AAPA's Policy Manual - American Academy of Physician Assistants

Last updated October 24, 20122012-2013 Policy ManualAAPA MissionAAPA provides innovative solutions that empower our members to connect,enhance their careers and improve patient health.AAPA VisionPAs transforming health through patient-centered, team-based care.

AAPA Core ValuesExcellenceAAPA sets a high standard of performance and demonstrates competence in its actions and support ofPAs.AAPA demonstrates innovation and vision as it enhances the visibility and value of the profession,while supporting and enabling PAs and their patient-centered focus.AAPA sets a high standard of performance for its staff and promotes the same as a standard for theprofession.EthicsIn all of its activities, AAPA acts with integrity and civility with its members, business partners, andothers.AAPA, by its example, encourages all PAs to adhere to the highest standards of professional behavior.ExpertiseAAPA is recognized by PAs and the health care community broadly as the primary authority on issuesrelated to the utilization and practice of PAs.AAPA promotes its members as experts in patient care, providers of innovative solutions to healthcare challenges, and knowledgeable members of the patient-centered health care team.LeadershipAAPA is at the forefront of critical and innovative thinking in its efforts to increase patient access toquality health care services.AAPA considers and moves forward creatively to advance the profession and improve health care.AAPA promotes and positions the PA profession to maximize its influence on health care policy, thussecuring the future of the profession.AAPA supports continuous quality improvement.AAPA actively attracts recruits and retains member leaders and staff of different backgrounds andvarying perspectives to ensure a diverse pool of qualified applicants when calling for leadershipcandidates.Member-FocusAAPA’s paramount concern is to understand, appreciate, and respond to the unique needs andconcerns of its members.AAPA always remembers that its sole reason for being is to serve its members and to support theirefforts to serve their patients.AAPA uses its influence to gain recognition for the profession and for its members.2

AAPA BYLAWS[Adopted by revision 2005 and 2010, amended 2006, 2009, 2011, 2012]AAPA BYLAWSARTICLE IName.The name and title by which this corporation shall be known is the American Academy Of Physician Assistants,Inc., herein referred to as the Academy or AAPA.ARTICLE IIPurpose and Mission.The Academy is organized and shall be operated exclusively to ensure the professional growth, personalexcellence, and recognition of physician assistants, and to support their efforts to enable them to improve thequality, accessibility, and cost-effectiveness of patient-centered health care. To represent physician assistantsand physician assistant students so as to maximize the benefit of their services to the public, the Academy shall:a. Encourage its membership to render quality service to the health professions and to the public;b. Develop, sponsor, and evaluate continuing medical or medically related education programs for thephysician assistant;c. Assist in the development of role definition for the physician assistant;d. Assist with the coordination and standardization of curricula for the physician assistant;e. Participate in the accreditation of physician assistant training programs;f. Participate in the development of criteria leading to certification of the physician assistant;g. Develop, coordinate, and participate in studies having an impact either directly or indirectly on thephysician assistant profession;h. Serve as a public information center with respect to its members, health professions, and the public.Notwithstanding any other provision of these Bylaws, the Academy shall exercise its powers, rights, andprivileges, whether conferred by this instrument, or by the laws of the state of North Carolina or otherwise, tocarry on such other activities as are permissible for corporations exempt from federal income tax under Section501(c)(6) of the Internal Revenue Code of 1986.ARTICLE IIIMembership.Section 1: Eligibility. Membership in this Academy shall be open to all individuals wishing to participatein promoting the purposes of the Academy. Specifically, membership shall consist of individuals who arecognizant of their obligation to the public and who meet the requirements for membership as defined by AAPA’sArticles of Incorporation, these Bylaws, and such other of AAPA’s rules and policies that may be establishedfrom time to time. Membership in the Academy is an honor that confers upon the individual certain rights andresponsibilities. Adherence to the AAPA Guidelines for Ethical Conduct for the Physician AssistantProfession (See: PP tab 18), AAPA’s Articles of Incorporation, these Bylaws, and AAPA’s rules and policies,and generally acting in a manner that is consistent with AAPA’s purposes, is a condition of membership.Section 2: Classes of Membership. The membership shall consist of fellow, student, affiliate, sustaining,physician, honorary, associate, retired, and such other members as may be recognized by the Academy.Section 3: Fellow Members. A fellow member shall be a physician assistant who is a graduate of aphysician assistant program accredited by the Accreditation Review Commission on Education for the PhysicianAssistant (ARC-PA), or by one of its predecessor agencies (Committee on Allied Health Education andAccreditation [CAHEA], Commission on Accreditation of Allied Health Education Programs [CAAHEP]) orwho has passed the Physician Assistant National Certifying Examination (PANCE) administered by the NationalCommission on Certification of Physician Assistants (NCCPA) or an examination administered by anotheragency approved by the Academy. Fellow members must satisfy such continuing medical and/or medicallyrelated educational requirements as may be prescribed by the Academy. Non-clinical fellow members will notbe required to maintain continuing medical education (CME). Fellow members shall vote for Academy Officersand Directors with the exception of the Vice President and Student Director, and shall be eligible to hold office.3

Section 4: Student Members. A student member is an individual who is enrolled in an ARC-PA orsuccessor agency approved physician assistant program. Except as otherwise provided in these Bylaws withrespect to the election of the Student Director, student members shall not have the privilege to vote or holdoffice. Notwithstanding the preceding sentence, one student shall be elected by his/her peers to sit on the Boardof Directors and this Student Director shall have and enjoy all rights and privileges of any other member of suchBoard.Section 5: Affiliate Members. Affiliate members shall consist of individuals approved by the MembershipDivision of the National Office from the health professions who desire to associate with the Academy. Affiliatemembers shall be entitled to the privileges of the floor, but shall not be entitled to vote or to hold office.Section 6: Sustaining Members. Sustaining members shall consist of ARC-PA, CAHEA, CAAHEP orsuccessor agency approved physician assistant program graduates who have chosen not to actively practice in theprofession and opt to be classified as sustaining members. Sustaining members shall be entitled to privileges ofthe floor, but shall not be entitled to vote or hold office.Section 7: Physician Members. Physician members shall consist of licensed physicians who desire toassociate with the Academy. Physician members shall be entitled to the privileges of the floor, but shall not beentitled to vote or hold office.Section 8: Associate Members. Associate members shall consist of representatives of businesses engagedin selling products or services to PAs or individuals employed by government agencies who do not qualify forany other membership category. Associate members are not entitled to the privileges of the floor, to vote, or tohold office.Section 9: Honorary Members. Honorary membership may be conferred by the Academy upon nonphysicianassistants who have rendered distinguished service to the physician assistant profession. Honorarymembers shall have all the rights and privileges of the Academy with the exception of voting, holding office,and/or chairing commissions or work groups. All honorary members shall be exempt from the payment of dues.Section 10: Retired Members. A retired member shall be a physician assistant who is a former fellowmember who has chosen to retire from the profession, and opts to be classified as a retired member. Retiredmembers shall be entitled to privileges of the floor, but shall not be entitled to vote or hold office.Section 11: Applications for Membership. All applications for membership shall be in a format approvedby the Membership Department of the National Office. There shall be issued to each member a certificate ofmembership in such form as may be determined by the Membership Department of the National Office; title tosuch certificate shall remain at all times with the Academy.Section 12: Suspension or Revocation of Membership. Membership in the Academy may be suspended orrevoked as provided in Article X. Any member who has been suspended or has their membership revoked shallnot be entitled to any of the rights or benefits of this Academy or be permitted to take part in any of theproceedings until (s)he has been reinstated.Section 13:Non-Discriminatory Policy. AAPA will remain non-discriminatory in granting membership.Section 14: Annual Meeting. There shall be an annual meeting of those members who are entitled to votefor Directors, to be held during the Academy’s annual conference, or at such other time and place as may bedetermined by the Board of Directors. Notice of the place, date, and time of the annual meeting shall be given tothose members who are entitled to vote for Directors at least 30 days but not more than 60 days before themeeting date. Notice may be delivered by electronic means.ARTICLE IVConstituent Organizations.Constituent organizations consist of state and federal services chapters, specialty organizations, caucuses and4

special interest groups, as defined in AAPA policy.ARTICLE VStudent Academy.Section 1: Purpose. The Student Academy of the AAPA is the national representative body of the AAPAstudent members and, as such, while embracing all the AAPA policies and purposes, the Student Academyfurther strives to serve students.Section 2: Assembly of Representatives. The Student Academy shall have an Assembly ofRepresentatives (“AOR”), which shall represent the interests of the AAPA student members. The AOR shall becomposed of representatives of the student members as set forth in the Student Academy Bylaws and policies.The AOR is responsible for determining the process for selection of the student delegates to the AAPA House ofDelegates in accordance with Article VI, Section 2.Section 3: Student Director. The Student Director of the Academy shall be elected in the manner setforth in the Student Academy Bylaws and policies, and in accordance with the requirements of North Carolinalaw.ARTICLE VIHouse of Delegates.Section 1: Duties and Responsibilities. The Academy shall have a House of Delegates, which shallrepresent the interests of the membership. The House of Delegates shall exercise the sole authority on behalf ofthe Academy to enact policies establishing the collective values, philosophies, and principles of the physicianassistant profession. The House of Delegates shall make recommendations to the Board for granting charters toChapters and for granting official recognition to specialty organizations. The House of Delegates shall makerecommendations to the Board for the establishment of Academy commissions and work groups, and shallestablish such committees of the House of Delegates as necessary to fulfill its duties. The House of Delegatesshall be entitled to vote on amendments to these Bylaws on behalf of the members in accordance with ArticleXIII of these Bylaws. The House of Delegates shall be solely responsible for establishing such rules ofprocedure, which are not inconsistent with these Bylaws, the Articles of Incorporation, or existing law, as maybe necessary for carrying out the activities of the House (i.e. House of Delegates Standing Rules).Section 2: Composition. The voting membership of the House of Delegates shall consist of theimmediate past and current House Officers, one delegate elected by each officially recognized specialtyorganization, one delegate from each caucus, delegates from Chapters, and delegates from the Student Academyof the American Academy of Physician Assistants. All delegates, other than those of the Student Academy, shallbe fellow members of the Academy. Student delegates shall be student or fellow members of the Academy. Thedelegates from the Chapters, specialty organizations, and caucuses are elected by the fellow members of thoseorganizations. Chapter and Student Academy delegate seats shall be allocated as follows:a. Chapter Delegates. Each Chapter shall be entitled to two (2) delegates. Additional delegateswill be apportioned among the Chapters according to the number of Academy fellow memberswithin the jurisdiction of each as of January 31 of each year. When the number of fellowmembers within a Chapter’s jurisdiction exceeds 220, it will be apportioned a third delegate.An additional delegate will be apportioned for each 300 additional members within a Chapter’sjurisdiction thereafter. The Academy’s Constituent Relations Work Group will develop andrecommend to the Board the definition of the Chapters’ jurisdiction.b. Student Academy Delegates. The Student Academy shall be entitled to one delegate for each600 Student Academy members as of January 31 of each year.Section 3: House Officers. The House of Delegates shall elect from among its members the followingHouse Officers: a Speaker (who shall also serve as Vice President of the Academy), a First Vice Speaker, and aSecond Vice Speaker (the First Vice Speaker and the Second Vice Speaker are not Officers of the Corporation).a. Election and Term of Service. Each House Officer shall be elected by a majority of votes cast.No absentee or proxy vote shall be cast. The Governance Commission shall determine the5

general procedures for House Officers elections. The terms of office shall be as specified inArticle XIII, Section 2.b. Delegate-at-large Designation. Each House Officer elected shall become a delegate-at-largeduring the term(s) as a House Officer, plus one additional year as an immediate past HouseOfficer. The delegate-at-large shall be accorded all the rights and privileges of electeddelegates.c. Duties of House Officers.i. The Speaker shall preside at all meetings of the House of Delegates.ii. The First Vice Speaker shall assume the duties of the Speaker in the event ofthe absence of the Speaker, or in the event of vacancy in the position of Speaker.iii. The Second Vice Speaker will assume the duties of the First Vice Speaker inthe absence of the First Vice Speaker, or in the event of vacancy in the position ofFirst Vice Speaker.iv. The Second Vice Speaker shall be responsible for verification of thecredentials of the delegates, for compiling the records of all general meetings of theHouse of Delegates, and for submitting such records to the Secretary-Treasurer ofthe Academy for filing with the Academy’s books and records.d. Resignation or Removal of House Officers. Any House Officer may resign at any time bygiving written notice to the Speaker, the President of the Academy, or the Board of Directors.Such resignation shall take effect at the time specified in such notice, or, if no time is specified,at the time such resignation is tendered. Any House Officer may be removed from his or herposition at any time, with or without cause, by the affirmative majority vote of the House ofDelegates. Removal may only occur at a meeting called for that purpose, and the meetingnotice shall state that the purpose, or one of the purposes, of the meeting is removal of theHouse Officer. Vacancies in these positions shall be filled in accordance with Article VI,Section 3 and Article XIII, Section 10 of these Bylaws.Section 4:Meetings of the House of Delegates.a. Annual and Special Meetings. The House of Delegates shall hold an annual meeting. Specialmeetings of the House of Delegates shall be called by the Speaker upon written request of 25percent or more of the delegates. Special meetings of the House shall also be called by a twothirds(2/3) affirmative vote of the Board of Directors. The object of such special meetingsshall be stated in the meeting notice, and no other business other than that specified in thenotice shall be transacted at the meetingb. Notice. Notice of the place, date, and time of meetings of the House of Delegates shall begiven to each member of the House of Delegates at least 30 days but not more than 60 daysbefore the meeting date. If proposed Bylaws amendments are to be presented to the House ofDelegates for approval at the annual House meeting, the notice of the meeting shall include adescription of the proposed amendments to be approved, and must be accompanied by a copyor summary of the proposed amendments. Notice of a special meeting shall include adescription of the matter or matters for which the meeting is called. Notice may be deliveredby electronic means.c. Quorum. A majority of the total number of delegates shall constitute a quorum at any meetingof the House of Delegates. Unless otherwise stated in the Bylaws, an affirmative vote by amajority of the delegates present and voting shall constitute action of the House.d. Mail and Electronic Voting. Mail and electronic voting of the House of Delegates will bepermitted for any House business. Mail and electronic votes will be called for by the Speakerof the House when directed by: (i) a simple majority of the House Officers; (ii) a two-thirdsaffirmative vote of the Board of Directors; or (iii) a call from 25 percent of delegates currentlycredentialed. Additionally, mail and electronic votes will be called for by the Speaker whenthere is a vacancy in an elected office of the House during the time period between regularlyscheduled House elections. The House of Delegates Officers and Academy staff shalldetermine the procedures for voting on issues requiring a mail or electronic ballot, subject tothe requirements of the North Carolina Nonprofit Corporation Act.ARTICLE VIIBoard of Directors and Officers of the Corporation.6

Section 1: Board Duties and Responsibilities. The Academy shall have a Board of Directors, which, inaccordance with North Carolina law, shall be responsible for the management of the Corporation, including, butnot limited to, management of the Corporation’s property, business, and financial affairs. In addition to theduties and responsibilities conferred upon it by statute, by the Articles of Incorporation, or by these Bylaws, it isexpressly declared that the Board of Directors shall have the following duties and responsibilities:a. To grant charters to Chapters, recognize specialty organizations, establish criteria forcaucuses, and establish Academy commissions or work groups as may be in the best interestsof the Academy, taking into consideration any recommendations of the House of Delegatesthereon;b. To appoint or remove the Executive Vice President pursuant to the affirmative vote of a twothirds(2/3) majority of the Directors;c. To direct the activities of the Academy’s national office through the Executive Vice President;d. To provide for the management of the affairs of the Academy in such a manner as may benecessary or advisable;e. To establish committees necessary for the performance of its duties;f. To establish, regularly review, and update the Academy's management plan to attain the goalsof the Academy;g. To call special meetings of the House of Delegates as provided under Article VI, Section 4;h. To report the activities of the Board of Directors for the preceding year to the House ofDelegates and members at the Academy’s annual meeting;i. To establish the amount and timing of Academy membership dues and assessments.j. To review and determine, on no less than an annual basis, how to implement those policiesenacted by the House of Delegates on behalf of the Academy that establish the collectivevalues, philosophies, and principles of the physician assistant profession. If it determines thatimplementation of one or more such policies will require an inadvisable expenditure ofAcademy resources, or is otherwise not presently prudent or feasible, the board shall, at itsearliest convenience, report to the House the reasons for its decision.Section 2: Board Composition. There shall be the following members of the Board of Directors: five (5)Academy Officers, five (5) Directors-at-large, one (1) Student Director, and the First Vice Speaker and SecondVice Speaker. The First Vice Speaker and Second Vice Speaker are voting members of the Board of Directorsby virtue of position. The terms of office shall be as specified in Article XII, Section 2.Section 3: Officers of the Corporation. The Officers of the Corporation shall be a President, a Presidentelect,a Vice President, a Secretary-Treasurer, and the Immediate Past President (“Academy Officers”). TheAcademy Officers are voting members of the Board of Directors by virtue of position.Section 4:Duties of Officers of the Corporation.a. The President shall be the chief spokesperson for the Academy. The President shall report tothe House of Delegates and the members at the annual meeting of the Academy with anaccount of the activities of the Board for the past year and its recommendations for the Houseof Delegates.b. The President-elect shall succeed to the office of President at the expiration of the President’sterm or earlier should that office become vacant for any reason.c. The Vice President is the Speaker of the House of Delegates and shall represent the House ofDelegates to the Board of Directors and shall perform such other duties as shall be assigned bythe Board of Directors.d. The Secretary-Treasurer shall:i. be responsible for adequate and proper accounts of the properties and funds of the Academy;ii. give a full report to the membership at the annual meeting;iii. deposit or call to be deposited all monies and other valuables in the name and to the credit ofthe Academy with such depositories as may be designated by the Board of Directors;iv. disburse the funds of the Academy as may be ordered by the Board of Directors;7

