|
|
| Administrative
Practice Issue References
Important to Your Practice
NEWLY
UPDATED!!! |
| Joseph
Streff, PA-C
Webmaster, 1995-present |
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READY REFERENCE FOR THE VA PHYSICIAN ASSISTANT
|
| ———————————————————————— |
| Federal Supremacy (February
28, 2010)
I am
copying a posting by the VACO Office of Nursing Services
regarding federal supremacy. Although the posting is focused
on NP practice, it also applies to all other VA occupations,
including PAs. This is the best description of state vs.
federal authority and controlled substance prescribing I
have found. I recommend you save this to your reference
archives.
Licensure requirements
for the employment of VA health care providers have been
established by Federal law, not State law. Under 38 USC
7402(b), VA physicians, dentists, nurses, podiatrists,
optometrists, pharmacists, psychologists, social workers,
chiropractors, and certain other health care positions
must be licensed or registered in “a” State
to practice their profession. There is no requirement
that they be licensed in the State of practice. Thus,
a licensed VA health care practitioner may practice at
any VA facility, regardless of its location or his or
her State of licensure.
Under the Supremacy
Clause of the Constitution, States are prohibited from
regulating or controlling the activities of the Federal
Government, absent Congressional consent. However, where
required by a Federal law, VA practitioners must comply
with State licensure or registration requirements. Through
the Controlled Substances Act (CSA), 21 USC 801 et seq.,
and implementing regulations in 21 CFR Part 1300, Congress
has subjected health care practitioners to the requirements
of State licensure law for purposes of prescribing controlled
substances. Under the CSA, a health care practitioner
can prescribe controlled substances only if authorized
to do so by his or her State of licensure and either registered
or exempted from registration with the Drug Enforcement
Administration (DEA). 21 CFR 1306.03(a)(1)-(2). Accordingly,
VA health care practitioners must possess a State license
that allows them to prescribe controlled substances, but
can utilize the DEA registration number of the VA medical
facility, with a suffix.
Where Federal law
and State law conflict, the Federal law will govern the
official actions of Federal employees. Thus, where VA
rules or policy conflict with the requirements of a State
licensure law, VA employees would be bound by the VA rules
or policy. Generally, the scope of practice of a nurse
is determined by VA, without regard to State Practice
Acts. For example, VA permits NPs to prescribe non-controlled
substances provided the NP is licensed, certified, and
has completed an approved upper division or continuing
education course in pharmacology. To do this, VA establishes
a scope of practice that authorizes the NP to prescribe
certain non-controlled substances. Thus, for aspects of
clinical practice other than controlled substances prescribing,
the NP would be required to comply with VA rules or policy,
even if his or her State Practice Act were more restrictive.
For controlled substances prescribing, however, the NP
would be required to meet the licensure requirements for
controlled substances prescribing authority of his or
her State of licensure.
|
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Best Jobs in America Include Physician
Assistants! http://finance.yahoo.com/career-work/article/107926/best-jobs-in-america.html |
| ———————————————————————— |
| Links to: VHA
Directive 2004-031 Guidance On Primary Care Panel Size.pdf
and
VHA
Primary Care DPCT 2006-060.DOC |
| ———————————————————————— |
| Federal General Schedule Pay System
(Tuesday, November 03, 2009)
OPM chief:
'Cracks are showing' in the General Schedule
By Alyssa Rosenberg
Story talks about Options for reform that include extending
bonuses to rank-and-file employees.
Full story: http://www.govexec.com/story_page.cfm?articleid=43957&dcn=e_gvet |
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| Changes in FERS Retirement
(Thursday, October 29, 2009 )
Wednesday, October
28, 2009, the President signed into law the Defense
Authorization Act of 2010. The Act provisions modifying
sections of Title 5 of the US Code relating to retirement
benefits. The following is a summary of the changes for
FERS retirement :
1. Credit for Unused Sick Leave.
a. FERS employees will be eligible to receive credit
for a percentage of unused sick leave (see below) when
determining the total years of service. This time cannot
be used in determining average pay or retirement eligibility.
b. Employees retiring on or before December 31, 2013
will receive credit on 50% of their ending sick leave
balance.
c. Employees retiring after December 31, 2013 will receive
credit on 100% of their ending sick leave balance.
d. Unused sick leave cannot be used for determining retirement
eligibility. In other words, you must be eligible for
retirement without unused sick leave credit. However,
your sick leave can be credited to total federal service
time.
