most recent developments on the legislative front.


    We introduced a bill early in the legislative session, HB2094, addressing the onsite supervision requirements and looking to reduce the current 66% onsite supervision. We were having some difficulty getting traction on our bill as there appeared to be opposition from the Missouri State Medical Association (MSMA). Talks had been ongoing but as the session progressed, it looked like we were not even going to be able to get our bill heard in committee. However, I was notified this past Tuesday that indeed our bill was going to be heard in the House Professional Registration Committee on Wednesday, May 2. Therefore, I drove to Jefferson City on Wednesday and testified on behalf of our bill, HB2094. The start of the committee hearing was delayed, shortening the actual meeting time, meaning that I had a chance to testify in favor but opposition was unable to testify and will be heard next Wednesday, May 9. We anticipate opposition in committee from the MSMA as well as the Missouri Association of Osteopathic Physicians (MAOPS) but talks will be ongoing with these groups. Keep in mind that besides these potentially opposing groups, our other obstacle is time. The legislative session expires in mid-May so if we don't get this done by then, we will start from scratch again next session which will start in January 2013.


    What can you do you ask?


    First, please identify if your state rep is one of the members of the Professional Registration Committee; they are listed at the end of this message. You should have received information about contacting them already but if you have not and you do live in a member's district, please call or email him or her immediately and encourage him or her to vote this bill out of committee!!


    Second, have your family members and your supervising physician(s) call/email as well. This is all about numbers, so please increase the number of people contacting them to support this bill. If you do not live in one of these committee members’ districts, still reach out to your state reps. Let them know you are a PA, live in their district, we have this bill in process, and you need their support. Let them know that you will contact them again when a full vote from the House of Representatives happens to make sure that you can count on their support. If they ask you questions that you are unsure about, no problem, just note the question and feel free to email and ask me and we will get the answer they need. Just make sure you are diligent with the follow up to find out the information they are requesting.


    Lastly, please dialogue with your physicians and find out if they are members of either the MSMA or MAOPS and ask them to contact their organization(s) ASAP to express their support for this bill and say that they do not support their organization opposing this bill. This also goes for anyone whose physician is a member of the Missouri Family Practice Association (MFPA). They have not fully committed to opposing us but it is possible so they need to hear from their members as well. Like all organizations, MFPA relies on membership so they want to make sure they are representing their members effectively. If their members oppose something that they are doing, they need to hear about it. I cannot express how important that piece is to this process. All of these requests require very little time but are very important so please do not delay in doing all of these.


    We will continue to pursue this over the next 3 weeks. There are ways to get this bill through but it will not be easy mainly due to time constraints. I hope this message comes across clear and does not cause confusion but as always, if you have any questions, never hesitate to contact me and I will do my best to clarify. Thanks for reading and thanks in advance for your actions.


    Paul Winter
    MOAPA President


    Professional Registration and Licensing Committee Members

    Ellen Brandom- Chair

    Eric Burlison- Vice Chair

    Sue Allen

    Chris Carter

    Kevin Elmer

    Diane Franklin

    Ward Franz

    Keith Fredrick

    Caleb Jones

    Bart Korman

    Michelle Kratky

    Bill Lant

    Donna Lichtenegger

    Betty McCann

    Mary Nichols

    Vicki Schneider

    Scott Sifton

    Jason Smith

    Jay Swearingen

    Steve Webb

    Don Wells

  • February 28, 2012 1:23 PM | Deleted user

    On Monday, March 5, 2012, MOAPA members will receive a ballot via email with a proposal for a change in the districting which we have used for several years in Missouri.  The Board has noticed an increase in the PA population in the central part of Missouri such as Columbia, Jefferson City, and the surrounding area.  In addition, the numbers in the SE region of the state have been steady but without the growth that we have seen in the middle part of the state.  Also, we have been unable to fill the vacancy for the Southeast Region Director at Large Board position for several years which has put us in violation of the bylaws of AAPA for active state chapters.  Therefore, the Board is proposing that the SE district be absorbed into the current NE district and a "Mid-Missouri" district be created.  This issue must be voted on by the membership and so members will be sent a ballot in which to vote “yes” or “no” on this proposal.  As a member, please consider the proposal and keep a watch on your email inbox as your ballot will be arriving on Monday.  Please direct any questions regarding the redistricting process to MOAPA President Paul Winter at paultwin@aol.com.

  • November 04, 2011 2:24 PM | Deleted user
    On December 1, 2011, the Missouri BNDD will implement its new database rules.  Click here to read the full memo.

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