v. render to the Board of Directors, whenever it may request it, an account of all thetransactions as Secretary-Treasurer, and of the financial conditions of the Academy;vi. maintain the records of the Academy including the records of the Board of Directors and ofthe House of Delegates;vii. execute the general correspondence;viii. attest the signature of the Academy Officers;ix. affix the corporate seal on documents so requiring; andx. have such other powers and perform such other duties as may be prescribed by the Presidentor the Board of Directors.e. The Immediate Past President shall perform such other duties as may be assigned by thePresident or the Board of Directors.Section 5:Meetings of the Board of Directors.a. Regular and Special Meetings. The Board of Directors shall hold such regular meetings atsuch time and at such places as designated by Board policy, but in no event shall there befewer than two such meetings in any calendar year. Regular meetings of the Board may beheld without notice. Special meetings shall be called by the Secretary-Treasurer at the requestof the President or upon written request to the President of at least 20 percent of the membersof the Board then in office. The object of such special meetings shall be stated in the meetingnotice, and no business other than that specified in the notice shall be transacted at the meeting.Notice of a special meeting shall be provided not less than two (2) days before the meeting.b. Quorum. A majority of the membership of the Board then in office shall constitute a quorumfor the purposes of transacting business.c. Manner of Acting. The affirmative vote of a majority of the Directors present at a meeting atwhich a quorum is present shall be the act of the Board of Directors, except as otherwiseprovided by law, by the Articles of Incorporation, or by these Bylaws. Each Director shallhave one (1) vote on all matters submitted to a vote of the Board of Directors. No Directorvoting by proxy shall be permitted.d. Teleconferencing. To the extent permitted by law, any person participating in a meeting of theBoard of Directors may participate by means of conference telephone or by any means ofcommunication by which all persons participating in the meeting are able to hear one another,and otherwise fully participate in the meeting. Such participation shall constitute presence inperson at the meeting.e. Action by Unanimous Written Consent. Any action required to be taken at a meeting of theBoard of Directors or any action which may be taken at a meeting of the Board of Directorsmay be taken without a meeting if a consent in writing, setting forth the action so taken, issigned by all of the Directors entitled to vote with respect to the subject matter thereof. ADirector's consent to action taken without a meeting may be in electronic form and deliveredby electronic means.Section 6: Chair of the Board. The Board of Directors may elect a Chair of the Board from among itsmembers. The Chair of the Board shall have such duties and responsibilities and may be elected according tosuch procedures as may be determined by the Board from time to time.Section 7: Executive Committee. The Executive Committee of the Board of Directors shall consist of thePresident, Vice President, President-elect, Immediate Past President, Chair of the Board, and Secretary-Treasurer. The Executive Committee shall be empowered to act for the Board of Directors on emergencymatters only. Actions of the Executive Committee shall be reported to the Board of Directors no later than theBoard’s following meeting. All such Committee actions must be reviewed and ratified by the Board of Directorsand shall be included in the official Board minutes.Section 8: Resignation or Removal of Directors and Officers of the Corporation. Any Director orAcademy Officer may resign at any time by giving written notice to the President or the Board of Directors.Such resignation shall take effect at the time specified in such notice, or, if no time is specified, at the time suchresignation is tendered. Any Director-at-large, Student Director, or Academy Officer (excluding the VicePresident) may be removed from office at any time, with or without cause, by the affirmative majority vote of8

those members entitled to elect them. Removal may only occur at a meeting called for that purpose, and themeeting notice shall state that the purpose, or one of the purposes, of the meeting is removal of the Director orOfficer. Vacancies in these positions shall be filled in accordance with Article XII, Section 11 of these Bylaws.Removal of the Vice President/Speaker shall be done in accordance with Article VI, Section 3 of these Bylawspertaining to House Officers.ARTICLE VIIIExecutive Vice President.An Executive Vice President (EVP) may be employed by the Academy. The EVP shall have such rights,powers, duties, and responsibilities as may be set forth by the Board of Directors from time to time, consistentwith that provided in any employment agreement. The EVP shall be bonded at the expense of the Academy insuch amounts as the Board of Directors may require. The Executive Vice President shall have no vote in themeetings of the Board of Directors. The Executive Vice President shall be under the control and supervision ofthe Board of Directors and, in the case of his/her death, resignation, or removal, the Board of Directors shallhave the power to fill the vacancy.ARTICLE IXSection 1:Judicial Affairs.The Board of Directors shall be responsible for the internal judicial affairs of the Academy.Section 2: The Academy has the inherent right through the Board of Directors to discipline, suspend, orexpel an Academy member or Academy-recognized PA organization.Section 3: Anyone may in good faith refer charges against any Academy member or AcademyrecognizedPA organization believed to have violated the Academy Articles, Bylaws, policies, or rules, or forunethical or unprofessional conduct, or for failure to uphold the principles outlined in the Guidelines for EthicalConduct for the Physician Assistant Profession (See: PP tab 18), or for acting in a manner inconsistent withAAPA’s purposes.Section 4: The Academy, after due notice and hearing, may discipline any member or AcademyrecognizedPA organization for a violation of the Academy Articles, Bylaws, policies, or rules, or for unethicalor unprofessional conduct, or for failure to uphold the principles outlined in the Guidelines for Ethical Conductfor the Physician Assistant Profession (See: PP tab 18), or for acting in a manner inconsistent with AAPA’spurposes. The notice and hearing procedures for such disciplinary actions may be determined by the Board ofDirectors from time to time.Section 5: If any member has their physician assistant license, certificate, registration, or temporarypermit currently revoked as the result of a final adjudicated disciplinary action for violation of their professionalpractice statutes or regulations, then their AAPA membership shall be automatically revoked. Any individualwho has their physician assistant license, certificate, registration, or temporary permit currently revoked as theresult of a final adjudicated disciplinary action for violation of their professional practice statutes or regulationsshall be ineligible to apply for AAPA membership during the period of that revocation.ARTICLE XBoard Committees; Academy Commissions and Work Groups; Task Forces, Ad Hoc Groups.Section 1: Board Committees. The Board of Directors, by resolution adopted by a majority of theDirectors present at a meeting at which a quorum is present, may establish and appoint such Board Committeesas may be necessary to carry out the duties of the Board. Only members of the Board of Directors shall beeligible to serve on Board Committees, and each Board Committee shall have two or more members, who shallserve at the pleasure of the Board. Board Committees may exercise the Board’s authority only to the extentspecified by the Board of Directors by resolution, or by the Articles of Incorporation or these Bylaws. A BoardCommittee shall not, however, (1) authorize distributions; (2) recommend to members or approve dissolution,merger or the sale, pledge, or transfer of all or substantially all of the corporation’s assets; (3) elect, appoint, orremove Directors, or fill vacancies on the Board of Directors or any of its committees; or (4) adopt, amend, orrepeal the Articles of Incorporation or the Bylaws. The designation of and the delegation of authority to anysuch committee shall not operate to relieve the Board of Directors, or any individual Director, of anyresponsibility imposed upon them by law.9

Section 2: Other Committees. Other committees not having and exercising the authority of the Board ofDirectors in the management of the Corporation may be designated by the Board of Directors or by the House ofDelegates as follows:a. Commissions and Work Groups. The House of Delegates shall recommend to the Board theestablishment of commissions and work groups of the Academy. The Board of Directors shallestablish such commissions and work groups, and set forth the respective duties,responsibilities, and membership eligibility requirements thereof as the Board may deemadvisable. With the exception of the Nominating Work Group, the Board of Directors shallappoint commission and work group chairs and members according to procedures establishedby the Board.b. Task Forces, Ad Hoc Groups and Other Committees. The Board of Directors may establishand appoint such Academy task forces and ad hoc groups and set forth the respective duties,responsibilities, and membership eligibility requirements thereof as the Board may deemadvisable. The House Speaker may establish and appoint such House Committees and ad hocgroups as may be necessary to carry out the duties of the House of Delegates.ARTICLE XINominating Work GroupSection 1: Duties and Responsibilities. The Nominating Work Group shall carry out such duties andresponsibilities as (1) are set forth in these Bylaws; and (2) are established by the Board of Directors inaccordance with Article X, Section 2, subject to the approval of the House of Delegates. Such duties andresponsibilities shall include:a. Receiving applications from potential candidates seeking nomination for the positions ofpresident-elect, secretary-treasurer, and directors-at-large;b. Evaluating all candidates seeking nomination according to the qualification criteria setforth in these Bylaws and according to such other selection guidelines as may beestablished in accordance with this section;c. Selecting a single or multiple slate of candidates for each nominated position.Section 2: Composition; Method of Election or Appointment. The Nominating Work Group is composedof seven (7) members of which five (5) are elected by plurality vote at the House of Delegates annual meeting.Two members are appointed by the Board of Directors. Nominating Work Group candidates should pre-declaretheir candidacy; however, write-in candidates, and nominations and self-declarations from the House floor willbe accepted at the time of elections. The House of Delegates shall determine procedures for the election of nonboardappointed members to the Nominating Work Group.Section 3: Eligibility and Qualifications. Nominating Work Group members may not run for any of thepositions they are evaluating for the upcoming election. Additionally:a. A candidate must be a fellow member of the AAPA.b. A candidate must have been an AAPA fellow member for the last five years.c. A candidate must have accumulated at least three distinct years of experience in the past fiveyears in at least two of the following major areas of professional involvement:i. An AAPA or constituent organization officer, board member, committee, council,commission, work group, or task force chairii.iii.A delegate or alternate to the AAPA House of DelegatesPA Foundation, Society for the Preservation of Physician Assistant History, PhysicianAssistant Education Association or American Academy of Physician AssistantsPolitical Action Committee trustee, board member or committee chairiv. AAPA board appointees.d. Any calendar year or Academy year in which the candidate served in more than one area ofprofessional involvement shall be counted as one distinct year of experience.10

e. With the exception of the board-appointed members, a Nominating Work Group membercannot hold any other elected office or commission or work group position in the AAPAduring the time of service on the Nominating Work Group.Section 4: Term of Service. The term of service for members of the Nominating Work Group shall betwo (2) years. Terms shall be staggered. Individuals appointed to temporarily fill a vacancy shall be eligible torun for the vacated seat. The unexpired term the appointee previously filled shall not be counted as a filled termfor purposes of determining work group tenure.Section 5:ARTICLE XIIVacancies. Nominating Work Group vacancies shall be filled in the following manner:a. Board-appointed Member. The Board of Directors shall appoint a replacement member tofill the remainder of the unexpired term.b. Elected Members. The House Officers shall appoint a temporary replacement member.The temporary appointees shall serve until replaced by the House of Delegates in thefollowing manner: (1) the position shall be declared open for election at the next House ofDelegates election and shall be filled by appropriate election process; and (2) uponcompletion of the election, the temporary appointee shall continue to serve until the newlyelected work group member takes office at the next change of office.Rules of Order.In the absence of any provisions to the contrary in these Bylaws, all meetings of the Academy, the Board ofDirectors and the House of Delegates shall be governed by the parliamentary rules and usages contained in thecurrent edition of The Standard Code of Parliamentary Procedure.ARTICLE XIIIElections.Section 1: Positions to be Filled by Election. Elected positions include Directors-at-large; one StudentDirector; the Academy Officer positions of President-elect and Secretary-Treasurer; and the House Officerpositions of Speaker, First Vice Speaker, and Second Vice Speaker; and such number of members of theNominating Work Group as may be set forth in Article XI of these Bylaws. The House Officer positions shall befilled by the House of Delegates in the manner prescribed by Article VI, Section 3. The Student Director shall beelected in the manner prescribed by Article V, Section 3. The Nominating Work Group positions shall be filledby the House of Delegates in the manner prescribed by Article XI. All other elected positions shall be filled inthe manner prescribed by this Article XIII.Section 2: Term of Office. The term of office for the Academy Officer positions of President, Presidentelect,and Immediate Past President shall be one year. The term of office for the Student Director shall be oneyear. The term of office for Directors-at-large and for the Academy Officer position of Secretary-Treasurer shallbe two years. The term of service for House Officer positions shall be one year.Section 3: Eligibility and Qualifications of Candidates for Elected Positions Other Than Student Directoror Nominating Work Group Member.a. A candidate must be a fellow member of the AAPA.b. A candidate must be a member of an AAPA Chapter.c. A candidate must have been an AAPA fellow member for the last three years.d. A candidate must have accumulated at least three distinct years of experience in the past fiveyears in at least two of the following major areas of professional involvement. This experiencerequirement will be waived for currently sitting AAPA board members who choose to run for asubsequent term of office.i. An AAPA or constituent organization officer, board member, committee, council,commission, work group, task force chairii.iii.A delegate or alternate to the AAPA House of DelegatesA board member, trustee, or committee chair of the PA Foundation, Society for thePreservation of Physician Assistant History, American Academy of Physician Assistants11

iv.Political Action Committee, Physician Assistant Education Association or NationalCommission on Certification of Physician Assistants.AAPA board appointees.Section 4: Self-declaration of Candidacy. Self-declaration, in accordance with policy, shall be permittedin the election of Academy Officers, Directors-at-large, and House Officers.Section 5: Time of Elections. The time of House Officers’ elections is prescribed in Article VI, Section3. The Governance Commission shall determine the timing of elections of all other positions, in accordance withthe requirements of these Bylaws.Section 6: Eligibility of Voters. For all positions other than the Student Director, House Officer, andNominating Work Group positions, eligible voters are fellow members listed on the Academy membership rosteras of the date that is thirty (30) days before the election.Section 7: Election Procedures. The Governance Commission shall determine the procedures for theelection of Academy Officers and Directors-at-large, including the dates for distribution and return of ballots,subject to the requirements of the North Carolina Nonprofit Corporation Act. Voting shall be by mail orelectronic ballots. The Academy staff shall manage the ballot distribution. The procedures for electing theHouse Officers are prescribed in Article VI, Section 3; and the procedures for electing the Student Director areprescribed in Article V, Section 3; and the procedures for electing members of the Nominating Work Group shallbe determined by the House of Delegates in accordance with Article XI, Section 2.Section 8: Vote Necessary to Elect. A plurality of the votes cast shall elect the Directors-at-large and theAcademy Officers (excluding the Vice President), so long as the number of votes cast equals or exceeds aquorum of one (1) percent of the members entitled to vote in the election. In the case of a tie vote, theGovernance Commission shall determine the process for selecting the winner. The vote necessary to elect theHouse of Delegates Officers (including the Speaker, who shall serve as the Vice President of the Academy) shallbe prescribed in Article VI, Section 3.Section 9: Commencement of Terms. The term of office for all elected positions, including Directors-atlarge,the Student Director, Academy Officers, and House Officers, shall begin on June 10. In the event that theelection of the House Officers occurs later than June 10, the new House Officers will take office at the close ofthe meeting during which they were elected.Section 10: Vacancies. Academy Officers and Directors, and House Officers may resign or be removed asprovided in these Bylaws. The method of filling positions vacated by the holder prior to completion of termshall be as follows:a. OFFICE OF THE PRESIDENT. The President-elect shall become the President to serve theunexpired term. The President-elect shall then serve his/her own successive term as President.b. OFFICE OF THE PRESIDENT-ELECT. In the event of a vacancy in the office of Presidentelect,the Immediate Past President shall assume the duties, but not the office of the Presidentelectwhile continuing to perform the duties of Immediate Past President. The NominatingWork Group will prepare a slate of candidates. The House of Delegates shall elect a newPresident-elect from the candidates proposed and any candidates that self-declare, who willtake office immediately upon election and will serve the remainder of the un-expired term.c. SPEAKER; FIRST VICE SPEAKER; SECOND VICE-SPEAKER. A vacancy in thepositions of the Speaker, First Vice Speaker, or Second Vice Speaker shall be filled in themanner prescribed by the House of Delegates Standing Rules, and in accordance with ArticleVI, Section 3 of these Bylaws.d. STUDENT ACADEMY BOARD MEMBER. A vacancy in the Student Director positionshall be filled in the manner prescribed by the Student Academy Bylaws.e. OTHER BOARD VACANCIES. All other vacancies occurring in the Board of Directors shallbe filled by a vote of the majority of the remaining members of the Board from a slate ofcandidates prepared by the Nominating Work Group. All terms of office for such appointees12

SR-1100.3Transitory and/or temporary measures (i.e., those to be carried out before the next House meeting) will not beincluded in the published Policy Manual.SR-1100.4Policies and position papers adopted by the House shall expire five years after adoption unless revised, referred,or reaffirmed.SR-1100.5AAPA Policy DefinitionsThere are two vehicles utilized to articulate policy:1. Policy statement2. Position paperWhen policy statements and position papers are under consideration, they are termed “draft” and become policyonly when the House of Delegates or Board of Directors approves them, as appropriate.(1) Policy Statement, DefinitionA policy statement is a relatively short, concise statement setting forth Academy policy on a particulartopic. Policy statements cover fundamental issues of mission, typically involving questions ofAcademy direction, values, priorities and philosophies/principles that guide other decisions. Policiesmay also include philosophical decisions that may affect or recommend allocation of resources,activities, and relationships among the Board, House of Delegates, commissions, work groups,constituent chapters, and staff departments. The House of Delegates determines policy that establishesthe collective values, philosophies, and principles of the physician assistant profession.(2) Position Paper, DefinitionA position paper presents Academy policy and supporting information on a particular topic. Thesupporting information cites facts and figures from a variety of sources and may even include abibliography. The House of Delegates approves position papers. A position paper brought to theHouse floor for approval or review may be amended on the floor of the House.In addition to those documents noted above, the following two types of non-policy documents are utilized toguide the Academy and its components:(1) Procedure(2) RulesProcedure: These documents outline the mechanisms and procedures to handle routine transactions and normaloperations. Procedures are matters of form, process, method and application of other policies. The Board ofDirectors, House Officers, commissions, work groups and staff are responsible for determining procedure.Rules: Regulations that guide or prescribe everyday conduct. Each functional unit is responsible forestablishing its own rules of conduct (i.e., House Standing Rules, Board Rules and Procedures, Staff Handbook).SR-1200.00ANNUAL REPORTSSR-1200.1Academy officers, commissions, and work groups as appropriate, shall submit annual reports to the House ofDelegates, which may contain resolutions for consideration by the House.SR-1200.2Annual reports must be received in the national office by a date determined by the Speaker prior to theconvening of the House of Delegates and will be included in the House of Delegate materials. Addenda toannual reports must be presented in advance of the convening of the House of Delegates at a time prescribed bythe Speaker.15