2. FERS Retirement Refund Redeposit Upon Return
to Federal Service.
a. This provision allows for re-deposit
of refunds received for FERS retirement payroll deductions
when an employee left federal service and subsequently
returned. Previous to the enactment of this legislation,
the time covered by the refund was not eligible to be
considered in the total federal service time for retirement
purposes and the refund could not be could not be re-deposited.
b. Payroll deduction is authorized for repayment
of refunded retirement deposits.
c. Federal service time for the period covered
by the retirement deposit refunds may be restored upon
repayment of the total amount originally refunded plus
interest.
For questions contact:
Denni J. Woodmansee, PA-C
PA Advisor to the Under Secretary for Health
Department of Veterans Affairs
(774) 826-2035 |
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| Grade 13 October 6, 2009
Please see the link below. Save to your favorites for future
reference.
http://vaww1.va.gov/ohrm/HRLibrary/Dir-Policy.htm
(only available from a VA computer) |
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| OPM Time-in-Grade Requirements (Thursday,
March 19, 2009 (see update in second part of this subject)
)
Current OPM regulations include a time-in-grade
requirement for promotion. OPM has changed their regulations
to eliminate this requirement and was supposed to be effective
November 7, 2008. However, due to a White House Memorandum
on regulatory review, agencies were requested to extend
for 60 days the effective date of regulations published
in the Federal Register but not yet taken effect. In response,
OPM has effected an additional comment period before the
new regulation takes effect. The new estimated effective
date is May 18, 2009. VA is expected to revise
VA Handbook 5005 to eliminate time-in grade
requirements for Title 5 on that date and include Title
38 occupations as well.
This change will effect physician assistant eligibility
for promotion. Under current policy, a PA must occupy a
grade for two years before becoming eligible for promotion.
With elimination of the time-in-grade requirements, a PA
must only meet the grade qualifications as specified in
the VA PA Qualification Standards. The PA Qualification
Standards specifies certain experience requirements in each
grade qualifications. The proposed revision of the PA Qualification
Standards includes modifying the experience requirements
to "at least 1 year experience in the previous grade
or equivalent". These combined changes in regulation
and policy will make it much easier for VHA PAs to be promoted
in a much shorter time period.
UPDATE - October 2009
Question: I was wondering if anyone knew if the OPM did
actually change the proposed “Time-in-Grade”
requirements for Title 38’s? I was looking in the
VA Handbook and did not see any new literature regarding
this change. I am asking secondary to we have an excellent
PA on our Staff Service who is 1 year out of school and
with the current payscale, her salary is not even close
to the national average for new grads. Thanks for your time
and your assistance.
Answer: The time-in-grade elimination
was pulled when OPM deliberated whether to include Title
5. They decided not to. VA will now go forward with elimination
of Title 38 time-in-grade requirements and will include
language to this effect in the forthcoming revision of VA
Handbook 5005. It is in the concurrence process now and
should be out in the next month or so.
I'm also trying to get language inserted into the revised
policy that would establish time frames for acting on promotion
and special advancement requests as well as eliminate HR
from the processing of PSB Board Action Requests. |
| ———————————————————————— |
Legislation modifying federal retirement
rules advances
By Alyssa Rosenberg
Legislation was reintroduced this year that would allow
employees under the FERS retirement system
have their unused sick leave added to their credited federal
service time for retirement annuity computation. In the
past this leave was lost if not used. Read the full story
for details...
Provisions would make it easier for retirees to cash out
unused sick leave and return to government service.
Full story: http://www.govexec.com/story_page.cfm?articleid=42297&dcn=e_gvet
|
| ———————————————————————— |
| Lilly Ledbetter Fair Pay Act - A Word
about PA vs NP Salaries in VHA. FYI – PA
demographics in VHA is changing. There are more female PAs
coming on board every week. The past arguments about pay
have centered around gender, however, this is rapidly becoming
a non-issue. NPs are outpacing PAs in salary overall. These
stats are taken from the VHA Pay files.
As of December 31, 2008, there were 1,826 PAs on the VHA
payroll. 962 males – 52.7% and 864 females –
47.3%
NCCPA reports that for all first time PANCE takers in 2008,
26% were men and 74% were women.
