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Timeline: VAPAA's History and Accomplishments

1965: The PA Profession is born

    • First PAs Graduate - Duke University
    • VA hired first PA in Durham, NC


    • The PA Certificate Program is developed, a collaborative effort by Michael E. DeBakey VAMC & Baylor University
    • First PA Qualifications are established for positions GS-7 through GS -11
    • Comprehensive Health Manpower Act of 1971: Congress includes $4 million for establishment of new PA educational programs
    • First “PA Utilization Guidelines” are established - VA standardizes the role of PAs by defining specific hospital departments and the functions in which PAs can be utilized
    • First Bachelor’s Degree program for PAs is established at Alderson-Broaddus College (West Virginia)


    • NCCPA is established, the national PA certifying exam is created, PA-C becomes the new credentials


    • PAs are granted prescriptive authority in 10 states

1984: VAPAA is founded 

1986: 717 PAs employed by the VA


    • 869 PAs employed by the VA
    • Master’s Degree in PA Studies is first awarded, Duke University

1989: VAPAA is chartered as a constituent chapter of the AAPA


“General Guidelines for Physician Assistants” (VA circular 10-91-117) is published:

    • PAs have “managing” physicians required to be available for immediate consultation via telephone
    • All PA orders require physician co-signature


  • First Chairperson of the VA’s PA Field Advisory Committee is appointed and involved in writing the
  • PA Qualification Standards, including the ability for PAs to advance to Grade 13

1994: VAPAA holds its first independent CME conference in Minneapolis, MN


    • VAPAA meets with Under Secretary for Health (USH) to advocate signing of a revised utilization policy

which restructures VA PA practice

    • “PA Guidelines for Utilization” (VA Directive 10-95-020) is signed and published

  -PAs have a SOP and “supervising” physicians that require daily contact by phone or in person

  -All initial inpatient/outpatient H&Ps and discharge summaries require co-signature

  -PAs have Rx authority and orders written by PAs no longer require co-signature


      • VAPAA works with DEA to allow controlled substance prescriptive authority
      • VHA utilizes a national “Lead PA,” an informal position that advises on policy and gives guidance on PA practice 2000:
      • National PA Advisor role is established, reports to the USH within VHA, advises on PA employment and utilization (Public Law 106-419
      • 1,100 PAs employed by the VA
      • National PA Advisor role is established, reports to the USH within VHA, advises on PA employment and utilization 


      • Educational Debt Reduction Plan (EDRP) is established which includes PA
      • First PA Doctoral Program is established at Nova Southeastern University (Florida)


      • A Field Advisory Committee (PA-FAC) is established
      • PA Advisor and PA-FAC makes comprehensive revisions to Directive 2004-029: “Utilization of PAs:”

      -Lists specific duties PAs can perform

      -Provides requirements for PAs to prescribe controlled and non-controlled medication

      -PAs are considered to be “supervised” by physicians

    2007: PAs have prescriptive authority in all 50 states, DC and Guam

    2008: Over 1,600 PAs employed by the VA

    2010: 1,878 PAs employed by the VA


      • First PA residency program established
      • Congress promotes the VHA PA Advisor to Director of PA Services, a full-time position reporting on PA education, training, employment, utilization, and optimal participation of PAs in the VA (H.R. 1302)
      • NCCPA administers first “Certificate of Added Qualifications” (CAQ), developed to credential PAs in specialty fields


      • “Utilization of Physician Assistants” (Directive 1063) is revised and published:

                   -the term "collaborate" is used to describe the relationship between PAs and Physicians instead of the term “supervise” 

                   -Physician co-signature is not required on PA notes or orders

                   -PA autonomy levels established

                   -Facility Lead PA positions are established


        • 2,020 PAs employed in the VA
        • VAPAA Conference held in Houston, TX (October)
        • VAPAA Legislative Committee Member provides testimony to Congress; recommendation highlights:

        -Convert PAs to LPS to remain competitive with the private sector

        -Include education debt reduction incentive (EDRP) in all PA job postings

        -Include PAs in the hierarchy for funding allocation for scholarship program (EISP)

        -Streamline PA hiring process at VA


        • VAPAA Conference held in Houston (February)
        • The Choice and Quality Employment Act of 2017 is approved and allows for competitive pay for VA PAs by adding 
                them to the Title 38 Locality Pay System (LPS)
        • VA’s Health Professional Scholarship Program (HPSP) awards scholarships to PAs


        • 2,400+ PAs employed by VA
        • Federal Rule: “Anywhere to Anywhere Care” is established and allows VA providers (including PAs) ability to provide care to Veterans across state lines when using telehealth technology


        • VAPAA Conference held in San Antonio (November) 


        • 2,600+ PAs employed by VA
        • Implementation of “The Choice and Quality Employment Act of 2017”: PAs in the VA are converted from GS scale 
                to LPS (PA 1-5), allowing for competitive pay 


        • PA profession is named best overall job in US News & and World Report
        • PA title is changed to “Physician Associate” by AAPA


        • 2,700 PAs employed by VA
        • R.A.I.S.E (Retention and Income Security Enhancement) Act signed into LAW and increases PA and nurse pay caps


        • 2,850 PAs employed by VA
        • VAPAA CME Conference & Annual Meeting in Orlando, FL (November) 

      The stars above signify the tremendous dedication and effort made by VAPAA which has successfully advanced the PA profession in the VA system

      Veterans Affairs PA Association 

      PO Box 4968

      Lago Vista, TX 78645

      VAPAA is a 501c(6) non-profit organization

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