SR-1300.00COMMISSIONS, WORK GROUPS, AND HOUSE COMMITTEESSR-1300.1The House of Delegates shall make recommendations to the board for the establishment of Academycommissions and work groups.The House of Delegates shall establish such committees of the House of Delegates as necessary to fulfill itsduties.SR-1400.00SR-1400.1.0HOUSE OF DELEGATES - GENERALDuties and ResponsibilitiesSR-1400.1.1Without prejudice to the duties and responsibilities confirmed by statute, by the Articles of Incorporation, or bythe Bylaws, the House of Delegates of the Academy shall be solely responsible for the setting of policies thatestablish the collective values, philosophies, and principles of the physician assistant profession. In addition, theHouse of Delegates shall have the following responsibilities: a) make recommendations to the board forgranting charters to chapters and for granting official recognition to caucuses and specialty organizations b)make recommendations to the board for the establishment of Academy commissions and workgroups and toestablish such committees of the House of Delegates as necessary to fulfill its duties c) vote on amendments tothe Bylaws on behalf of its members d) establish such rules of procedure as may be necessary for carrying outthe activities of the House.SR-1400.1.2The power to amend bylaws shall be vested with the board of directors and the House of Delegates.SR-1400.2.0CompositionSR-1400.2.1The voting membership of the House of Delegates shall consist of delegates elected by fellow members ofchartered constituent chapters, delegates elected by fellow members of officially recognized specialty PAorganizations, delegates elected by the Student Academy of the American Academy of Physician Assistants, adelegate elected by fellow members of the Caucus Congress, and the immediate past and current House Officers.SR-1400.2.2Current members of the Academy’s Board of Directors, current chairs of commissions and work groups, pastpresidents of the AAPA, and past speakers of the House of Delegates shall be advisory members of the House ofDelegates and shall have the right to speak and debate.SR-1400.2.3Each constituent chapter shall be entitled to two (2) delegates. Additional delegates will be apportioned amongthe chapters according to the number of the Academy fellow membership within the jurisdiction of eachconstituent chapter as of January 31 of each year. When the number of fellow members within a chapter’sjurisdiction exceeds 220, the chapter will be apportioned a third delegate. An additional delegate will beapportioned for each 300 additional members within a chapter’s jurisdiction thereafter. The ConstituentRelations Work Group will define such jurisdiction. For apportionment purposes, each AAPA member shall berequired to signify annually in which constituent chapter s/he wishes to be counted.SR-1400.2.4The Student Academy shall be entitled to one delegate for each 600 Student Academy members as of January 31of each year.SR-1400.2.5The term of delegates to the House shall begin July 15, with the exception of those delegates representing theStudent Academy who will be identified by December 1.16

SR-1400.2.6One delegate from each constituent chapter will be designated as chief delegate for that constituent chapter in amanner prescribed by that chapter. The Student Academy will select a chief delegate.SR-1400.2.7Each constituent chapter, each officially recognized specialty PA organization, the Student Academy, and theCaucus Congress may select alternate delegates who may be credentialed and seated by the sergeant at arms inthe event that a regular delegate is not present. Seated alternate delegates are accorded all the privileges of aseated regular delegate.SR-1400.2.8All eligible constituent chapters and organizations shall submit an official notification of delegates selected to theappropriate staff member at the national office by July 1 of the year the delegate/alternate delegate takes office.Notification process may be in writing or by electronic method. The process for the identification of delegates shallbe established by the House Officers, and published in procedure in the House manual. Constituent chapters andorganizations that fail to meet this deadline may not be seated in the House of Delegates unless granted exceptionby the House Officers not later than two weeks prior to the opening of the House.SR-1400.2.9No delegate shall be seated who is not a fellow member or student member in good standing of the Academy.SR-1400.2.10Upon notification from the appropriate body of the AAPA that a constituency of the House of Delegates hasbeen suspended, or had its chapter or recognition revoked, the Credentials Committee will remove thatconstituency from the list of eligible delegations and any delegates credentialed to that delegation will benotified that they will not be seated until their constituency is brought into compliance with AAPA policy.SR-1400.3.0Meetings and Rules of OrderSR-1400.3.1The House of Delegates shall hold an annual meeting. Special meetings of the House of Delegates shall becalled by the Speaker upon written request of twenty-five (25) percent or more of the delegates. Specialmeetings of the House shall also be called by a two-thirds (2/3) affirmative vote of the Board of Directors.SR-1400.3.2A majority of the total number of credentialed delegates shall constitute a quorum at any meeting of the House ofDelegates. Unless otherwise stated an affirmative vote by a majority of the delegates present and voting shallconstitute action of the House.SR-1400.3.3Each seated delegate or seated alternate delegate is entitled to one (1) vote. No proxy or absentee votes may becast.SR-1400.3.4Except as provided for in SR-1400.7.0 and SR-1400.3.19 of these House of Delegates Standing Rules, onlyseated delegates of the House may introduce business, make motions, or vote.SR-1400.3.5Official observers are representatives from organizations with interests and goals consistent with those of theAAPA, who desire regular communication with the AAPA House of Delegates. Official observer status isgranted by the House. Official visitors are the invited guests of the House Officers or board. Observers andvisitors may testify or speak in reference committees or the house floor in accordance with SR-1400.3.7.SR-1400.3.5.1The House Officers may grant provisional official observer status to organizations as outlined in SR-1400.3.5.Permanent observer status must be ratified by the House.17

SR-1400.3.5.2Organizations granted official observer status in the House of Delegates are:Physician Assistant Education Association (PAEA)SR-1400.3.6The House may meet in an open meeting to which any registered conference attendee, Academy member orofficially recognized visitor or observer may be admitted. Other individuals may be admitted at the discretion ofthe sergeant at arms of the House. However, no one under 18 years of age will be admitted during any session ofthe House, formal or informal, except at the discretion of the Speaker of the House. By a majority vote of thedelegates present and voting, an open meeting may be moved into a closed meeting. By a two-thirds vote of thedelegates present and voting, an open meeting may be moved into an executive meeting. A closed meeting shallbe restricted to fellow and student members of the Academy and to such persons as the delegates determine. Anexecutive meeting shall be limited to the voting membership of the House.SR-1400.3.7The Speaker may extend the privilege to speak to any Academy member, national office staff member or withprior advanced recognition of the Speaker, an officially recognized visitor or observer. The privilege to speakmay be extended to other non Academy members by a majority vote of the delegates voting. The sergeant atarms and tellers shall assist persons not seated in the House of Delegates in requesting the privilege to speak.SR-1400.3.8In the absence of any provisions to the contrary in the bylaws, or Standing Rules, all meetings of the House ofDelegates shall be governed by the parliamentary rules and usages contained in the current edition of TheStandard Code of Parliamentary Procedure.SR-1400.3.9Debate on a motion and discussion on an issue shall include input from proponents and opponents. The Speakermay limit the length of time allotted for debate on a particular topic. A delegate who has not spoken is privilegedover one who has already discussed the motion. Each speaker shall be limited to five minutes on his firstpresentation, and three minutes on any subsequent presentation. The Speaker may call on individuals to provideinformation as expert witnesses whose testimony shall be limited to the provision of information.A motion to vote immediately must be presented formally. When attempting to end the debate, a delegate maynot precede the motion to vote immediately with testimony.SR-1400.3.10A resolution may be referred for further study. A resolution referred for study, will become the property of thereceiving body. That body will report back to the House of Delegates.The referred resolution with a recommendation to accept or reject, orWith an amended or substitution resolution, as long as the resolution proposed deals substantially withthe intent of the original resolution.Resolutions, whether intact or modified, brought back to the House of Delegates as a result of a referral will beconsidered “new business.” And the receiving body will be considered the sponsor.SR-1400.3.11The Speaker shall appoint a parliamentarian and a sergeant at arms. The parliamentarian answers any questionsabout parliamentary procedure that arise during House proceedings and advises the presiding officer. Thesergeant at arms preserves order during the House of Delegates meeting, maintains security of the floor and incooperation with the chair of the Tellers Committee, supervises the tellers in controlling access to the floor, andproviding support to House Officers and delegates. The sergeant at arms is a member of the Standing RulesCommittee and chairs the Credentials Committee.SR-1400.3.1218

The chair of the Tellers Committee and the sergeant at arms will coordinate the activities of tellers during theHouse of Delegates. All materials and other handouts must be approved by the Speaker or his/her designee, andwill be distributed to the delegates from the sergeant-at-arms desk.SR-1400.3.13The Standing Rules of the House of Delegates may be amended by two-thirds (2/3) vote of delegates present andvoting. The Standing Rules may be suspended by two-thirds (2/3) vote of the delegates present and voting. TheStanding Rules remain in effect unless acted upon by the House.SR-1400.3.14Mail and electronic voting in the House of Delegates will be permitted for any House business other thanbusiness requiring Bylaws changes. Mail and electronic voting will be called for by the Speaker of the Housewhen directed by (1) a simple majority of the House Officers; 2) a two-thirds affirmative vote of the Board ofDirectors; or 3) a call from twenty-five (25) percent of the currently credentialed delegates. An issue requiringan alternative ballot shall be decided by a simple majority of the ballots returned. The House of DelegatesOfficers and Academy staff shall determine the procedures for voting on issues requiring a mail or electronicballot, subject to the requirements of the North Carolina Nonprofit Corporation Act.SR-1400.3.15Roll call voting of the House of Delegates will be permitted after appropriate motion, second, and passage by athree-fourths (3/4) vote of the seated delegates. Roll call votes will be conducted by the Tellers Committee inaccordance with procedure outlined in the House manual.SR-1400.3.16“Friendly” amendments to a motion may be accepted by the Speaker, provided there is no objection from thefloor. If any objections are raised to the “friendly” amendment, the Speaker shall rule the amendment out oforder and a formal amendment with an appropriate second shall be required.SR-1400.3.17In order to conduct the business of the House of Delegates with clarity and good order, beepers and othercommunications devices should not be audible in the House of Delegates room. Placing these devices in a quietmode is acceptable with the caveat that any cell phone conversations be conducted outside the doors of House ofDelegates during House of Delegates activities.SR-1400.3.18Persons who have a conflict of interest in the matter under consideration must publicly disclose that interestbefore initially testifying at a reference committee about that resolution and before initially speaking on the floorof the House of Delegates about that resolution.A conflict of interest is defined as a financial, commercial, or other interest in the matter under consideration thatis not readily available to other PAs and AAPA members.SR-1400.3.19The chairpersons of all commissions and the Nominating Work Group of the AAPA shall have the privilege tomake the following motions regarding any resolution upon which their respective commission or the NominatingWork Group is the sponsor:AmendPostpone to a certain time (postpone definitely)Postpone temporarilyRefer to committeeDivision of a questionWithdraw a motionMake a parliamentary inquirySR-1400.4.0Order of BusinessSR-1400.4.119

The Speaker shall determine the general order of business at all meetings of the House of Delegates.SR-1400.4.2The agenda for the meetings of the House of Delegates shall be determined by the House Officers and publishedin the House materials.SR-1400.5.0OfficersSR-1400.5.1The elected officers of the House of Delegates are a Speaker of the House, who shall serve as vice president ofthe Academy, a first vice speaker, and a second vice speaker.SR-1400.5.2Each House Officer elected will become a delegate at large during the term(s) as a House Officer, plus oneadditional year as an immediate past House Officer. The delegates at large shall be accorded all the rights andprivileges of elected delegates.SR-1400.5.3The Speaker presides at all business meetings. The first vice speaker assumes the duties of the Speaker in theevent of the temporary absence of the Speaker. The second vice speaker assumes the duties of the Speaker in theevent of the temporary absence of the Speaker and the first vice speaker. The second vice speaker keeps therecords of all meetings of the House. The sergeant at arms, with the oversight of the second vice speaker, isresponsible for the verification of the credentials of delegates and alternate delegates.SR-1400.5.4The Speaker shall report all activities and actions of the House of Delegates to the Board of Directors at its nextmeeting.SR-1400.6.0ElectionsSR-1400.6.1At each annual meeting of the House of Delegates, there shall be elected from the House of Delegates a Speakerof the House who shall also serve as vice president of the Academy, a first vice speaker of the House, and asecond vice speaker of the House. Each shall be elected by a majority of votes cast. No absentee or proxy voteshall be cast.SR-1400.6.2The names of candidates for the offices of Speaker, first vice speaker, and second vice speaker shall be placed innomination either at the time of call for nominations from the Governance Commission or from the floor of theHouse of Delegates during the annual meeting. The call for nominations from the floor shall take place at a timedesignated by the House Officers.SR-1400.6.3All candidates for office must be seated delegates or alternates and must be fellow members. It is highlyrecommended that candidates have recent AAPA House of Delegates, Board of Directors, commission or workgroup experience.SR-1400.6.4The names of candidates for the offices of Speaker, first vice speaker, and second vice speaker shall be readbefore the House of Delegates. All candidates whose names are placed in nomination must consent to suchnomination. The voting membership of the House of Delegates shall consist of credentialed delegates present atthe time of elections.SR-1400.6.5The term of office of the House Officers shall begin June 10 or in the event that the election of the House ofDelegates Officers occurs later than June 10, the new House Officers will take office at the close of the meetingduring which they were elected.20

SR-1400.6.6In the event of a vacancy in the office of Speaker, the first vice speaker shall assume both the duties and theoffice of the Speaker. In the event of a vacancy in the office of first vice speaker, the second vice speaker shallassume the duties and the office of first vice speaker. A vacancy in the office of second vice speaker shall befilled by the delegates currently credentialed who will elect from a list of candidates prepared by the NominatingCommittee.SR-1400.6.7The procedures for the election of House Officers shall be the responsibility of the Governance Commission.One member of the Governance Commission shall serve on the House Elections Committee to oversee Houseelections.SR-1400.6.8Five (5) members of a seven (7) member Nominating Work Group shall be elected by the House of Delegates atthe annual meeting. The Board of Directors shall appoint the final two members. Nominations for this workgroup shall be made either at the time of call for nominations from the Governance Commission or from thefloor of the House of Delegates. Member of the Nominating Work Group shall be fellow members of theAcademy and shall meet such eligibility requirements as stated in the Bylaws. Elections for members of theNominating Work Group shall be held at the time of election of House of Delegates Officers. The term of officefor elected members of the Nominating Work Group shall be a two (2) year staggered term. The votingmembership of the House of Delegates shall consist of credentialed delegates present at the time of elections.Members shall be elected by a plurality vote. The House of Delegates shall determine procedures for the electionof non-board appointed members to the Nominating Work Group Bylaws Art XI, Sect 2 & 3.SR-1400.6.9The following shall be qualifications for candidates for election to the AAPA Nominating Work Group:a. A candidate must be a fellow member of AAPA.b. A candidate must have been an AAPA fellow member for at least five years.c. A candidate must have accumulated at least five years of experience in the past seven years in at leasttwo of the following major areas of professional involvement:1) an AAPA or constituent organization officer, board member, commission, or work group chair2) a delegate or alternate to the AAPA House of Delegates3) PA Foundation, Society for the Preservation of Physician Assistant History, or AmericanAcademy of Physician Assistants Political Action Committee trustee or committee chair4) AAPA board appointeesd. Any calendar year or Academy year in which the candidate served in more than one area ofprofessional involvement shall be counted as one distinct year of experience.e. With the exception of the board-appointed members, a Nominating Work Group member cannot holdany other elected office or commission or work group position in the AAPA during the time ofservice on the Nominating Work Group.f. Nominating Work Group candidates should pre-declare. Write-in candidates will be accepted at thetime of elections.SR-1400.6.10If a complete, unopposed slate of candidates is presented for House election, a simple majority of delegatesseated shall be required to immediately elect the slate of candidates.SR-1400.7.0ResolutionsSR-1400.7.1Resolutions are defined as expressions of philosophy or policy governing the Academy. Resolutions may furtherbe defined as proclamations of importance to the profession such as expressions of congratulations,commendation, or condolence.SR-1400.7.221