Pay Disparity: PA Senior Grade (12), step 10 vs. NP Nurse
III, top step (12-14)
Salary data for PAs and NPs as of December 31, 2008 show
the following:
NPs < PAs 4 facilities Range: 1.1% - 3.1%
NPs = PAs 11 facilities (less than 4% discrepancy in NP
favor)
NPs > PAs 104 facilities Range: 4.1% - 48.2%
NPs > PAs (> $10,000) 74 facilities
NPs >PAs ( > $25,000) 13 facilities
NPs > PAs ( > $30,000) 9 facilities
Maximum pay discrepancy is $44,000 or 48.2%. (San Diego
VA)
PA and NP salaries will vary from facility to facility
due to factors such as locality pay, PA special pay rates,
Nursing Locality Pay, and existence of NP pay bands. Pay
comparisons were between the full performance level grades
for each profession – PA Senior Grade and NP Nurse
III.
|
| ———————————————————————— |
| PA to MD article: Interesting
thoughts from our "father", Dr. Eugene Stead,
Jr.
This is directly from Dr Stead's own web site : http://easteadjr.org
or http://easteadjr.org/thoughts.html
"Using Distance Learning to Provide a
Medical Education to Non-traditional Students"
Go to “Mostly My thoughts” section
then scroll down to “Breaking the Medical
Monopoly on Manpower Production “. It is
contained under that section.
The article goes into the concept of using distance learning
to advance PAs to the status of MD using the PA concept
as a stepping stone to a medical degree. Interesting argument
that I actually used in a paper during my first semester
of PA school in 1977. I argued that all MD or DO candidates
should actually come "from the ranks" rather than
"jumping" directly into being a physician from
college. -jos
|
| ———————————————————————— |
| Q: Do you have any national
or local VISN policies regarding P.A.'s performing after
hours on call duty?
A: Yes: See VA HANDBOOK
5007, PART V CHAPTER 5 & CHAPTER 2
CHAPTER 5. ON-CALL PAY AND STANDBY PAY
1. ON-CALL PAY FOR NURSES, PAs, AND EFDAs APPOINTED UNDER
38 U.S.C. 7401(1) OR 7405(a)(1)(A)
a. A nurse, PA or EFDA officially scheduled to be on-call
outside of his or her regular duty hours shall receive 10
percent of his or her applicable overtime rate for each
hour of on-call duty. When called back to perform overtime
work, such personnel shall receive overtime pay in accordance
with chapter 2 or chapter 4 of this part, as appropriate.
On-call pay shall be suspended during the period of actual
overtime duty; when released from overtime duty, such personnel
shall return to the remaining scheduled on-call duty, if
any, and receive on-call pay accordingly.
b. While in an on-call status, such personnel shall be
available for prompt response to perform service. In the
event of incapacitation or unavailability during the period
for which scheduled to be on-call, such unavailability shall
be promptly reported by the employee to the authorizing
official or other responsible official. An employee who
is relieved from scheduled on-call duty as a result thereof
shall not receive on-call pay during the period from which
relieved.
c. An employee who is excused from duty on a holiday may
receive on-call duty during such hours of excusal. Authorizing
officials for on-call duty shall be the same officials authorized
to order and approve overtime, as indicated in chapter 1
of this part
SEE ALSO: VA
HANDBOOK 5007, PART V CHAPTER 2
2. OVERTIME PAY AND COMPENSATORY TIME OFF FOR EMPLOYEES
APPOINTED UNDER 38 U.S.C. 7306, 7401 AND 7405
c. Call-Back Overtime
(1) Any overtime on a day when a nurse, PA or EFDA was
not scheduled to work, or for which an employee is required
to return to his or her place of employment, shall be deemed
to be a minimum of 2 hours in duration, regardless of whether
or not service is performed for a full 2 hours. When an
employee is called back from an on-call status to perform
overtime work, the callback overtime provisions shall be
applied upon return to duty of the employee.
(2) To be eligible for the full 2 hours of overtime, employees
must be called into work at a time which is outside of and
unconnected with their basic workweek (45 Comp. Gen. 53).
|
PAs obtaining doctoral degrees
in ER, Ortho, Gen Surgery FYI…http://physician-assistant.advanceweb.com/Article/More-PA-Doctorates.aspx
This will take you to the article.
|
| AUTOMATIC PAY GRADE INCREASES
PA Q: Are there automatic increases
in grade?
PA Advisor: There are no "automatic"
increases in grade. Although you may meet the PA Qualification
Standards for promotion to a higher grade, grade promotions
must be requested by the Service Chief. Requests must be
submitted to the facility PA PSB and, if recommended for
approval by the Board, forwarded to the Director for approval.
I am unclear on how you were promoted from a grade 9 to
11 if the promotion request by your supervisor was denied.
