VAPAA's History and Accomplishments

1965: PA Profession is born


1967

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


1971: 

  • 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


1972:

  • 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


1975:

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


1980: 

  • PAs are granted prescriptive authority in 10 states

1984: VAPAA is founded 

1986: 717 PAs employed by the VA

1988: 

  • 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


1991: “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


1993: 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


1995: 

  • 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


    1997: 

    • 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)


    2000:

    • 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 


    2002

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


    2004:

    • 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


    2011:

    • 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


    2013:

    • “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


      2015:

      • 2,020 PAs employed in the VA
      • 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


      2017:

      • 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


      2018:

      • 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


      2020:

      • 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 with private sector


      2021:

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


      2022:

      • 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

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


      Contact VAPAA: Leadership@vapaa.org

      Veterans Affairs Physician Assistant Association 

      13423 Blanco Rd

      Unit #3057 

      San Antonio, TX 78216

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


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