Resolutions, except resolutions which propose bylaws amendments, may be submitted by constituent chapters,the Student Academy, officially recognized specialty PA organizations, Caucus Congress, commissions andwork groups, House ad hoc committees, the Board of Directors, Academy and House Officers. The officialminutes of the submitting body should record the vote on each resolution submitted for consideration by theHouse.A proposal for the amendment or repeal of bylaws or adoption of new bylaws shall be initiated by (a) the Boardof Directors, (b) any commission, (c) the Caucus Congress, (d) any constituent chapter, (e) officially recognizedspecialty PA organizations, (f) the Student Academy, or (g) the collective House Officers.SR-1400.7.3The House Officers shall create guidelines for resolution submission. Resolutions must be submitted in theapproved format. Sponsors of resolutions may obtain endorsement of their resolutions by other delegations andshould submit estimated costs associated with proposed resolutions.SR-1400.7.4Resolutions calling for changes in the Bylaws must comply with Bylaws Article XIV and, be received in thenational office at least three (3) months prior to the convening of the House of Delegates. Other resolutions mustbe received in the national office at a time to be determined and published by the House Officers.SR-1400.7.5Late resolutions shall be defined as those resolutions that have been submitted after the deadline outlined in SR-1400.7.4, but prior to the convening of the House. Sponsors who wish to submit late resolutions must notify theSpeaker of their desire to do so prior to the opening session and submit the resolution in accordance withprocedure outlined in the House manual. A Resolutions Review Committee consisting of the referencecommittee chairs and at least one House Officer will review each late resolution and report to the House whetheror not it believes each late resolution should be accepted for consideration. If there is any objection from thefloor, a two-thirds (2/3) vote of the delegates present and voting is necessary to accept the late resolution forconsideration.Any resolution to amend the Bylaws must comply with Article XIV of the Bylaws.Emergency resolutions shall be defined as those resolutions submitted after the convening of the House.Emergency resolutions are to be submitted under “additional new business” and distributed to the delegates forreview. Emergency resolutions require an 80 percent vote of delegates present and voting for consideration.SR-1400.7.6Resolutions submitted for consideration by the House shall be numbered and assigned to a reference committeeor the consent agenda by the Speaker. Until the resolution is accepted by the House of Delegates, it may bewithdrawn by the sponsor. If there are no objections to considering the resolutions, they will be referred to theappropriate reference committee or placed on the consent agenda. Objections to a resolution can only be basedon whether the resolution is in order. Resolutions brought to the House by a body receiving a referral from aprevious House cannot be objected to or withdrawn. After acceptance of the resolution they become theproperty of the House of Delegates which then has the sole right to any action on the resolutions.SR-1400.7.7The general consent agenda shall contain: the policies from the five-year review process as well as any properlysubmitted resolutions selected by the Speaker. Any objection from the floor to the placement of an item on thegeneral consent agenda will result in the item being assigned a resolution number and being referred to areference committee. The procedure for extraction and voting on the consent agenda will be outlined in theHouse manual.SR-1400.7.8Resolutions adopted by the House of Delegates that are expressions of philosophy shall become officialAcademy policy.SR-1400.7.922

Resolutions of CondolenceResolutions of condolence will be introduced as part of the Speaker’s report and will not require introduction asa part of the standard resolution process. Upon inclusion in the Speaker’s report, these resolutions shallautomatically be accepted by the House without further comment, debate, or vote. The House Officers willinsure that the Academy maintains an appropriate historical archive of these resolutions.Special ResolutionsSpecial resolutions of congratulations, recognition, or other special resolutions deemed appropriate by the HouseOfficers shall be introduced as a part of the Speaker’s report and will not require introduction as a part of thestandard resolution process. Upon inclusion in the Speaker’s report, these resolutions shall automatically beaccepted by the House without further comment, debate, or vote. The House Officers will insure that theAcademy maintains an appropriate historical archive of these resolutions.SR-1400.7.10Delegates are encouraged to review, discuss and evaluate each resolution before the opening of the AAPA Houseof Delegates. AAPA resources may be used to facilitate these activities as long as their use allows forthe representation of all points of view and does not conflict with AAPA policy (BA-2500.1.5, BA-2500.1.6).SR-1400.8.0Reference CommitteesSR-1400.8.1Reference committees shall conduct hearings during the annual meeting of the House of Delegates for thepurpose of hearing testimony on resolutions that have been accepted for consideration by the House.SR-1400.8.2At the conclusion of reference committee hearings each committee shall write and submit to the House a reportcontaining a summary of the testimony and reference committee research on each resolution and arecommendation for House action on each resolution. The procedure for extraction and voting on the referencecommittee report will be outlined in the House manual.SR-1400.8.3No second is needed for a reference committee motion offered by the reference committee chair.SR-1400.8.4Reference committees are appointed by the House Officers. Each reference committee shall be composed of atleast five Academy members from those membership classes eligible to sit in the House of Delegates. The chairof each reference committee shall be a credentialed delegate or alternate.SR-1400.8.5The House Officers shall promulgate guidelines for reference committee function.SR-1400.8.6Reference committee reports presented by extraction will proceed as follows:All recommendations of the reference committee will be placed on the reference committee consentagenda.The Speaker will entertain requests for extraction of individual resolutions from the referencecommittee consent agenda. A resolution will be extracted upon the request of a seated delegate.The House will vote immediately to accept the reference committee consent agenda once all requestsfor extraction have been heard.A vote to accept the reference committee consent agenda will be a vote to accept the recommendationsof the reference committee on each consent agenda resolution.Extracted resolutions will then be reported out by the reference committee, considered and voted uponindividually.Amendments suggested in reference committee reports will be considered first order amendments andwill not require a second.23

A mail or electronic vote will be used also in a special election to fill an office, which has been vacated duringthe time period between regularly scheduled House elections.SR-1500.1.3The voting body will be those delegates currently credentialed.SR-1500.1.41. An issue requiring a mail or electronic ballot shall be decided by a majority of the ballots cast.2. Receiving a majority of the votes cast will elect a candidate for house office. In the event that no majority isobtained, a revote will be taken.3. Receiving a plurality of the votes cast will elect a candidate for the Nominating Work Group.SR-1500.1.5The term of office will begin immediately following the special election.SR-1500.2.0Resolution Procedures - ElectronicSR-1500.2.1Resolutions may be debated and voted on electronically at the request of the sponsor with Speaker of the Houseapproval or at the discretion of the House Officers. If 25% of the delegates object to voting on a particularresolution electronically, it will be deferred to the annual meeting. The options for online voting will be yes, noor abstain. Amendments will not be allowed for resolutions debated and voted electronically.SR-1500.2.2Electronic discussion and voting on resolutions will have a schedule of at least 10 days of during which the issueis posted for review by the delegates, at least 5 days of discussion and then a vote. House Officers will post theschedule for each resolution for which online discussion and voting is desired.SR-1500.2.3The procedure for posting, discussion and voting will be outlined by the House Officers. Only the businessstated in the notice will be transacted during the electronic discussion and voting.25

HA-2000.00HA-2100.0HA-2100.1.0ACADEMY/ORGANIZATIONHOUSE ACADEMYEducational PhilosophyHA-2100.1.1AAPA should provide ongoing educational experiences that are focused on diversity and health care disparityissues.[Adopted 2001, amended 2006, reaffirmed 2011]HA-2100.1.2The annual conference provides quality, cost-effective continuing medical education, a forum for professionaland social interaction, and a setting for activities of the House of Delegates and governance organizations ofAAPA.[Adopted 1993, reaffirmed 1998, 2003, 2008]HA-2100.2.0LeadershipHA-2100.2.1The House of Delegates encourages the AAPA Board of Directors to provide face to face opportunities forvolunteer physician assistant leaders to conduct business successfully on behalf of the profession.[Adopted 2010]BA-2200.00ACADEMY/ORGANIZATION – DEFINITIONBA-2200.1The Academy’s definition for racial and ethnic minorities shall be persons who are Black or African American,Hispanic or Latino, Asian, Native Hawaiian or other Pacific Islander, American Indian or Alaska Native, or twoor more races.[Adopted 1984, reaffirmed 1990, 1998, and 2004, amended 1993, 1999, 2009]BA-2200.2The American Academy of Physician Assistants defines family as any person or persons who play a significantrole in an individual’s life. This may include persons not legally related to the individual. The AAPA recognizesthat physician assistants are obligated to follow state and federal laws regarding family, however, AAPAencourages PAs to acknowledge, respect and consider any non-legally or non-genetically related familymembers.[Adopted 2010]BA-2200.2.1Health Disparities: Promoting the Equitable Treatment of All Patients (PP tab 37)[Adopted 2011]BA-2300.00BA-2300.1.0CONSTITUENT ORGANIZATIONSConstituent Organizations, GeneralBA-2300.1.1AAPA defines the following positions as officers of a Constituent Organization: President, President-elect, VicePresident, Secretary and Treasurer, and/or Secretary-Treasurer.This definition is for AAPA policy purposes and does not require any organization to have a particular office.[Adopted 2012]BA-2300.2.0Constituent Chapter Rules26

BA-2300.2.1Constituent chapters may not deny any form of membership to an AAPA fellow member of the AAPA unless theindividual’s fellow membership has been revoked for reason of an ethical or judicial nature by the AAPA or by aconstituent chapter through a process consistent with AAPA policies.[Adopted 1981, reaffirmed 1990, 1995, 2000, 2005, 2008, amended 1986, 2009]BA-2300.2.2All officers (president, president elect, vice president, secretary, treasurer) of a constituent chapter must be andremain fellow members in good standing of the American Academy of Physician Assistants for the duration oftheir term in office. Any chapter that is unable to fill all of its officer positions with AAPA fellow members maypetition the Constituent Relations Work Group for consideration of exemption from this policy.[Adopted 1981, reaffirmed 1990, 1995, 2000, 2005, 2010]BA-2300.2.3The time when AAPA constituent organization officers may take office may be either January or July 1.However, constituent organizations are encouraged to have a standard term of office for their elected officersbeginning July 1 and continuing through June 30.[Adopted 1981, amended 1986, 1998, reaffirmed 1990, 1995, 2000, 2005]BA-2300.2.4AAPA members who belong to more than one constituent chapter may vote on AAPA issues in only oneconstituent chapter.[Adopted 1981, reaffirmed 1990, 1995, 2000, 2005, 2010]BA-2300.3.0Relationship to AAPABA-2300.3.1A constituent chapter of AAPA is an independent affiliate physician assistant organization that has applied forand received a charter from the AAPA Board of Directors. In chartering constituent chapters the Board ofDirectors shall take into consideration any recommendations of the House of Delegates.The chapter and its members are required to meet all the provisions outlined in the policies of AAPA. Theconstituent chapters and their members are encouraged to support the vision and mission of AAPA.AAPA has responsibilities to the constituent chapter. It must be responsive to the needs of the constituentchapters and their members, and must represent the profession in a unified and effective manner.[Adopted 1979, reaffirmed 1990, 1995, 2000, amended 2005, 2010]BA-2300.3.2The constituent chapter retains the right to address local concerns and issues without interference from AAPA.The constituent chapters and their members must follow the philosophy of AAPA. If they are unable to do so,they must work through AAPA and the House of Delegates to change the philosophy by altering AAPA’spolicies.[Adopted 1979, reaffirmed 1990, 1995, 2000, 2004, 2009]BA-2300.3.3All fellow members of a constituent chapter must be fellow members of the American Academy of PhysicianAssistants. Constituent chapters may amend their bylaws to create alternative membership categories, which mayinclude chapter members who elect not to join AAPA or are ineligible for AAPA fellow membership. Nonfellowmembers of chapters may be active in chapter affairs but may not participate in issues relating to AAPA,such as voting for delegates, submitting resolutions, or representing the chapter in the AAPA House ofDelegates.[Adopted 1981, amended 1986, 1997, reaffirmed 1990, 1995, 2000, 2005, 2010]BA-2300.3.4Each chartered constituent organization in a state, the District of Columbia or a U.S. territory in which a PAprogram exists should provide at least one seat to student member on their Board of Directors. The AAPA27

encourages these constituent organizations to formally confer full voting privileges in their Bylaws to thesestudent board members. The physical location of a PA program should determine the state or constituentorganization of student service.[Adopted 1981, amended 2006, reaffirmed 1990, 1995, 2000, 2011]BA-2300.3.5AAPA believes that chartered constituent chapters, officially recognized specialty PA organizations andofficially recognized caucuses should adopt a code of ethics. In an effort to maintain one standard of ethicalbehavior for the profession, chartered constituent chapters, officially recognized specialty PA organizations andofficially recognized caucuses are strongly advised to utilize the Guidelines for Ethical Conduct for thePhysician Assistant Profession (PP tab 18).[Adopted 1995, amended 1998, reaffirmed 2000, 2005, 2010]BA-2300.3.6AAPA strongly encourages each constituent organization to have a diversity contact/committee.[Adopted 2001, reaffirmed 2006]BA-2300.3.7The AAPA recommends that every constituent organization include a federal liaison position on theirGovernment Affairs Committee or comparable body to coordinate national PA legislative efforts.[Adopted 2012]BA-2300.3.8AAPA assists constituent organizations in maintaining active status.[Adopted 2002, amended 2004, 2008]BA-2300.4.0Chartering GuidelinesBA-2300.4.1The Board of Directors has the sole authority to charter or recharter constituent chapters, as well as to suspend,or revoke the charter of a constituent chapter. The Board of Directors shall take into consideration anyrecommendations of the House of Delegates when acting on the charter of an existing constituent chapter. Thereshall be only one chartered chapter per state, the District of Columbia, each US territory, and each of the federalservices. The chapter is required to have a minimum of five (5) fellow members to obtain and maintain activeconstituent chapter status.A suspended chapter will have its status reevaluated by the appropriate work group prior to the next annualmeeting. The Board of Directors may choose to follow the recommendation of the appropriate work groupregarding the status of the chapter. The delegates of a suspended chapter will not be seated at the House ofDelegates.[Adopted 1981, reaffirmed 1990, 1995, 2000, amended 1988, 2003, 2008]BA-2300.4.2Suspended chapters will be ineligible to receive Academy staff resources or financial support with the exceptionof assistance that may be required to comply with AAPA policy.The delegates of a revoked chapter will not be seated at the House of Delegates. Chapters that have had theircharter revoked may reapply for a charter at any time. Revoked chapters are ineligible to receive any academystaff resources or financial support.A constituent chapter may request to have their charter revoked without being suspended. This request will bemade to the appropriate work group.Application for reinstatement will be made via the appropriate work group.[Adopted 1981, reaffirmed 1990, 2000, amended 1993, 1998, 2004, 2008]BA-2300.4.328

At the annual meeting of the House of Delegates, the appropriate work group will present a credentials reportregarding the status of all constituent organizations.[Adopted 1981, reaffirmed 1990, 2000, amended 1986, 1990, 1993, 1998, 2005, 2008]BA-2300.4.4The appropriate work group shall review the charters of each constituent chapter on a five-year cycle and makerecommendations to the Board of Directors for its consideration.[Adopted 2005, reaffirmed 2010]BA-2300.5.0Specialty PA OrganizationsBA-2300.5.1An officially recognized specialty physician assistant organization shall be defined as a group of physicianassistants that joins together in an association that represents a practice specialty and that meets the criteria forrecognition.Specialty organizations provide valuable information and insight about their specialty to AAPA membership andleadership. Specialty organizations are not chartered, but remain an integral part of the complex framework thatassures AAPA the maximum amount of knowledge and understanding of all issues involving PAs in thatspecialty. Specialty organizations strengthen the PA profession through their liaisons with their medical andprofessional counterparts. These relationships allow specialty organizations to partner with AAPA to effectivelyaddress challenges such as reimbursement, clinical practice, and regulation.[Adopted 2000, amended 2004, reaffirmed 2009]BA-2300.5.2A specialty organization may choose to apply to be officially recognized by the American Academy of PhysicianAssistants. The American Academy of Physician Assistants recognizes the following specialties: 1) thoseholding the name of a board listed by the American Board of Medical Specialties (ABMS); 2) those specialtiesunder the boards of internal medicine, surgery, and psychiatry named as eligible for general or subspecialtycertificates; and 3) those specialties under the Board of Preventive Medicine named as eligible for generalcertificates. Only one organization per specialty will be recognized.[Adopted 1997, amended 1998, reaffirmed 2003, 2008]BA-2300.5.3The Constituent Relations Work Group shall review the completed application and will present a resolution tothe Board of Directors.To be considered for recognition, the specialty organization shall:1. Submit the appropriate AAPA application to the Constituent Relations Work Group.2. Have a minimum of 5 members.3. Submit the bylaws of the organization for review by the Constituent Relations Work Group.[Adopted 1997, reaffirmed 2002, amended 200, 2008]BA-2300.5.4Specialty PA organization members are encouraged to be AAPA fellow members. Only those specialtyorganization members who are fellow members in good standing of AAPA may participate in issues relating toAAPA such as voting for AAPA delegates, submitting resolutions, or representing the specialty PA organizationin the AAPA governance structure.[Adopted 1997, amended 2000, reaffirmed 2005, 2010]BA-2300.5.5All officers of an officially recognized specialty PA organization are required to be and remain fellow membersin good standing of AAPA. Only those specialty PA organization officers who are fellow members in goodstanding of AAPA may participate in issues relating to AAPA such as voting for AAPA delegates, submittingresolutions, or representing the specialty organization in the governance structure. Any specialty organization29

that is unable to fill all of its officer positions with AAPA fellow members may petition the ConstituentRelations Work Group for consideration of exemption from this policy.[Adopted 1997, reaffirmed 2005, amended 2000, 2010, 2012]BA-2300.5.6AAPA specialty organizations are encouraged to involve physician assistant students in their leadership activitiesand encouraged to confer full voting privileges upon student board members in their bylaws.[Adopted 2004, reaffirmed 2009]BA-2300.5.7The Board of Directors may withdraw the official recognition of a specialty PA organization in the event of anyaction by the specialty PA organization that is in conflict with AAPA’s vision or mission. The Board ofDirectors shall take into consideration any recommendations of the House of Delegates when acting on therecognition of an existing specialty organization. Delegates from the specialty organizations that have had theirrecognition withdrawn will not be seated at the House of Delegates.[Adopted 1997, amended 2000, 2005, reaffirmed 2010]BA-2300.5.8At the start of the annual meeting of the House of Delegates, the Constituent Relations Work Group will presenta credentials report regarding the status of all specialty organizations.[Adopted 2005, reaffirmed 2010]BA-2300.5.9The appropriate work group shall review the recognition of each specialty PA organization on a five-year cycleand make recommendations to the Board of Directors for its consideration.[Adopted 2005, reaffirmed 2010]BA-2300.6.0CaucusesBA-2300.6.1A caucus is defined as a group of 50 or more AAPA fellow members who share a common concern, interest, orgoal in the delivery of and access to health care. Caucuses are national or international in scope and complementthe vision or core values of AAPA.[Adopted 2000, reaffirmed 2010, amended 2005, 2012]BA-2300.6.2A caucus shall:1. Have a minimum of 50 AAPA fellow members;2. Submit a completed AAPA constituent organization affiliation agreement;3. Submit the bylaws of the organization for review;4. Maintain the requirements of the AAPA affiliation agreement.The affiliation agreement will be submitted to the Board of Directors for approval. Caucuses meeting therequirements set by this policy will be represented in the AAPA House of Delegates in accordance with AAPABylaws.[Adopted 2002, amended 2007, 2008, 2012]BA-2300.6.3All members of an AAPA caucus are encouraged to be members of the AAPA.[Adopted 1997, reaffirmed 2005, amended 2000, 2010, 2012]BA-2300.6.4A caucus may amend its bylaws to create alternative membership categories that may include members whoelect not to join AAPA or are ineligible for AAPA membership. Caucus members who are not AAPA membersmay be active in caucus affairs, but may not participate in issues relating to AAPA, such as voting for AAPAdelegates, submitting resolutions, or representing the caucus in the AAPA governance structure.[Adopted 1997, reaffirmed 2002, 2007, 2012]30