To be eligible for promotion, you must also meet an OPM
time-in-grade requirement. PAs must be in their current
grade for a period of 2 years before being eligible for
promotion. Again, I'm not sure how you were promoted to
Senior Grade (grade 12) since you only had a little over
1 year time-in-grade. Your promotion was not in compliance
with technical requirements. I am surprised that HR did
not block this. Be that as it may, it happened and I would
not call it into question.
Periodic Within Grade Increases (automatic step increases)
occur every two years. These are "automatic" unless
the performance appraisal is unsatisfactory. Promotion to
a higher grade "resets' the clock for these step increases.
It is important to keep this in mind when going for a grade
promotion. If you are eligible for a step increase and a
promotion around the same time, it may be wise to hold off
on your promotion request until after your step increase.
Otherwise, you will "lose" your step increase
if your promotion occurs first. You would then have to wait
another 2 years from the date of promotion for another step
increase.
PA: The PA Advisor's last point
is good but also, going up a grade can not be less money
than you are currently receiving, so getting the last step
in will put you at a higher step within the next grade when
it comes.
Step increases within a grade can also be for 'reward' your
supervisor or cmo can request a step increase almost at
any time, and this does not effect the q 2 yr automatic
increases,
it a nice way to get the steps up, i don't think it can
cross grade levels, sorry 12-10s,
and i think it is easer to get a step than a grade increase.
PA Advisor: The step placement
when promoted must be the equivalent of at least a two step
increase. For example, if are promoted to Senior Grade (12)
and are at 11/10, multiply the step interval amount for
Intermediate Grade X 2 and add to the 11/10 salary amount.
Then find the corresponding step on the Senior Grade pay
schedule that is equal to or greater than the calculated
amount.
This PA is describing Special Advancement for Performance
and Special Advancement for Achievement. There are criteria
to meet for these step advancements. He is correct, SAPs
and SAAs do not effect the waiting period for Periodic Within
Grade Step Increases.
|
|
| On 24 April 2008 the Education Funding for Non-certified
PAs was issued. Click
here for a copy of that announcement. |
|
| A CANADIAN VIEW OF THE PHYSICIAN
ASSISTANT
http://www.nationalreviewofmedicine.com/issue/2007/12_15/4_patients_practice05_20.html |
|
| Grade/Step Comparisons :
VA Pay information can be found at: http://vaww.appc1.va.gov/ohrm/PAY/PAYRATE1.htm
|
|
Retirement Information: Please
use the link provided below to connect to the OPM CSRS and
FERS Handbook for Personnel and Payroll Offices.
http://www.opm.gov/asd/htm/hod.htm |
|
VA Handbook 5007, Part VI, Chapter
3, Retention Incentives (Posted
03Aug2007)
b. Likelihood of Leaving Federal Employment.
Each supervisor shall make a separate certification that an
employee, or for group authorizations, a significant number
of employees in the group, is likely to leave Federal service
in the absence of an incentive (see appendix VI-E). This certification
will only be made when the supervisor is reasonably convinced
that the employee is likely to leave Federal service. Such
a certification may be based on:
(1) Receipt by an employee, or for group authorizations,
a significant number of employees, of one or more bona fide
offers of employment, as evidenced by a formal written job
offer or affidavit signed by the employee or employees providing
the position and salary being offered, the name and location
of the organization, and the prospective date of employment;
or
(2) Evidence of high demand in the private sector for
the knowledge and skills possessed by the employee or group
of employees and significant pay disparities between Federal
and non-Federal salaries; or
(3) A discussion with the employee of the employee’s
career plans. |
|
| VHA Directive 2007-015 Interfacility
Transfer Policy (Posted 26
May 2007) This
Directive was just released. I have posted sections that
may pertain to Physician Assistants.
<<VHA Directive 2007-015 Inter-Facility Transfer Policy.DOC>>
(4) No patient is transferred to the VA facility or from
the VA facility to a non-VA facility, without the prior
approval by an appropriately-credentialed, privileged, and
responsible VA staff physician, or designee.
(a) No patient may be transferred from a VA facility to
a non-VA facility without the prior approval from an accepting
physician, or designee, at the receiving non-VA facility.
(b) The accepting physician, or designee, must speak directly
with the referring physician, or designee, regarding the
care of the patient. NOTE: A nurse to nurse contact is essential.
These verbal communications need to allow for questions
and answers from both transferring and receiving facilities.