BA-2300.6.5All officers of a caucus must be and remain fellow members in good standing of AAPA for the duration of theirterm in office. Any caucus that is unable to fill all of its officer positions with AAPA fellow members maypetition the Constituent Relations Work Group for consideration of exemption from this policy.[Adopted 1997, reaffirmed 2002, 2007, amended 2012]BA-2300.6.6The Board of Directors may authorize a caucus name change as long as the caucus remains in compliance withAcademy policy and has not changed the original purpose identified in the governing documents of the caucus.[Adopted 1995, reaffirmed 2000, 2005, 2010, amended 2012]BA-2300.6.7AAPA caucuses are encouraged to involve physician assistant students in their leadership activities andencouraged to confer full voting privileges upon student board members in their bylaws.[Adopted 2004, reaffirmed 2009]BA-2300.6.8The Board of Directors may suspend or revoke the status of a caucus in the event of any action by the caucusthat is in conflict with AAPA’s vision or core values.[Adopted 1997, reaffirmed 2010, amended 2000, 2005, 2012]BA-2300.6.9At the start of the annual meeting of the House of Delegates, a report will be presented regarding the status of allcaucuses.[Adopted 2005, reaffirmed 2010, amended 2012]BA-2300.6.10The appropriate work group shall review the recognition of each caucus on a five-year cycle and make arecommendation to the Board of Directors for its consideration.[Adopted 2005, reaffirmed 2010]BA-2300.6.11AAPA encourages participation by AAPA caucuses in displaying and sharing their expertise at CME activitiesof AAPA constituent chapters.[Adopted 2006, reaffirmed 2011]BA-2300.6.12All caucuses, chapters, and specialty organizations are encouraged to provide unused exhibit space or otherdisplay space near the exhibit area at no charge or at a reduced rate on a first-come, first-served basis tocaucuses.[Adopted 2006, amended 2011]BA-2300.7.0Special Interest GroupsBA-2300.7.1Special interest groups are defined as a group of AAPA members who share a common concern, interest, or goaland desire to meet informally. The purpose of a special interest group (SIG) shall be consistent with the visionand mission of AAPA.The appropriate work group has the responsibility for approving and suspending SIG status.[Adopted 1981, reaffirmed 1990, 1995, amended 1982, 1996, 2000, 2002, 2007, 2009]BA-2300.7.2AAPA special interest groups are encouraged to involve physician assistant students in their leadership activities.[Adopted 2004, amended 2009]31

BA-2300.8.0Academy CongressesBA-2300.8.1A congress is a grouping of AAPA recognized organizations formed for the purpose of discussion, arrangement,or promotion of individual or common interests and goals within the group. A congress will not have a seat inthe House of Delegates if an individual organization within the congress is already represented.[Adopted 1998, reaffirmed 2003, 2008]BA-2400.00BA-2400.1.0ACADEMY/ORGANIZATION – GOVERNANCEGeneralBA-2400.1.1AAPA business is to be conducted by AAPA members. This includes, but is not limited to, voting for AAPAdelegates, submitting and voting on resolutions, and representation in the AAPA governance structure.[Adopted 2000, reaffirmed 200, 2010]BA-2400.2.0Student AcademyBA-2400.2.1AAPA grants the Student Academy the right to operate as a subsidiary unit representing AAPA studentmembers. In so doing, the Academy reserves the right to monitor the Student Academy’s adherence to AAPA’spurposes and policies. Accordingly, the Student Academy will submit a revised copy of its governingdocuments, within thirty (30) days of each revision, to the AAPA Judicial Affairs Commission for review.[Adopted 1983, amended 1985, 2002, reaffirmed 1990, 1995, 2000, 2007, 2012]BA-2400.2.2The Student Academy of the AAPA is the national representative body of AAPA student members and, as such,while embracing all AAPA policies and purposes, the Student Academy further strives to serve students(Bylaws, Article V, Section 1). The Student Academy retains the right to address student concerns and issues,provided that the Student Academy adheres to its responsibility to follow the philosophy of AAPA in theprocess. The Student Academy shall educate physician assistant students regarding both the profession and theAAPA. The Student Academy shall also represent AAPA student members in matters of concern to themregarding their education and their profession.[Adopted 1983, reaffirmed 1990, 1995, 2000, 2005, 2010]BA-2400.2.2.1Policy statements or position papers adopted by the Assembly of Representatives must be reviewed by theappropriate AAPA body prior to being officially recognized by AAPA and/or before any public distribution.[Adopted 2005, reaffirmed 2010]BA-2400.2.2.2Student Academy members are represented and provide input to AAPA through the student delegation to theHouse of Delegates, the student member of the Board of Directors, and the student members of AAPAcommissions and/or work groups.[Adopted 2005, amended 2010]BA-2400.2.3The Student Academy shall receive input from AAPA through an advisor designated by the AAPA Board ofDirectors. Such input would provide additional insight into AAPA, its policies, goals, objectives, and functions,as well as provide additional opportunity for guidance to the Student Academy. This graduate advisor shall alsoadvise the AAPA Board of Directors on student activities.The AAPA Board of Directors’ advisor to the Student Academy Board of Directors shall sit as a non-voting exofficio member of the Student Academy Board of Directors. The advisor shall attend meetings of the AAPABoard of Directors, Student Academy Board of Directors, and other meetings necessary to fulfill the duties of theposition.32

[Adopted 1983, reaffirmed 1990, 1995, 2000, 2005, amended 1997, 2010]BA-2400.3.0Commissions, Work Groups, and Task ForcesBA-2400.3.1.0 CommissionA commission is a permanent group that carries out the volunteer work of the academy. Each commission isdefined by a set of charges. The primary focus of these charges is policy formulation and implementation.Each commission has a chair and an even number of members, allowing for an overall odd number of groupmembers to facilitate majority voting. In addition to overseeing the responsibilities of the commission,commission chairs oversee the activities of work groups and task forces, which exist beneath the umbrellas ofappropriate commissions.[Amended 1989, 1994, 1997, 1998, 2002, 2003, 2007, 2010]BA-2400.3.2.0 Work GroupA work group is a leadership body that exists beneath the umbrella of a commission and has a technical rolerelated to the scope of practice of that commission.Each work group has a chair and an even number of members, allowing for an overall odd number of groupmembers to facilitate majority voting. A work group chair reports to the chair of the appropriate commission.[Adopted 2010]BA-2400.3.3.0 Task ForceA task force is a temporary group created by the board of directors on an as needed basis that exists beneath theumbrella of a commission. Its life span is based on the charges of the group.A task force addresses an issue that is related to the scope of that commission that is either too time or laborintensive for the commission members to address as part of their normal commission or work groupresponsibilities.A task force has a chair and an even number of members, allowing for an overall odd number of group membersto facilitate majority voting.A task force chair reports to the chair of the appropriate commission.[Adopted 2010]BA-2400.3.4All commission and work group members who are physician assistants shall be members of a constituentorganization.[Adopted 2003, reaffirmed 2008, amended 2010]BA-2400.3.5The selection process of AAPA commissions and work groups should take into consideration the multifacetedconcept of diversity. The AAPA should encourage and support training in diversity for all commission and workgroup chairs and members.[Adopted 2001, reaffirmed 2006, amended 2010]BA-2400.4.0Commissions and Work Groups—ChargesBA-2400.4.1Clinical and Health Affairs Commission:1. identifies, monitors and disseminates information about clinical and scientific development includingrelated health policies that may impact the practice of medicine2. develops papers, policy recommendations and other materials for, or in response to, AAPA Board ofDirectors, House of Delegates and the general membership3. determines the winners of the poster sessions4. specific areas of focus include:33

A. evidenced based medicine: genomicsB. health and wellness promotion: preventive service and health literacyC. special/underserved patient populations (ex hiv, tb, minority)D. health disparitiesE. cultural proficiencyF. public health interface: vaccines, guidelines/clinical policiesG. quality of careH. risk managementI. standards of careJ. poster evaluation/call/awardsK. clinical watch/editorials/papers[Adopted 2010]BA-2400.4.2Health Disparities Work Group (of the Clinical and Health Affairs Commission):1. monitors issues of health disparities2. makes recommendations to the profession to promote awareness and the elimination of healthdisparities3. develops systems to educate the profession about health disparities[Adopted 2010, amended 2012]BA-2400.4.3Quality Care Work Group (of the Clinical and Health Affairs Commission):1. monitors issues of patient safety relative to PA practice2. makes recommendations to the profession to promote patient safety3. works with other public and private entities to enhance the quality of care in all areas of practice[Adopted 2010]BA-2400.4.4Professional Practice Commission:1. evaluates PA practice environments2. provides guidance on the maximization of the PA role in all aspects of health care3. presents relevant health policy recommendations4. specific areas of focus include:A. practice settings – underserved, rural, managed care, federal government, PA credentialing, PAownedclinicsB. physician-PA team – scope of practice, delegation, conscientious objection, conflicts of interestC. patient acceptanceD. health policy[Adopted 2010]BA-2400.4.5Research Work Group (of the Professional Practice Commission):1. Provides advice on implementing the National PA Research Agenda2. Acts as advisory body in support of AAPA research initiatives and other research-related activities uponrequest from AAPA research staff3. Introduces new ideas in PA research and grant funding opportunities to AAPA4. Assists in developing collaborative relationships with other individual PA researchers, organizations,academic institutions, and health policymakers to further the research agenda for the profession.[Adopted 2012]BA-2400.4.6Membership Commission:1. coordinates all aspects of membership services2. promotes membership with the Academy3. specific areas of focus include:34

A. recruitment and retention – including customer serviceB. value of membershipC. membership servicesD. awardsE. member diversity[Adopted 2010, amended 2012]BA-2400.4.7Awards Work Group (of the Membership Commission):1. honors AAPA's commitment to excellence in the AAPA awards program2. establishes sound judging criteria3. solicits high quality nominees4. decides the recipients of AAPA's paragon awards and recognition awards5. decides the recipients of emeritus status of membership[Adopted 2010]BA-2400.4.8Judicial Affairs Commission:1. reviews AAPA bylaws and policy annually2. reviews state medical boards for current AAPA members with disciplinary actions against them3. takes the necessary action[Adopted 2010, amended 2012]BA-2400.4.9Advocacy and Government Affairs Commission:1. provides recommendations on AAPA policy2. facilitates the implementation of AAPA policy regarding legislative, regulatory, and reimbursementissues with the goal to improve access to care3. encourages the efficient optimal utilization of physician PA teams in health care delivery4. each commission member chairs one Advocacy and Government Affairs Commission Work Group5. specific area of work group focus includeA. state legislative affairsB. federal affairsC. reimbursement issuesD. regulatory affairs[Adopted 2010]BA-2400.4.10State Legislative Affairs Work Group (of the Advocacy and Government Affairs Commission):1. advises AAPA staff in reviewing proposed state legislation that stands to affect PA practice2. advises AAPA staff in collaboration with constituent organization leaders to propose state legislation3. advises AAPA staff in collaboration with constituent organization leaders in regulatory andreimbursement affairs[Adopted 2010]BA-2400.4.11Federal Affairs Work Group (of the Advocacy and Government Affairs Commission):1. drafts and adopts AAPA’s legislative agenda2. advises AAPA staff in implementation of the Academy’s federal legislative agenda3. advises AAPA staff in the review of proposed federal legislation from other stakeholders4. testifies at public hearings5. consults with legislators6. attends legislative events7. proposes commitment of AAPA to any legislative or regulatory lawsuits that affect the practice of PAs[Adopted 2010]BA-2400.4.1235

Reimbursement Issues Work Group (of the Advocacy and Government Affairs Commission):1. advises AAPA staff in the review of state and federal reimbursement policy2. proposes reimbursement policy at the state level (in collaboration with AAPA staff and constituentorganization leaders)3. proposes reimbursement policy at the federal level (in collaboration with AAPA staff)4. testifies at public hearings5. consults with policy makers[Adopted 2010]BA-2400.4.13Professional Education Commission:1. fosters, initiates, monitors and evaluates professional and clinical educational activities sponsored bythe AAPA that assist in the clinical and professional development of graduate physician assistants2. enriches the learning experience of PA students during their entry-level medical education3. specific areas of focus include:A. continuing professional educationB. postgraduate education – specialty certification, PA residency training programsC. AAPA annual conferenceD. clinical training sites for PA students[Adopted 2010]BA-2400.4.14Conference Education and Planning Work Group (of the Professional Education Commission):1. participates in the planning, delivery, and evaluation of lecture learner and workshop programs atAAPA annual conference2. develops a three-year plan for continuing medical and professional education programs at AAPA annualconference3. participates in discussions related to the marketing and branding of the AAPA annual conference4. conducts periodic surveys to determine member wants and preferences related to educational activitiespresented at AAPA annual conference[Adopted 2010]BA-2400.4.15Leadership Development Work Group (of the Professional Education Commission):1. identifies and catalogues leadership opportunities available to PAs2. recruits and facilitates recruitment of new leaders3. creates a stratified leadership development program4. builds leadership capacity through a life-long learning process for all experience levels5. creates a leadership skills database that catalogues the skills of current and potential PA leaders6. recognizes leadership excellence[Adopted 2010, amended 2012]BA-2400.4.16Governance Commission:1. works with all volunteer leadership groups to ensure charges and competencies are met for each group2. specific areas of focus include:A. validation of election proceduresB. oversight of constituent organizations (COs) complianceC. evaluation of governance structureD. job descriptions reviews for board members, commissions and work groupsE. new leader recruitment and orientation - BOD, commission members, liaisons, work group and taskforce membersF. assessment of board composition for strengths and weaknessesG. strategic planning creation and implementation[Adopted 2010]BA-2400.4.1736

Nominating Work Group (of the Governance Commission):1. endorses candidates for the board of directors2. educates AAPA membership on the endorsement process[Adopted 2010]BA-2400.4.18Constituent Relations Work Group (of the Governance Commission):1. charters new constituent organizations2. approves recognition of specialty organizations and caucuses3. seeks opportunities for AAPA to enhance and advance specialty organizations and caucuses4. serves as a resource to members and leaders on membership related issues5. determines the winner of the constituent organization awards[Adopted 2010]BA-2400.5.0Board of DirectorsBA-2400.5.1The AAPA Board of Directors may provide interim approval of policy for which they do not have specificguidelines from the House between meetings of the House with the following restrictions:1) The Board of Directors may not alter or amend the function of the House of Delegates.2) The Speaker and one other officer of the House of Delegates must concur with the immediate need torespond.3) The president and the president elect of the Board of Directors must concur with the immediate need torespond.4) The item receiving interim approval by the Board of Directors must be presented to the House ofDelegates for final approval at its next regular meeting.5) A complete report, justifying the need for interim approval will be mailed by the Speaker to alldelegates within forty-five (45) days of the Board of Directors action.[Adopted 1983, amended 1987, 1995, 1998, reaffirmed 1990, 2000, 2005, 2010]BA-2400.6.0Political Action CommitteeBA-2400.6.1AAPA encourages the Political Action Committee to communicate with the appropriate state chapters whileconsidering contributions to candidates within that state. AAPA encourages the Political Action Committee toconsider the overall voting record of a legislator in light of AAPA policy statements before contributing to thatlegislator’s campaign.[Adopted 1983, reaffirmed 1990, 1995, 2000, 2005, 2010]BA-2500.00BA-2500.1.0ACADEMY/ORGANIZATION – OPERATIONSAcademy RulesBA-2500.1.1AAPA prohibits any person holding himself out as speaking for the Academy without sanction of the Board ofDirectors or its agents.[Adopted 1977, reaffirmed 1990, 1995, 2000, 2005, 2010]BA-2500.1.2The Academy logo is copyrighted and registered by the U.S. Patent and Trademark Office and may not bealtered in any way without permission. Any contemplated use must have prior Academy approval.[Adopted 1978, amended 1996, reaffirmed 1990, 1995, 2000, 2005, 2010]BA-2500.1.337