This is irrespective of whether the transferring facility
is VA or non-VA.
) An assigned designee, involved in any decisions or actions
related to transfers, is a credentialed provider.
(a) The designee cannot be an individual who is at the
VA as a post graduate trainee (intern, resident, or fellow).
If the designee is not a physician, the designee must be
a qualified medical person as determined by the facility’s
by-laws or rules and regulations.
(b) Transfer-related decisions by a non-physician designee
may be made only after a physician is consulted and agrees
with the action. Signatures of any transfer-related documentation
by the non-physician designee must subsequently be counter
signed by the physician consulted.
(6) Only the Emergency Department or Urgent Care Unit
physician, or designee on duty and in charge, accepts patients
for evaluation in the Emergency Department or Urgent Care
Unit. NOTE: Responsibility for accepting direct admissions
to inpatient units is determined by local policy. |
|
| VHA Directives
Links: (Posted 20
May 2007) Special Awards
Some confusion exists about the difference between Special
Awards for Achievement versus those for Performance. Here
are the latest copies of the regs for you to download and
keep in your files:
Physician_Assistant_Criteria_for_Special_Advancement_for_Performance.doc
(30k)
Physician_Assistant_Criteria_of_Special_Advancement_for_Achievment.doc
(33k)
Special Advancements (Originally
Posted 25 Feb 2007)
Q. What are the rules on Special Advancements?
A: VA Handbook 5017, Part V authorizes Special
Advancement for Performance and Special Advancement for
Achievement. These provisions may be used to recognize a
PA who exhibits superior performance or sustains professional
achievements. Requests for SAPs and SAAs must be submitted
to the PA Professional Standards Board for review and approved
by the Director. Step increases awarded under SAP and SAA
do not take the place of the regular periodic step increase
and does not reset the waiting period for the next step
increase. They also do not effect eligibility for grade
promotion. One could receive a step increase for SAP, a
regular periodic within grade step increase, followed by
a grade promotion in the same year. SAP are limited to one
occurrence in 52 weeks. Step increases may not exceed the
maximum step in the grade.
Special Advancement for Performance (SAP)
- Allows for a one step increase.Criteria
d. Physician Assistants. The employee must have demonstrated
a sustained high level of performance and ability over and
above that normally expected of employees in the particular
grade and profession or there must have been noted contributions
in some aspect of health care. Criteria for one-step advancement
will be demonstrated superior performance as evidenced by:
(1) Assumption of a major responsibility in administering
a major patient care program.
(2) Significant accomplishments associated with an academic
program conducted in affiliation with the facility where
the physician assistant is employed.
Special Advancement for Achievement (SAA)
- Allows for one to five step increase. The number of steps
awarded will depend on the level of achievement. The average
award is a 2-3 step increase. A 5 step increase is extremely
rare and usually involves significant achievements that
are national in scope. Note: Those holding faculty appointments
with a university based PA training program may be eligible
for a SAA.
d. Physician Assistants. Full-time, part-time
and intermittent physician assistants may be advanced within
the grade from one to five steps on the basis of professional
achievement above that expected for the grade level or assignment
provided they have demonstrated excellence in performance
and potential for assumption of greater responsibility.
Examples of such achievements include, but are not limited
to:
(1) A graduate level degree in a field related to the
Department’s health care mission;
(2) Appointment to a university faculty position;
(3) Significant contributions to the Department’s
health care mission. Such accomplishments may result from
leadership or exceptional efforts on facility, regional
or national task forces or committees, or by serving as
a consultant on matters relating to education research,
health care management, or quality of care issues;
(4) Recognition of outstanding and exceptional achievement
by a professional or academic organization;
Election to office in a professional organization
at the State or national level
Independently producing or serving as a principal assistant
or major contributing member on research producing publishable
results that advance patient care or medical science; or
(7) Attainment of specialty certification
within the occupation. This does not include certification
as a physician assistant by the National Commission on Certification
of Physician’s Assistants, which is a condition of
employment as a physician assistant in VHA.
----- -----
All the MP-5s were converted to Handbooks. I have found
the links listed below to be very helpful. That last one
on the list includes any updates or changes.
http://www1.va.gov/vapubs/
http://www1.va.gov/vhapublications/
http://vaww.appc1.va.gov/ohrm/Directives-Handbooks/Direct_Hand.htm |
|
| VHA Directives Links:
(Posted 13 May
2007)
As discussed at the VAPAA Conference, the link to most
of the relevant VHA Directives effecting PAs is provided
below. This site incorporates changes to the directives
as they occur so this reference is the most up to date.
(These are VA Intranet links and not available from outside
the VA realm.)
http://vaww.appc1.va.gov/ohrm/Directives-Handbooks/Direct_Hand.htm
Also included is a index of VA Handbooks 5001 - 5027 (HRMS
Directives) that enables you to more easily find which handbook
addresses a particular topic.
http://vaww.appc1.va.gov/ohrm/Directives-Handbooks/Documents/TerryKguide.doc
|
|
|
AAPA Reimbursement
Policy Template Available (posted
01May2007)
The AAPA’s Reimbursement Policy Staff developed a
template of reimbursement policy information to add to your
organization’s website. The link below will take you
to information on Medicare, Private Payer, Medicaid, and
Workers’ Compensation reimbursement policy that will
help your members answer their reimbursement questions and
will direct them to the AAPA’s reimbursement policy
staff members to solve more difficult reimbursement problems.
http://www.aapa.org/cor/WebResources.htm
The web page can also be located by going through the Constituent
Organization Services section of our website at: http://www.aapa.org/cor/index.html
We encourage you to review this information and add it
to your organization’s website. If you have additional
questions about reimbursement policy, or need assistance
customizing the Medicaid and Workers’ Compensation
sections for your state, please contact Gwen Gordon (ggordon@aapa.org)
in the AAPA’s Reimbursement Policy Department at 703/836-2272
ext. 3219.
Sincerely,
Gwen Gordon
Manager, Reimbursement Policy
American Academy of Physician Assistants
950 N. Washington Street
Alexandria, VA 22314-1552
The following message was sent on behalf of the AAPA Reimbursement
Department. All e-mail replies should be directed toward
ggordon@aapa.org.
All constituent organization leaders were blind copied on
this message.
|
|
| Travel Policy Changes
(Posted 01
Feb 2007)
From: Travel Policy Division (047E3)
Subject: Travel Notice 07-07 – Mileage Rate Reimbursement
Change
To: All VA Administrations and Staff Offices
This is Travel Notice 07-07 to inform all VA Administrations
and Staff Offices of a change to the reimbursement rate
for the use of a privately owned vehicle (POV) for official
travel. This change in the POV rate is effective for travel
on and after February 1, 2007.
1. Reimbursement rates when the use of a POV is authorized
as advantageous to the government:
· privately owned automobile rate increases from
44.5 cents per mile to 48.5 cents per mile.
2. Reimbursement rate for the use of a POV when a government
vehicle is authorized as the mode of transportation:
· rate for use of POV remains at the same at 28.5
cents per mile.
3. Reimbursement rate for the use of a POV when traveler
has signed a commitment statement to use a GOV:
· rate for use of POV remains the same at 12.5 cents
per mile.
Again, please note these changes are effective February
1, 2007.
Questions or concerns regarding this Travel Notice should
be directed to the Travel Policy office on 202-273-9375,
or at travelpolicy@va.gov.
|
Quote of the Week: (Posted
28Jan2007) "Fair
pay is a crucial element in attracting and retaining the talented
employees federal agencies require if they are going to meet
the public's needs and expectations." -- Colleen Kelley,
president of the National Treasury Employees Union, in support
of a call for civilian-military pay parity in 2008. |
| Overtime Pay
(Posted 29 Jan 2007)
Q: What is the policy on overtime pay? A: Physician
Assistants were re-classified by the FLSA as a "learned
profession" which meets the criteria of "exempted"
profession. You may find that the FLSA designation in your
service record in VISTA is Exempt. FLSA, as administered
by the Department of Labor, sets standards for overtime
payment for all employers (public and private) which is
at least 1 1/2 times the basic rate of pay. There is a complicated
formula use to determine which occupations are exempt from
these provisions which means the employer does not have
to pay OT rates. VA addresses this issue in VA Handbook
5007 where FLSA exempt employees have OT pay rates capped
at GS-10 levels.
HOWEVER, VA has a separate policy provision
for Nurses, PAs, and EFDAs concerning OT and OT pay rates.
Therefore, it does not matter if PAs are FLSA exempt or
non-exempt. OT pay rates for VA PAs are not capped. If someone
tries to tell you this, give them a copy of the reference
below.