All correspondence appearing under AAPA stationery letterhead should reflect the cohesive and current policyof the Academy; therefore, AAPA stationery should be used only in an official capacity on behalf of theAcademy.[Adopted 1977, reaffirmed 1990, 1995, 2000, 2005, 2010]BA-2500.1.4Any legal advice provided to a fellow member of the Academy shall be provided at the expense of the individualAcademy member unless the case is believed to have significant ramifications on the PA profession as a whole.The president and Speaker of the Academy, in conjunction with the executive vice president, shall decide theevaluation of the significance of the case. The final decision will rest with the AAPA Board of Directors.[Adopted 1982, reaffirmed 1990, 1995, 2000, 2005, 2010]BA-2500.1.5Notwithstanding any restrictions in information distribution policy, the Academy may distribute e-mailaddresses, practice and home addresses and phone numbers from the masterfile to assist AAPA constituentorganizations with their legislative and regulatory activities.[Adopted 2002, amended 2007, 2009]BA-2500.2.0Membership/Membership ServicesBA-2500.2.1AAPA shall recognize select fellow physician assistants who have retired from the PA profession after greaterthan twenty (20) years of AAPA membership with an emeritus status membership. These individuals will beselected by the AAPA Awards Work Group for their outstanding service and contribution to the PA profession.[Adopted 2003, amended 2005, reaffirmed 2010]BA-2500.2.2AAPA recognizes physician assistants who are eligible for fellow membership but whose special circumstancesmake payment of fellow member dues an unreasonable hardship. PAs requesting a reduced membership fee maybe accepted for membership when the reason for petitioning is illness, injury, or other significant personalhardship. AAPA will consider each request on an individual basis to include, but not be strictly limited to, theabove guidelines. Such members shall be accorded full privileges of fellow membership.[Adopted 1982, reaffirmed 1990, 1995, 2000, amended 1984, 2005, 2010]BA-2500.2.3AAPA shall recognize those AAPA Fellow and Sustaining Members who have distinguished themselves amongtheir colleagues, as well as in their communities, by their service to the physician assistant profession, theadvancement of health care to all people, and by their exemplary personal and professional development.[Adopted 2007, reaffirmed 2012]BA-2500.2.4AAPA recognizes excellence and significant contributions to the physician assistant profession through itsAwards Program. The Awards Program is overseen by the appropriate work group of the Academy.[Adopted 1990, amended 1998, reaffirmed 1995, 2000, 2005, 2010]BA-2500.2.5AAPA shall continue to honor the historic foundations of the profession in rural health care by recognizingmembers who exemplify excellence in rural health care delivery.[Adopted 2003, reaffirmed 2008]BA-2500.3.0Information on the ProfessionBA-2500.3.1AAPA is committed to the collection and dissemination of information about physician assistants in order toensure the future of the profession.[Adopted 1996, reaffirmed 2001, 2006, 2011]38

BA-2500.3.2The AAPA supports the designation of National Physician Assistant Week commencing on October 6.[Adopted 2004, reaffirmed 2009]BA-2500.4.0Strategic GoalsBA-2500.4.1The American Academy of Physician Assistants works toward establishing a culture of leadership excellence inthe Academy by endorsing and supporting the importance of personal and professional leadership developmentfor PAs.See: Leading the AAPA Towards a Culture of Leadership Excellence (PP tab 23)[Adopted 2003, reaffirmed 2008]BA-2500.4.2AAPA leadership and national office staff will incorporate ethnic and cultural diversity in their planning, actions,and discussions on behalf of the physician assistant profession in publications and media activities; in theselection of commission, work group, and task force members, and in awards.[Adopted 1995, reaffirmed 2000, 2005, 2010]BA-2600.00BA-2600.1.0ELECTIONSRules and Regulations for Election of Officers and Directors at Large - Elections/VotingBA-2600.1.1All fellow members listed on the AAPA membership rolls by March 1 will be mailed (by regular mail or by e-mail) ballots.[Amended 2004, reaffirmed 2009]BA-2600.1.2The American Academy of Physician Assistants supports an electronic means of balloting for the officers anddirectors at large of AAPA. The protection of confidentiality shall be of the highest concern in the ballotingprocess. Also, anonymity will be respected to the extent possible in order to ensure the security of our ballotingprocess.[Adopted 2000, reaffirmed 2007, amended 2012]BA-2600.1.3Self-declaration of candidacy for elected office on the Board of Directors of the Academy, excluding the officeof vice president and other House of Delegates Officers, must occur by a date determined by the GovernanceCommission and publicized to the general membership.[Adopted 2005, amended 2010]BA-2600.1.4The official AAPA ballot shall identify those candidates endorsed by the Nominating Work Group.[Amended 2004, 2009]BA-2600.1.5Receiving a plurality of the votes cast will elect a candidate.[Amended 2004, reaffirmed 2009]BA-2600.1.6The term of office for officers and directors at large will begin June 10 or at the adjournment of the annualconference, whichever is later.[Amended 1990, 1997, 2004, reaffirmed 2002, 2003, 2009]BA-2600.2.0Rules and Regulations for Election of House of Delegates Officers - NominationsBA-2600.2.1.0 Qualifications for Office39

BA-2600.2.1.1House of Delegates Officersa. A candidate must be an officially designated delegate or alternate listed on the official delegate roster forthe upcoming House of Delegates. The House Tellers Committee will confirm the delegate status inwriting.b. All candidates for House office must be seated delegates or alternates and must be fellow members. It ishighly recommended that candidates have recent AAPA House of Delegates, Board of Directors,commission, or work group experience.[Reaffirmed 2009, amended 2003, 2004, 2010]BA-2600.2.2.0Elections/VotingBA-2600.2.2.1All seated delegates present at the time of call for elections of the House of Delegates are eligible to vote.[Amended 2004, reaffirmed 2009]BA-2600.2.2.21. A candidate for each House office will be elected by receiving a majority of the votes cast in that race.2. In the event that no majority is obtained by a House office candidate, a run-off ballot will be between the twocandidates receiving the highest plurality of votes. Write-in candidates are not permitted.3. If the House Officers have a complete but unopposed slate of candidates, a motion to immediately elect theentire slate of candidates passing by a simple majority vote shall constitute a vote and take the place of apaper ballot.[Amended 2004, 2005, 2009, 2011]BA-2600.2.2.3The term for the House of Delegates Officers and the Nominating Work Group will begin June 10, or at theadjournment of the annual conference, whichever is later.[Amended 1990, 1997, 2004, reaffirmed 2002, 2003, 2009]BA-2700.00BA-2700.1.0NOMINATING WORK GROUPResponsibilitiesBA-2700.1.1Receive applications from potential candidates by November 1. Prepare by March 1 a single or multiple slate ofcandidates for each elected position (excluding House elections) to be filled. The slate of candidates should beselected for nomination based on the criteria as outlined in Bylaws, Article XIII, Section 3. Offices to be filledare: 1) president-elect; 2) secretary-treasurer every two years, and 3) directors at large (2).[Adopted 1982, reaffirmed 1990, 2003,2008, amended 2010]BA-2700.1.2Composition of the Nominating Work Group shall meet the criteria as outlined in the AAPA Bylaws.[Adopted 1982, reaffirmed 1990, 2003, 2008, amended 2009]BA-2700.1.3a. Provide up-to-date information on qualifications and responsibilities for Nominating Work Groupendorsement to the membersb. Evaluate all candidates who seek endorsementc. Provide a list if endorsed candidates to the Governance Commission and membership by March 1.[Adopted 1982, reaffirmed 1990, 2003, amended 2007, 2009, 2010]BA-2700.2.0Candidate EndorsementBA-2700.2.140

To be considered for endorsement by the Nominating Work Group, the proposed candidate must meet, at aminimum, the eligibility and qualification of a candidate as set forth in the AAPA Bylaws.[Adopted 1982, reaffirmed 1990, 2003, 2008, amended 1989, 1992, 2009]BA-2700.2.1.1The following selection guidelines, while subjective in nature, are flexible enough to allow for consideration ofspecific leadership needs from year to year:1) Thinking processes are logical, relevant, and well thought-out2) Intellectual creativity and flexibility3) Communicates clearly and effectively4) Acts with integrity and confidence5) Flexible, patient, and tolerant in attitudes6) Demonstrates commitment to carrying out Academy responsibilities7) Demonstrates executive capability8) Is knowledgeable of current Academy issues and goals9) Meets particular leadership and/or professional needs of the Academy as outlined in the current strategic plan[Adopted 1982, amended 1989, reaffirmed 1990, 2003, 2008]BA-2700.2.1.2Candidates for president-elect should have previous experience as an Academy and/or House Officer, boardmember or commission or work group chair. The candidate must be willing and able to fulfill the time andfinancial commitments of the office.Candidates for secretary-treasurer are encouraged to have previous experience in organizational secretarial dutiesand to have knowledge/experience in general accounting principles.[Adopted 1982, reaffirmed 1990, 2003, 2009, amended 1987, 2005, 2010]BA-2800.00BA-2800.1.0JUDICIAL AFFAIRS COMMISSIONComplaintsBA-2800.1.1AAPA Complaint Procedures[Amended 2002, 2007, 2009]See: Judicial Affairs Procedure Manual 1 (Complaints Involving a Potential Judicial Affairs CommissionHearing)Judicial Affairs Procedure Manual 2 (Membership Revocation Procedures Related to Members WhoHave Had Their State License Revoked)Judicial Affairs Procedures GlossaryBA-2800.1.2 Complaints Against Judicial Affairs CommissionIn the event that charges are filed against the Judicial Affairs Commission, the Speaker of the House ofDelegates shall appoint a five member Ad Hoc Hearing Committee that shall consist of two individualsrandomly chosen from among all current Academy commission or work group chairs (excluding the JudicialAffairs Commission chair) and three members randomly selected from among currently designated constituentchapter chief delegates. The chair of this committee shall be designated by the Speaker from among itsmembers. This committee shall utilize the standard forms and procedures developed for processing chargeswithin the Academy.[Adopted 1981, amended 1992, reaffirmed 1990, 2003, 2008]BA-2800.1.3Complaints Against Physician Assistant Organizations Recognized by the AAPA House of Delegates[Amended 2002, 2007, 2009]See: Judicial Affairs Procedure Manual 1 (page 13)BA-2800.2.0Challenging a General AAPA Election41

BA-2800.2.1A challenge of an AAPA election (except for the House of Delegates election) must be made to the JudicialAffairs Commission while the election is in progress or within one calendar month of the date of theannouncement of the election results. Elections may be challenged by a candidate or a member eligible to votein that election.BA-2800.2.2The grounds for challenging the election are as follows:1. Voting by ineligible persons2. The procedures for holding an election as outlined in the AAPA bylaws and policy are not observed.3. Negligence in conducting the election.BA-2800.2.31. The Judicial Affairs Commission will investigate any challenged election and will report its findingsand recommendations to the board of directors2. If the election is challenged while in progress, it will continue unless a recommendation from theJudicial Affairs Commission and a decision by the board of directors is made to stop the election anddeclare it void.3. If the election is challenged after the announcement of election results, the new officers will assumetheir elected office and remain in office until a recommendation from the Judicial Affairs Commissionand a decision is made by the board of directors. Any board member (as determined by the JudicialAffairs Commission) involved in a challenged election will not participate in the board of directorsdeliberation and decision on the election challenge.4. If the Judicial Affairs Commission finds that the illegal votes cast or the illegal practices engaged incould have changed the election results, then the board of directors will void the election. If the JudicialAffairs Commission finds that the illegal votes cast or the illegal practices engaged in could not havechanged the results of the election, then the board of directors need not void the election.5. This entire process must be completed, and members notified of action taken within eight weeks of thechallenge. If necessary, the board may approve a single four-week extension.BA-2800.2.4Challenging a House ElectionAny election conducted by the House of Delegates may be challenged by any seated delegate byRising to a point of order or inquiry.Bringing their concerns to the Judicial Affairs Commission.If any election conducted by the House of Delegates is challenged while the House of Delegates is in session, itmay be declared void by a majority of delegates present and voting is repeated.If any election conducted by the House of Delegates is challenged after the close of the house session, theprocess followed for challenging general election results will be followed.BA-2800.3.0 Adjudication Procedures for the Discipline or Removal (Impeachment) of ElectedOfficials of the Academy[Reaffirmed 2008, amended 2009]See: Judicial Affairs Procedure Manual 1 (page 23)HP-3000.00HP-3100.0.0PROFESSIONGENERAL42

HP-3100.1.0Professional TitleHP-3100.1.1The AAPA affirms "physician assistant" as the official title for the PA profession.[Adopted 2000, reaffirmed 2005, 2010]HP-3100.1.2The AAPA shall adopt “asociado médico” as the official Spanish translation for physician assistant.[Adopted 1998, reaffirmed 2003, 2008]HP-3100.1.3The AAPA believes that, whenever possible, PAs should be referred to as “physician assistants” and notcombined with other providers in inclusive non-specific terms such as “midlevel practitioner”, “advancedpractice clinician”, or “advanced practice provider”.[Adopted 2008]HP-3100.1.3.1PAs should utilize, and encourage employers (e.g., hospitals, HMO’s, clinics), third party payers, educators,researchers, and the government, to utilize, the term “physician assistant” or “PA” to reflect the unique positionof PAs in the healthcare system.[Adopted 2008]HP-3100.2.0DefinitionHP-3100.2.1Physician assistants (PAs) practice medicine with supervision by licensed physicians. As members of the healthcare team, PAs provide a broad range of medical services that would otherwise be provided by physicians.[Adopted 1980, amended 1991, 1996, reaffirmed 1990, 1993, 2000, 2005, 2010]HP-3100.2.2The AAPA recognizes graduates of all programs accredited by the Accreditation Review Commission (ARC-PA), or by one of its predecessor agencies as fulfilling the definition of the generic term “physician assistant.” Inconsumer and professional education and relations, and in negotiations with or policies presented to state and/orfederal governmental agencies, the AAPA treats physician assistants generically, using the same criteria spelledout in the Academy’s Bylaws for fellow membership.[Adopted 1978, amended 2006, reaffirmed 1990, 1995, 2000, 2011]HP-3100.2.3The AAPA opposes any regulations or guidelines that differentiate between physician assistants on the basis oflength of training program or academic credentials granted, if those physician assistants otherwise meet allcriteria for fellow membership in the Academy.[Adopted 1978, reaffirmed 1990, 1995, 2000, 2005, 2010]HP-3100.3.0RoleHP-3100.3.1Physician assistants are health professionals licensed or, in the case of those employed by the federalgovernment, credentialed, to practice medicine with physician supervision. Physician assistants are qualified bygraduation from an accredited physician assistant educational program and/or certification by the NationalCommission on Certification of Physician Assistants.Within the physician-PA relationship, physician assistants exercise autonomy in medical decision making andprovide a broad range of diagnostic and therapeutic services. The clinical role of physician assistants includesprimary and specialty care in medical and surgical practice settings in rural and urban areas. Physician assistantpractice is centered on patient care and may include educational, research, and administrative activities.[Adopted 1995, amended 1996, reaffirmed 2000, 2005, 2010]43

HP-3100.3.2All branches of the uniformed services shall be encouraged to delineate a well-defined peacetime and wartimemission for physician assistants based on the individual service component needs and requirements.The American Academy of Physician Assistants shall request that the various uniformed services peacetime andwartime missions should reflect, as closely as possible, the broad-based medical training and skills of physicianassistants in accordance with the current accreditation standards for physician assistant education.[Adopted 1986, amended 1991, 2001, reaffirmed 1996, 2006, 2011]HP-3200.00HP-3200.1.0PROFESSION – PA EDUCATIONInitial EducationHP-3200.1.1AAPA believes competency-based professional education at ARC-PA accredited entry level PA programsfollowed by life-long learning has been a successful formula for competent PA practice.[Adopted 2007, reaffirmed 2012]HP-3200.1.2AAPA believes the ability of PAs to practice and be reimbursed should not be compromised regardless of thedegree awarded upon completion of entry level PA education.[Adopted 2007, reaffirmed 2012]HP-3200.1.3AAPA recognizes that PA education is conducted at the graduate level and supports awarding the masters degreefor new physician assistant graduates.[Adopted 2007, reaffirmed 2012]HP-3200.1.4AAPA opposes the entry-level doctorate for physician assistants.[Adopted 2010]HP-3200.1.5AAPA recognizes that PA education exists based on unique mission-driven and geographical needs in a varietyof educational institutions and models.[Adopted 2006, reaffirmed 2011]HP-3200.2.0Continuing EducationHP-3200.2.1AAPA recognizes the concept of continuing professional development (CPD) as a means to maintaincompetence and ensure the delivery of high quality care. CPD is a process that includes ongoing identification oflearning needs, development of a learning plan, acquisition of new knowledge and skills, application to practice,and reassessment.Continuing medical education consists of clinical and professional educational activities that serve to maintain,develop, or increase the knowledge, skills, and professional performance and relationships that a physicianassistant uses to provide services for patients, the public, and the profession. Continuing medical education is aformal component of CPD. All continuing medical education reported should comply with this definition,regardless of whether it is reported as Category I (pre-approved) or Category II (elective).[Adopted 1988, reaffirmed 1990, 1993, 1998, 2005, amended 1997, 2009]HP-3200.2.2AAPA reviews and approves for Category 1 CME credit educational activities which serve to develop, maintain,or increase the knowledge, skills and professional performance of a physician assistant. These may include livepresentations, enduring material programs, and other educational activities. The AAPA stipulates that thefollowing activities meet the requirements for Category 1CME credit for physician assistants:44

those approved for Category 1 credit by the American Medical Association (AMA) (i.e. activitiessponsored by providers accredited by the Accreditation Council for Continuing Medical Education(ACCME))those approved for Category 1-A credit by the American Osteopathic Association (AOA)those approved for prescribed credit by the American Academy of Family Physicians (AAFP)accredited programs of the Royal College of Physicians and Surgeons of Canada (RCPSC), theCollege of Family Physicians of Canada (CFPC), or the Physician Assistant Certification Council ofCanada (PACCC)[Adopted 1979, reaffirmed 1990, 1998, 2003, amended 1985, 1993, 1996, 1997, 2006, 2011]HP-3200.2.3AAPA encourages the NCCPA to recognize CME Category 1 credit for continuing education activities thatincorporate professional self-assessment and self-improvement activities.[Adopted 2011]HP-3200.2.4The AAPA endorses the policies of the Accreditation Council on Continuing Medical Education (ACCME) oncommercial support of continuing medical education (CME) and applies those standards to its own reviewprocess.[Adopted 2003, reaffirmed 2008]HP-3200.2.5AAPA encourages physician assistants to be knowledgeable of the management of pain including theappropriate use and potential misuse of controlled substances.[Adopted 2002, amended 2007, reaffirmed 2012]HP-3200.2.6The AAPA encourages physician assistants to actively participate in the development and sharing of theknowledge regarding effects of the environment on the health of their patients and the larger community.The AAPA encourages physician assistants to limit their personal impact on the environment throughconservation, wise-use and recycling as an example to their patients and community.[Adopted 2010]HP-3200.2.6.1The AAPA supports development of strategic alignments that would promote reasoned societal momentum,valuing the best available science, to address critical issues of environmental impact on health.The AAPA supports legislative and regulatory actions that decrease the impact of anthropogenic waste andemissions as a means of decreasing exposure to toxic substances and environmental insults.[Adopted 2010]HP-3200.3.0Program Accreditation and CurriculumHP-3200.3.1The American Academy of Physician Assistants recognizes the Accreditation Review Commission on Educationfor the Physician Assistant (ARC-PA), as the body that accredits educational programs for physician assistants.AAPA also recognizes that the criteria used by the ARC-PA require graduates of these programs to beadequately prepared in a broad base of general medical competencies. It is the policy of AAPA that all PAseligible for certification by the National Commission on Certification of Physician Assistants be provided withthis broad-based medical background.[Adopted 1979, amended 2004, reaffirmed 1990, 1995, 2000, 2009]HP-3200.3.2AAPA believes that it is vital for graduate PAs to be involved in the education of student PAs. This involvementmay include, but is not limited to 1) recruitment of new students 2) participation in the selection of new students45