VHA Handbook 5007/21 - Pay Administration, Part V., Chapter
2, 2. Overtime and Compensatory Time off for Employees Appointed
Under 38 U.S.C 7306, 7401, and 7405
b. Overtime Pay for Nurses, PAs, and EFDAs
(1) Except as provided in paragraph 3a of this chapter,
probational and permanent full-time nurses, PAs, and EFDAs
are employed on the basis of a 40-hour basic workweek, unless
on an alternate work schedule, as indicated in VA Handbook
5011, Hours of Duty and Leave. Computation of regular pay
for employees on the 40-hour basic workweek shall be based
on a basic hourly rate, derived by dividing the employee’s
annual rate of basic pay by 2,080.
(2) General provisions for the payment of overtime pay for
nurses, PAs, and EFDAs
(a) Leave without pay is not included when computing hours
of work for overtime purposes.
(b) Overtime must be at least 15 minutes duration in a calendar
day to be creditable for overtime purposes.
(c) Overtime is payable for service performed in excess
of 40 hours in an administrative workweek, or in excess
of 8 hours in a day, whichever is greater, at a rate of
one and one-half times the employee’s basic hourly
rate of pay. NOTE: [For a full-time employee on a compressed
work schedule, overtime is pay-able for hours of work in
excess of the basic work requirement. For a part-time employee
on a compressed work schedule, overtime is payable for hours
of work in excess of the basic work requirement for a day
(but must be in excess of 8 hours) or for a week (but must
be in excess of 40 hours)]. |
PAY AND BENEFITS WATCH (Posted
25 Jan 2007) Rating
Benefits By Karen Rutzick
How do your 1.8 million federal co-workers feel about their
pay and benefits? The Office of Personnel Management surveyed
220,000 of them to get an idea. Some of the results released
last week could have been expected. But there were some
surprises, too.
This column is published at http://www.govexec.com/dailyfed/0107/012507pb.htm |
| DEA Exemption Letter
December 8, 2006
A recent email discussed that the
VA will need to require DEA registration for all PAs. After
further discussion, it was clarified that a PA may be licensed
in any state. However, personal DEA registration requires
licensure in the state in which the facility of employment
is located. Those not licensed in their state of practice
may use the facilities DEA number. This may seem to avoid
a problem but VA Pharmacy is pushing to implement a new
tracking system that requires every practitioner have their
own DEA number. So… we may have a reprieve for now
but there will be problems down the road. The best permanent
solution is to exempt VA practitioners from DEA registration
in the first place.
21 CFR 1300.01(b)(28) - "The term mid-level practitioner
means an individual practitioner, other than a physician,
dentist, veterinarian, or podiatrist, who is licensed, registered,
or otherwise permitted by the United States or the jurisdiction
in which he/she practices to dispense a controlled substance
in the course of professional practice."
Since VA practitioners are "agents" of the United
States and states recognize they do not have jurisdiction
over federal facilities, VA should use it's authority and
authorize ALL prescribing authority irrespective of state
licensure status. DOD did it. We just need someone with
enough chutzpa in the VA to override VA General Counsel
to make it happen.
|
Health
care employees benefit from retention bonuses
By Karen Rutzick (of GOVEXEC.com)
Health care workers are reaping the benefits of federal agencies'
efforts to use cash incentives to keep stellar employees on
the job, the Office of Personnel Management reported Monday.
Based on data from every agency that awarded retention
bonuses in 2005, OPM calculated that five of the top 10
occupations to receive retention incentives were in health
care: nurse, medical officer, pharmacology, physician's
assistant and practical nurse.
One reason for the health care emphasis is the disproportionate
use of retention incentives by the Health and Human Services
Department. HHS, which employs less than 70,000 people,
doled out more than a third of the 3,000 retention bonuses
throughout government 2005. The agency spent about $12 million
on the incentives to keep high-performing employees at risk
of leaving the agency.
Full story: http://www.govexec.com/story_page.cfm?articleid=35110&dcn=e_gvet
|
| Military
PAs - Recently Mobilized National Guard PAs Need To Read
This:
You have been identified as a Soldier that has served on
Title 10 Mobilization orders on or after September 11, 2001.
You may be eligible for educational benefits under the Reserve
Educational Assistance Program (REAP), Chapter 1607, Title
10, U.S. Code, as established by the Ronald Reagan National
Defense Authorization Act of 2005.
In accordance with this provision of the law, it is a requirement
that you be notified of these benefits.