3) classroom instruction and 4) clinical preceptorship. The AAPA will, through its publications, programs andservices, encourage its members to actively participate in these educational opportunities.[Adopted 1994, amended 2004, reaffirmed 1999, 2009]HP-3200.3.3AAPA believes it is necessary to assure the public that those persons who prescribe medication or write drugorders or are involved directly in prescriptive practices must be qualified to do so. Specifically, in order that PAsprovide adequate patient care, (s)he must have a basic understanding of pharmacology and therapeutics,including the indications, contraindications, adverse effects, and complications of commonly used drugs.[Adopted 1979, reaffirmed 1990, 1995, 2000, 2005, 2010]HP-3200.3.4AAPA shall continue to educate and serve as a resource to students, programs, and graduate PAs on issuesconcerning reimbursement for physician services provided by PAs.[Adopted 1995, reaffirmed 2000, amended 2001, 2006]HP-3200.3.5AAPA recommends that PA programs protect the health of their students and the patients they serve againstinfectious diseases by:1. verifying adequate immunization and or immunity status upon entering the program2. following the immunization recommendations of the Centers for Disease Control and Prevention’s AdvisoryCommittee on Immunization Practice3. ensuring students have access to adequate health care in the event of exposure to pathogens4. training students in standard precautions5. having specific protocols in place regarding post-exposure prophylaxis and counseling[Adopted 1998, amended 2000, 2006, 2011]HP-3200.3.6AAPA recognizes the important role of the PA in the areas of medical specialization, but feels that education inthe specialty areas must be concurrent with or after education in general medicine as described in theAccreditation Standards for Physician Assistant Education of the Accreditation Review Commission onEducation for the Physician Assistant.[Adopted 1979, reaffirmed 1990, 1995, 2000, 2005, 2010]HP-3200.4.0Postgraduate Education and CertificationHP-3200.4.1Maintaining Professional Flexibility: The Case Against Accreditation of Postgraduate PA Programs(PP tab 2)[Adopted 2005, amended 2010]HP-3200.4.2AAPA is opposed to specialty certification, the use of specialty examinations and certificates of addedqualification that could reduce the profession’s versatility and flexibility, drastically altering its value to society.Every effort must be made to prevent regulators, employers, third-party payers, and others, including PAs frommisusing specialty certification, the use of specialty examinations and certificates of added qualification.See: Flexibility as a Hallmark of the PA Profession: The Case Against Specialty Certification (PP tab 19)[Adopted 2002, reaffirmed 2007, amended 2012]HP-3200.4.3The AAPA opposes any NCCPA requirement that PAs must practice for an identified time in a given specialtypractice as a precondition for specialty certification.[Adopted 2010]46

HP-3200.4.4The AAPA strongly discourages physician assistants from taking optional specialty examinations offered by theNCCPA on the basis that such examinations are not in line with the founding principles of the physician assistanteducation model or standards of physician assistant practice.[Adopted 2010]HP-3200.4.5AAPA believes that NCCPA must limit its role to that of a certifying body and focus its resources on improvingthe certification process. AAPA further believes that disciplinary actions by NCCPA must be restricted tomatters dealing with the examination, such as falsifications of applications for certification or cheating on anexamination, not serving as the arbiter of morals for physician assistants. Allegations or evidence of criminalbehavior, moral turpitude, or unprofessional behavior received by the commission should be returned to thesender with the suggestion that it be sent to appropriate state regulatory agencies, the Federation of State MedicalBoards, and/or the National Practitioner Data Bank.[Adopted 1990, reaffirmed 1995, 2000, 2005, 2010]HP-3200.5.0PA Education FundingHP-3200.5.1AAPA shall actively promote the participation of physician assistants in National Health Service Corpsscholarship and loan repayment programs.[Adopted 1978, amended 2000, 2005, reaffirmed 1990, 1995, 2010]HP-3200.5.2AAPA recognizes the vital importance of scholarship dollars to the continued growth and survival of theprofession[Adopted 1990, reaffirmed 1995, 2000, 2005, 2010]HP-3200.5.3The American Academy of Physician Assistants believes it is sound public policy to strengthen the U.S. healthcare workforce by providing government support for physician assistant education. Such support may includegrants; entitlement funding; student scholarships, loans, and grants; loan repayment options; faculty developmentinitiatives; and other forms of assistance. Government funding for physician assistant training is necessary tomaintain and increase the number of PA educational programs, faculty, and students to assure that health caredelivery in the United States is not compromised by an inadequate supply of medical providers.[Adopted 2008]HP-3200.5.4In order to promote PAs moving into Primary Care (as defined by the federal government) AAPA will add to itslegislative agenda initiatives to allow PAs in primary care to deduct interest on student loans or provide loanforgiveness to PAs.[Adopted 2010]HP-3200.6.0Recruitment and RetentionHP-3200.6.1In order to ensure the age, gender, racial, cultural and economic diversity of the profession; AAPA stronglyendorses the efforts of physician assistant educational programs to develop partnerships aimed at broadeningdiversity among qualified applicants for physician assistant program admission. Furthermore, the Academysupports ongoing, systematic and focused efforts to attract and retain students, faculty, staff and others fromdemographically diverse backgrounds.[Adopted 1982, reaffirmed 1990, 1995, 2000, amended 2005, 2010]HP-3200.6.2The AAPA supports efforts to help US military veteran medics and hospital corpsmen become PAs.[Adopted 2011]47

HP-3200.6.3Affirmative Action in Physician Assistant Education (PP tab 27)[Adopted 2004, reaffirmed 2009]HP-3200.7.0Program FacultyHP-3200.7.1The AAPA encourages institutions of higher education that sponsor physician assistant education to establish theMaster’s Degree as the terminal degree for tenure and promotion of physician assistant program faculty.[Adopted 2006, reaffirmed 2011]HP-3300.00HP-3300.1.0PROFESSIONAL PRACTICEClinicalHP-3300.1.1Physician assistants, by virtue of their education and legal scope of practice as professionals who providemedical care in teams with physicians, are qualified to order and monitor the use of patient restraint andseclusion. This applies to restraints when used in conjunction with a medical or surgical procedure and whenused for behavioral reasons. Restraint or seclusion should only be for the purpose of protecting the patient orothers or to improve a patient's functional well being, and only if less intrusive interventions have beendetermined to be ineffective.[Adopted 2000, reaffirmed 2005, 2010]HP-3300.1.2Physician assistants are encouraged to identify key factors that may lead to violence in all ages and to be familiarwith and initiate appropriate interventions, including but not limited to, all legally required notifications toaddress these situations when occurring within their practice setting and/or the community. Interventions mayalso include innovative and multidisciplinary efforts.[Adopted 2000, amended 2005, reaffirmed 2010]HP-3300.1.3Physician Assistants - Roles in Health Promotion and Disease Prevention (PP tab 11)[Adopted 1994, amended 2004, 2009]HP-3300.1.4AAPA encourages and supports the incorporation of health promotion and disease prevention into physicianassistant practice, through advocacy of healthy lifestyles and preventive medicine practices to reduce the risk ofillness, injury, and premature death. Preventive measures include the identification of risk factors, e.g. familyhistory, substance abuse, and domestic violence; immunization against communicable diseases; and promotionof safety practices.Physician assistants should routinely implement recommended clinical preventive services appropriate to thepatient’s age, gender, race, family history and individual risk profile. Preventive services offered to patientsshould be evidence-based and demonstrate clinical efficacy. PAs should be familiar with the most currentauthoritative clinical preventive service guidelines and recommendations.[Adopted 1978, amended 2000, reaffirmed 1990, 1995, 2005, 2010]HP-3300.1.5The AAPA supports the Surgeon General’s 2008 Call to Action for prevention of venous thromboembolism(VTE). Support shall include but not be limited to:Encouraging PAs to increase patient awareness as to the risks of VTE.Encouraging PAs to use clinically appropriate practice guidelines for the prevention and treatment ofpatients with VTE.Encouraging PAs to model evidence-based VTE prevention in their practices, including:48

1. performing VTE risk assessment on all patients in their care undergoing surgical procedures or being admittedto the hospital2. ensuring personal and family history of VTE is incorporated into all health history examinations3. prescribing, according to established evidence-based guidelines, appropriate prevention strategies for VTEinclusive of both chemoprophylaxis and mechanical prophylaxis4. providing patient education on the risks of VTE5. providing patient education on the importance of compliance with prevention strategies for VTE6. providing patient education on the symptoms and actions that should be taken if they suspect VTE.[Adopted 2011]HP-3300.1.6The AAPA encourages all physician assistants to take an active role in the screening, prevention, management,and referral of patients for oral health disease.[Adopted 2011]HP-3300.1.7Genetic Testing in Clinical Practice (PP tab 22)[Adopted 2001, reaffirmed 2004, amended 2006, 2011]HP-3300.1.8.0Organ DonationHP-3300.1.8.1Physician assistants knowledgeable in the area of organ and tissue transplantation should become activelyinvolved with educating other health professionals.[Adopted 1985, amended 2005, reaffirmed 1990, 1995, 2000, 2010]HP-3300.1.8.2AAPA encourages physician assistants to be familiar with criteria for identifying potential organ/tissue donorsand to be involved where appropriate in the “request” for donation and subsequent acquisition of organ/tissuedonation as is medically indicated.[Adopted 1988, reaffirmed 1993, 1998, 2003, 2008]HP-3300.1.9.0 Health LiteracyAAPA will promote measures to reduce the barrier of limited health literacy by encouraging the development,and use of literacy-appropriate patient education material by physician assistants. These measures areencouraged through inclusion of culturally diverse health literacy components in continuing education programsas well as undergraduate and graduate education curricula.[Adopted 2004, reaffirmed 2009]HP-3300.1.9.1Health Literacy: Broadening Definitions, Intensifying Partnerships and Identifying Resources (PP tab 32)[Adopted 2006, amended 2011]HP-3300.1.9.2The AAPA encourages physician assistants to identify and utilize reliable and accurate consumer healthinformation to encourage patient compliance and improve health education. Health education information shouldbe evidence based and appropriate to the patient’s culture and level of literacy. Provision of such resources isconsistent with AAPA efforts to promote health literacy.[Adopted 2010]HP-3300.1.10.0 Emergency ContraceptionAAPA believes that all physician assistants should provide or refer to someone who can provide informationabout emergency contraception (EC) to victims of sexual assault and as a part of routine family planning.[Adopted 2004, reaffirmed 2009]HP-3300.1.11.0 Obesity49

HP-3300.1.11.1Physician assistants are encouraged to address the issues of healthy weight and regular physical activity ascritical components of health promotion.[Adopted 2004, amended 2009]HP-3300.1.11.2The American Academy of Physician Assistants (AAPA) encourages PAs to take a leadership role in preventionand early recognition of pediatric obesity as well as identifying and treating obesity related co-morbidities. PAsare urged to participate in collaborative efforts with public health organizations and federal agencies to preventpediatric obesity in our communities by encouraging healthy eating and nutritional practices with regularphysical activity.[Adopted 2004, amended 2009]HP-3300.1.11.3The AAPA encourages the PA profession to combat the epidemic of childhood obesity by improved nutritionaleducation in schools, expanded physical education and exercise programs. The Academy supports physicianassistants in their efforts to provide leadership in schools promoting healthy lifestyles for our nation’s children.[Adopted 2004, reaffirmed 2009]HP-3300.1.11.4The Academy encourages educating physician assistants about the prevention and management of beingoverweight and obese. Additionally, the AAPA encourages national efforts to educate the public about thehealth risks of being overweight and obese. AAPA encourages all physician assistants and patients to maintain adesired weight and prevent inappropriate weight gain.[Adopted 2004, reaffirmed 2009]HP-3300.1.12Physician assistants should attempt to identify patients with addictive disorders and appropriately refer them fortreatment.[Adopted 2002, reaffirmed 2007, 2012]HP-3300.1.13.0 Antimicrobial ResistanceHP-3300.1.13.1AAPA believes that PAs should be aware of antimicrobial resistance in their clinical practice.AAPA strongly recommends that PAs educate their patients regarding antimicrobial resistance, including theprudent use of antibiotics and the importance of preventive measures (e.g. pneumococcal vaccine), and notaccommodate patient demands or expectations for unneeded antibiotics.[Adopted 1999, amended 2004, 2009]HP-3300.1.13.2Antimicrobial Resistance (PP tab 21)[Adopted 1999, reaffirmed 2004, amended 2009]HP-3300.1.13.3AAPA encourages the development and dissemination of educational programs on antimicrobial resistance forPAs and PA students. Such programs should address the scope of the problem, contributing causes, specific localissues, and the role each individual can play in controlling and preventing further antimicrobial resistance.[Adopted 1999, amended 2004, reaffirmed 2009]HP-3300.1.14Complementary and Alternative Medicine (PP tab 17)[Adopted 1999, reaffirmed 2004, amended 2005, 2009]HP-3300.1.1550

Immunizations in Children and Adults (PP tab 8)[Adopted 1994, amended 2004, 2006, 2011]HP-3300.1.16AAPA encourages PAs to utilize educational resources to become aware of the medical, legal, social, and ethicalissues surrounding Advance Directives for Medical Care. PAs are encouraged to facilitate open discussion withpatients and their family members concerning an individual's right to make treatment choices. PAs areencouraged to collaborate with other health care professionals to facilitate discussions in communities, bringingthis complex issue into the public forum.[Adopted 1992, reaffirmed 1997, 2003, 2008]HP-3300.1.17AAPA believes that all physician assistants should become knowledgeable of programs that make availableprescription medications free of charge or at a reduced cost for patients.[Adopted 2002, reaffirmed 2007, amended 2012]HP-3300.1.18AAPA believes evaluation of mental health and appropriate diagnosis and treatment of mental illness andconsideration of patients’ mental health are essential to overall patient well being and improved health outcomes.The AAPA believes that optimal health is composed of physical, mental and social well-being and not merelythe absence of disease or infirmity.[Adopted 2006, amended 2011]HP-3300.2.0Non-ClinicalHP-3300.2.1AAPA values the involvement in the Academy of physician assistants who, although not practicing clinically,remain involved in positions related to health care delivery, including, but not limited to, health professionaleducation, health care administration, health care policy or regulation, or serving in an elected capacity ingovernment.[Adopted 2000, reaffirmed 2005, 2010]HP-3300.2.2AAPA encourages physician assistants to seek election to Federal, state, and local legislative bodies.[Adopted 2012]HP-3300.2.3AAPA recognizes and encourages the active participation of physician assistants in policy making,administration, government affairs, research, and other non-clinical roles.[Adopted 2000, reaffirmed 2005, 2010]HP-3300.2.4AAPA endorses and encourages that health care accrediting agencies utilize physician assistants on localaccreditation site teams.[Adopted 2000, reaffirmed 2005, 2010]HP-3300.2.5AAPA places a high priority on the increased involvement of physician assistants in national, state and localhealth care policy discussions involving patient care, legislative regulatory and reimbursement issues. To ensuremeaningful involvement of physician assistants in the Veterans Health Administration (VA) and promote equaland fair opportunities for physician assistants, the AAPA supports the creation of a full time Director ofPhysician Assistant Services in the VA central office; who shall be responsible to and report to the UnderSecretary of Health on all matters dealing with PA issues.[Adopted 2003, amended 2004, 2009]HP-3300.2.651