To obtain your Eligibility for Mobilized Soldier (EMS),
or receive further instructions, please click on the following
link.
https://www.nationalguardbenefits.com/MGIBWeb/CH_1607_Notification.aspx?SessionID=bd9332fa-bc8f-4365-be0e-efcd21ec8a5f
Alternatively you can follow these steps to obtain your
Eligibility for Mobilized Soldier (EMS) notification -
Go to https://www.nationalguardbenefits.com/
Logon using your AKO username and password
Review and print your Eligibility for Mobilized Soldier
(EMS) notification
POC for this email message is the ARNG GI Bill Support
Team.
ARNG GI Bill Support Team
Email.: esc@PEC.NGB.army.mil
Phone: 1-866-628-5999
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Proficiency Guidelines for Physician
Assistant Rating / Evaluation
HTML Document PA-Rate
Document
Proficiency Rating
System: (MP-5,
Part II, Chapter 6)
http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1042
ANNUAL LEAVE ACCRUAL
FOR PAs:
Handbook
5011 (Moved to OHRM Web Site)
Creditable
Service for Annual Leave:
http://www1.va.gov/ohrm/WorkLife/Leave/Flyer06-15.doc
Provider
Credential Information:
PAs are included in the VHA Directive
2001-013, Maintaining Provider Credential Information in
the VistA NewPerson File has been approved for distribution;
it may be found on the following web sites:
Internet http://www.va.gov/publ/direc/health/
Intranet http://vaww.va.gov/publ/direc/health/
Assignments,
Staff Adjustments, and Furloughs:
http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1428
Comp Time for Travel:
Compensation Time For Travel - VA
Handbook 5007, Part VIII, Chapter 15.doc
(2) Under the authority
of 38 U.S.C. 7421(a), the Secretary has extended provisions
of 5 U.S.C. 5550b, Compensatory Time Off for Travel, to
nurses, physician assistants, expanded function dental auxiliaries
and title 38 hybrid employees entitled to overtime under
38 U.S.C. 7453 and to part-time physicians, dentists, podiatrists,
chiropractors and optometrists appointed under 38 U.S.C
7306, 7401 or 7405. [Latest complete version is on VA website
dated July 20, 2005]
http://www1.va.gov/ohrm/Directives-Handbooks/Documents/5007-19.DOC
Other Directives (some
with Handbooks attached):
http://www1.va.gov/vhapublications/publications.
or http://www1.va.gov/ohrm/Directives-Handbooks/Direct_Hand.htm
(Human Resources HBs)
Other Handbooks:
http://www1.va.gov/vhapublications/publications
|
VA
HANDBOOK 5011/6, PART III, CHAPTER 3, 6.
ACCRUALS OF ANNUAL AND SICK LEAVE
f. Maximum Leave Accumulation,
(1) Annual Leave
(a) Full-Time Physicians, Dentists, Podiatrists , Chiropractors,
or Optometrists. A full-time physician, dentist, podiatrist
or optometrist may carry forward not more than [86] days
of accumulated annual leave at the end of any leave year.
(b) Full-Time Nurses, PAs or EFDAs. A
full-time nurse, PA, or
EFDA may carry forward not more than 685
hours of accumulated annual leave at the end of any leave
year.
(c) Part-Time Employees. A part-time employee may carry
forward not more than 240 hours of accumulated
annual leave at the end of any leave year except that an
employee converted to part-time from full-time may carry
forward more hours of unused annual leave as indicated in
subparagraphs 1 and 2.
http://vaww.appc1.va.gov/ohrm/Directives-Handbooks/Direct_Hand.htm
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Code of Federal Regulations
You can find the specific regulations at the DEA website:
http://www.deadiversion.usdoj.gov/
Also please check these specific pages; http://www.deadiversion.usdoj.gov/drugreg/index.html
It is so unique for VHA not to be requesting an exemption
for registration. See 1301.23. There are no PAs in the DOD,
Military or PHS required to have DEA registration (or state
license) to prescribe scheduled medications.
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July 1, 2006 Urgent Information from AAPA
About FOR-PROFIT Specialty Exam Company
House of Delegates policies concerning specialty certification
(http://www.aapa.org/policy/against-spec-cert.html).
|
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June 6, 2002
Texas Allows PAs to Submit for Reimbursement Without License!
Texas now has a law that allows PAs without licensure to
submit for insurance reimbursement for services if they
use the hospital or clinic's provider number. It is hoped
that more states will follow suit, so that federally employed
PAs, who due to their unique relationship with their supervising
physician in the federal system, cannot qualify for licensure
in most states, can have their services reimbursed. This
will help PAs become more widely acceptable, within the
federal system, we hope. |
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