AAPA encourages its membership to seek positions with the National Health Service Corps to help meet thehealth needs of the medically underserved areas.[Adopted 1978, reaffirmed 1990, 1995, 2000, 2005, 2010]HP-3300.2.7AAPA encourages physician assistants to provide care for medically underserved populations and/or practice inmedically underserved areas.[Adopted 1991, reaffirmed 2001, 2006, amended 1996, 2011]HP-3300.2.8Direct to Consumer Advertising (PP tab 26)[Adopted 2004, amended 2009]HP-3300.2.9AAPA believes physician assistants should continually work towards acquiring the knowledge, skills andattitudes needed to provide culturally competent care for patients with a wide variety of cultural attributes.[Adopted 2006, amended 2011]HP-3300.2.10PAs have an ethical and legal obligation to use appropriately trained medical interpreters for their patients withlimited ability to speak or understand English.See: Use of Medical Interpreters for Patients with Limited English Proficiency (PP tab 20)[Adopted 2003, reaffirmed 2008]HP-3300.3.0Environmental Health and AwarenessHP-3300.3.1The AAPA encourages physician assistants to acquire the knowledge and skills necessary to recognize theinfluence that environment has on the health of individuals and their communities.[Adopted 2010]HP-3300.3.2The AAPA supports continued educational efforts to keep the PA profession informed on issues ofenvironmental health in publications and through continuing educational opportunities.[Adopted 2010]HP-3300.4.0Society for the Preservation of Physician Assistant HistoryHP-3300.4.1The American Academy of Physician Assistants encourages physician assistants and their representativeorganizations to contribute to and actively participate in efforts to preserve and study our unique professionalhistory through the Society for the Preservation of Physician Assistant History.[Adopted 2002, amended 2007]HP-3400.00HP-3400.1.0PROFESSION – HEALTH CARE SYSTEMSGeneralHP-3400.1.1The Physician-PA Relationship in a Managed Care EnvironmentThere are three fundamental components in the unique relationship between PAs and physicians found in thephysician-PA team approach to patient care. They are the supervisory, business, and professional aspects of thatrelationship.The supervisory relationship is central to PA practice. It is defined by state law, the specific rules of theinstitution in which the PA and physician work, and delegation from the supervising physician. The business52

elationship defines the terms and conditions under which a PA works and is compensated. The professionalrelationship encompasses1) An association built on mutual respect and trust, where the PA provides quality, physiciandirectedcare;2) A mutual knowledge and understanding of the capabilities, skill, and competence of eachother, with effective delegation, appropriate consultation, and efficient patient care; and3) Shared responsibility and accountability within the framework of a medical practice for thequality of care provided to a patient through communication coordination and continuity ofcare between the PA and the physician.As health care delivery changes, there continue to be many reasons to use physician-PA teams such as qualitycare, improved patient access, patient satisfaction, and cost-effectiveness. However, when PAs and physicianswork side by side as employees of an organization, the traditional employment relationship with the physician asemployer and the PA as employee is absent. PAs and physicians may be assigned to one another without takingaccount of interpersonal and professional issues that have been an important part of the relationship betweenphysicians and PAs in the past.These factors may contribute to a loss of the professional relationship between a PA and a supervising physician,which may adversely affect patient care. PAs and physicians should work together to impress upon theadministrators of health care systems the importance of the professional component of this relationship and itsimportance in maintaining quality patient care.[Adopted 1999, amended 2004, 2009]HP-3400.1.2It is the obligation of each team of physician-PA team to ensure that the physician assistant's scope of practice isidentified; that delegation of medical tasks is appropriate to the physician assistant's level of competence; that therelationship of and access to the supervising physician is defined; and that a process of performance evaluation isestablished. Adequate and responsible supervision of the PA contributes to both high quality patient care andcontinued professional growth. AAPA is committed to the concept of physician assistant practice of medicinewith supervision by licensed physicians.[Adopted 1980, amended 1991, 1996, reaffirmed 1990, 1993, 2000, 2005, 2010]HP-3400.1.3AAPA believes that the physician-PA team relationship is fundamental to the PA profession and enhances thedelivery of high-quality health care. As the structure of the health care system changes, it is critical that thisessential relationship be preserved and strengthened.[Adopted 1997, reaffirmed 2002, 2007, 2012]HP-3400.1.4The American Academy of Physician Assistants (AAPA) supports expanded health care access for all people.AAPA encourages innovation in health care delivery, but remains committed to the model of physician directedteam care. AAPA maintains that continuity of care is a high priority; therefore communication between theepisodic care provider and the primary provider should be maximized within the constraints of regulation,patient confidentiality and patient preference.[Adopted 2003, reaffirmed 2008]HP-3400.2.0UtilizationHP-3400.2.1AAPA supports measures that allow for flexible and efficient utilization of PAs consistent with the provision ofquality health care. More specifically, PA employment and supervision are separate issues. The regulatoryrequirements of PA supervision should be unrelated to any aspect of employment.[Adopted 1996, amended 1997, reaffirmed 2001, 2007, 2012]HP-3400.2.253

The American Academy of Physician Assistants shall promote optimal utilization of physician assistants. Thisincludes providing information on credentialing, cost-effectiveness, scope of practice, reimbursement, and otherrelevant data.[Adopted 1996, amended 2006, reaffirmed 2001, 2012]HP-3400.2.3Physician Assistants as Medicaid Managed Care Providers (PP tab 12)[Adopted 1996, reaffirmed 2004, amended 1997, 2009]HP-3400.2.4AAPA shall promote the physician assistant profession to hospital administrators and other health care leaders asa cost-effective way to provide quality care by improving patient access and enhancing continuity of care.[Adopted 2000, reaffirmed 2005, amended 2010]HP-3500.00HP-3500.1.0PROFESSION – REGULATION/CERTIFICATIONGeneralHP-3500.1.1AAPA believes the integrity of physician assistant credentials should be assured through a credentialing process.Credentialing is a process for validating the background and assessing the qualifications of health careprofessionals to provide health care services in a variety of patient care settings. Privileges granted to PAs shouldbe consistent with state laws and regulations and hospital bylaws.[Adopted 1999, reaffirmed 2004, amended 2009]HP-3500.1.2American Academy of Physician Assistants recognizes that federally employed physician assistants are exemptfrom state licensing laws and regulations of the states regarding licensure and are subject to federal employmentcriteria established by their federal agencies or by Congress. The Academy therefore believes that federallyemployedphysician assistants should not be required to have a state license as a condition of employment, toobtain full practice privileges (including prescribing), to be credentialed in a federal facility, or to participate in afederal activity such as a disaster medical team. These federal employment credentials include graduation froma physician assistant program accredited by the Accreditation Review Commission on Education for thePhysician Assistant (ARC-PA), or by one of its predecessor agencies (Committee on Allied Health Educationand Accreditation (CAHEA), or the Commission on Accreditation of Allied Health Education Programs[CAAHEP]), and/or passage of the Physician Assistant National Certifying Examination (PANCE) administeredby the National Commission on Certification of Physician Assistants (NCCPA) and continual maintenance ofnational certification.[Adopted 1996, amended 2001, 2003, reaffirmed 2008]HP-3500.1.3AAPA strongly recommends and actively supports all efforts to ensure that medical school graduates who wishto obtain credentials to practice as physician assistants must attend and successfully complete an entry-levelphysician assistant program accredited by the Accreditation Review Commission on Education for the PhysicianAssistant and pass the physician assistant national certifying examination administered by the NationalCommission on Certification of Physician Assistants.[Adopted 1988, reaffirmed 1993, 1998, 2002, amended 2004, 2009]HP-3500.2.0CertificationHP-3500.2.1The American Academy of Physician Assistants endorses the National Commission on Certification of PhysicianAssistants (NCCPA) certification exam as the only entrance standard for physician assistants.[Adopted 1982, reaffirmed 1990, 1995, 2000, 2005, 2007, 2012]HP-3500.2.254

The American Academy of Physician Assistants opposes examinations given by individual states for the purposeof establishing entrance-level standards for individuals not eligible for the National Commission on Certificationof Physician Assistants examination.[Adopted 1982, amended 2005, reaffirmed 1990, 1995, 2000, 2010]HP-3500.2.3The AAPA believes that the NCCPA certificate should be time-limited and that maintenance of a current validcertificate requires that physician assistants pass the Physician Assistant National Recertifying Exam (PANRE)within four attempts if initiated in the fifth year of the recertification cycle.[Adopted 1999, amended 2004, reaffirmed 2009]HP-3500.3.0Regulations/RulesHP-3500.3.1AAPA believes that regulations governing the federal rural health clinic program should permit PAs to functionas employees, owners, or independent contractors. Rural health clinic program regulations should be flexibleand rational, allowing certified rural health clinics to address ongoing changes in the health care market in atimely and cost effective manner.[Adopted 1996, amended 2006, reaffirmed 2001, 2011]HP-3500.3.2Physician Assistants as Medical Review Officers (PP tab 9)[Adopted 1991, amended 2004, reaffirmed 2009]HP-3500.3.3Guidelines for Updating Medical Staff Bylaws: Credentialing and Privileging Physician Assistants (PP tab 3)[Adopted 2012]HP-3500.3.4Guidelines for State Regulation of Physician Assistants (PP tab 4)[Adopted 1988, amended 1993, 1998, 2001, 2005, 2006, 2009, 2011]HP-3500.4.0Legal/ContractualHP-3500.4.1The American Academy of Physician Assistants (AAPA) opposes the use of non-compete clauses in physicianassistant’s (PA’s) employment contracts. These covenants violate a PA’s right to practice his or her profession,negatively impact various aspects of patient care and access to care, and ultimately put financial interests aheadof patient and community care.[Adopted 2009]HP-3600.00PROFESSION – REIMBURSEMENT COMPENSATIONHP-3600.1.1AAPA shall explore and pursue avenues to cause amendment of the Social Security Act to permit Medicare PartB coverage of physician services provided by PAs and to clarify that the reimbursement and employmentrelationship are distinctly separate from supervision as defined by state law. [Adopted 1981, reaffirmed 1990,1995, and 2000, amended 1982, 1997, 2005, 2010]HP-3600.1.2AAPA believes that the cost-based reimbursement mechanism for Rural Health Centers should be continued oran equivalent payment mechanism should be developed to cover the costs of providing services to ruralMedicare and Medicaid patients and protect the financial viability of rural clinics.[Adopted 1996, reaffirmed 2001, 2006, 2011]HP-3600.1.355

The American Academy of Physician Assistants believes it is essential that all public and private insurers coverphysician services provided by physician assistants in all practice settings.[Adopted 1998, reaffirmed 2005, amended 2010]HP-3600.1.4AAPA believes it is vital to track the volume and quality of medical and surgical services provided by PAs toassess the impact of those services on patients and on the health care system. To facilitate that effort, AAPAsupports the recognition of, and direct payment to, PAs by public and private third party payers and health careorganizations. AAPA is committed to maintaining the established supervising physician-PA relationship that is acentral concept in the physician assistant profession and incorporated into every state’s law.[Adopted 2011]HP-3600.1.5The AAPA believes that services provided by physician-PA teams should be counted when federal and stategovernments determine the primary health care service needs of medically underserved and health professionalshortage areas. Recognition of physician-PA team productivity should not be done in such a way as to decreasepatient access to care.[Adopted 1998, reaffirmed 2003, 2008]HP-3600.1.6The AAPA shall educate the following groups to promote equitable reimbursement for physician servicesprovided by PAs: Centers for Medicare and Medicaid Services (CMS), third-party payers, employers, thirdpartyadministrators, and health benefit design organizations.[Adopted 1995, reaffirmed 2000, amended 2005, 2010, 2011]HP-3600.1.7AAPA believes in gender based equity in income for physician assistants having comparable responsibilitieswithin the same specialty. AAPA encourages additional research on gender based disparities in income.[Adopted 2011]HP-3700.00HP-3700.1.0PROFESSION – ETHICS/BEHAVIORGeneralHP-3700.1.1The AAPA believes that physician assistants must acknowledge their individual responsibilities to patients,society, other health professionals, and to themselves; and in meeting their responsibilities, their actions shouldbe guided by the Guidelines for Ethical Conduct for the Physician Assistant Profession. The AAPA believes theendorsement of the Guidelines for Ethical Conduct is a professional responsibility that underscores the principleof self-regulation.[Adopted 1990, amended 1991, 2001, reaffirmed 1996, 2006, 2011]HP-3700.1.2Guidelines for Ethical Conduct for the Physician Assistant Profession (PP tab 18)[Adopted 2000, amended 2004, 2006, 2007, 2008]HP-3700.1.3Physician Assistant Impairment (PP tab 10)[Adopted 1990, reaffirmed 2004, amended 1992, 2009]HP-3700.1.3.1The AAPA encourages all PAs to refrain from the use of any substance with the potential to cause impairment ofperformance during patient care activities.[Adopted 2006, reaffirmed 2011]HP-3700.1.3.256

AAPA shall support in principle the chemically dependent PA who has acknowledged his/her illness, engaged ina recovery program, and persists in a lifestyle compatible with ongoing recovery.[Adopted 1987, reaffirmed 1992, 1998, 2003, 2008]HP-3700.1.4End-of-Life Decision Making (PP tab 15)[Adopted 1997, reaffirmed 2004, amended 2009]HP-3700.1.5Guidelines for the Physician Assistant Serving As an Expert Witness (PP tab 5)[Adopted 1977, amended 1987, 1991, 2001, reaffirmed 2004, 2009]HP-3700.1.6False or Deceptive Health Care Advertising (PP tab 34)[Adopted 2007, reaffirmed 2012]HP-3700.2.0Disciplinary ProcessHP-3700.2.1AAPA believes that Academy members have an obligation to disclose what they believe in good faith to beunethical or unprofessional conduct, without reprimand or retaliation.[Adopted 1990, amended 1991, 2001, reaffirmed 1996, 2006, 2011]HP-3700.2.2AAPA will respond to allegations of unethical and unprofessional conduct with the utmost care, diligence,sensitivity, and respect for the rights of all concerned.[Adopted 1990, amended 1991, 2001, reaffirmed 1996, 2006, 2011]HP-3700.2.3AAPA will follow judicial review processes that encompass confidentiality, due notification, fair and equitableprocess, and an appeal procedure that protect the rights of the members involved.[Adopted 1990, amended 1991, 2001, 2006, reaffirmed 1996, 2011]HP-3700.2.4Upon completion of the Judicial Affairs Commission hearing process, the American Academy of PhysicianAssistants will report to the National Practitioner Data Bank and other appropriate regulatory agencies anyrevocation of membership due to violations of the Guidelines for Ethical Conduct for the Physician AssistantProfession.[Adopted 1990, amended 1991, 2001, 2007 reaffirmed 1996, 2006, 2012]HP-3700.2.5In keeping with the Guidelines for Ethical Conduct for the Physician Assistant Profession and the principle ofself-regulation, AAPA will publish in the appropriate publication and on the public pages of the AAPA Web sitethe names of PAs who have had their Academy membership revoked following either:a Judicial Affairs Commission hearing process, ora final adjudicated disciplinary action by a regulatory agency that resulted in revocation of licensure forviolation of their professional practice statute or regulation.[Adopted 2003, amended 2007, reaffirmed 2012]HP-3700.3.0InternationalHP-3700.3.1Guidelines for PAs Working Internationally1. PAs should establish and maintain the appropriate physician-PA team.2. PAs should accurately represent their skills, training, professional credentials, identity, or service bothdirectly and indirectly.57

3. PAs should provide only those services for which they are qualified via their education and/orexperiences, and in accordance with all pertinent legal and regulatory processes.4. PAs should respect the culture, values, beliefs, and expectations of the patients, local health careproviders, and the local health care systems.5. PAs should be aware of the role of the traditional healer and support a patient’s decision to utilize suchcare.6. PAs should take responsibility for being familiar with, and adhering to the customs, laws, andregulations of the country where they will be providing services.7. When applicable, PAs should identify and train local personnel who can assume the role of providingcare and continuing the education process.8. PA students require the same supervision abroad as they do domestically.9. PAs should provide the best standards of care and strive to maintain quality abroad.10. Sustainable programs that integrate local providers and supplies should be the goal.11. PAs should assign medical tasks to nonmedical volunteers only when they have the competency andsupervision needed for the tasks for which they are assigned.[Adopted 2001, reaffirmed 2006, amended 2011]HP-3700.3.2Licensure Eligibility for Physician Assistants Trained Abroad (PP tab 25)[Adopted 2004, amended 2009]HP-3700.4.0Continued CompetenceHP-3700.4.1AAPA recognizes life-long learning provides opportunities to improve competence, supports preparedness forcertification/licensure and increases the vitality and efficiency of a practice by providing learning opportunitieswhich are intended to improve performance in practice as measured ultimately by patient outcomes.AAPA believes it is the ethical responsibility of the practicing PA to maintain a level of competence sufficient topractice medicine safely and effectively. A component of that commitment is demonstrated by participating incontinuing educational activities which are scientifically valid, evidence-based, commercially unbiased, andbased on principles of effective adult learning.[Adopted 1987, reaffirmed 1992, 1997, 2002, 2006, amended 1996, 2003, 2011]HP-3700.4.2Professional Competence (PP tab 13)[Adopted 1996, amended 2005, 2010]HP-3700.4.3Competencies for the Physician Assistant Profession (PP tab 31)[Adopted 2005, reaffirmed 2010]HP-3800.00HP-3800.1.0PROFESSION – QUALITY ASSURANCEGeneralHP-3800.1.1AAPA believes that every PA is responsible for the delivery of cost-effective, accessible, quality health care.Furthermore the AAPA believes that every patient deserves care that is safe, effective, patient-centered, timely,efficient, and equitable.Physician assistants should take a role in ensuring that patient care is evidence-based, coordinated, integrated,and interdisciplinary.Physician assistants should be active participants and leaders in promoting patient safety, as well as evaluatingand improving the quality of care for patients.[Adopted 2003, amended 2008, 2010]58

HP-3800.1.2The AAPA believes that patient and family-centered care is beneficial to patients, family members, andhealthcare professionals.Physician Assistants should help educate patients, families, providers and institutions of the value of the patientandfamily-centered care.AAPA encourages PAs to participate and integrate patient- and family-centered care into their own practices.[Adopted 2009]HP-3800.1.3AAPA believes that effective peer-review is an essential part of quality health care. AAPA encourages thedevelopment and maintenance of voluntary and professionally directed peer-review. The membership isencouraged to actively participate in any peer review process involving the review of physician assistants.[Adopted 1997, amended 2007, reaffirmed 2002, 2012]HP-3800.1.4AAPA believes that physician assistants should honorably conduct their professional duties with transparency inaccordance with appropriate patient privacy protection and that evaluation of their performance should beassessed by peer-review practices.[Adopted 1990, reaffirmed 1996, 2006, amended 1991, 2001, 2011]HP-3800.2.0Liability/Risk ManagementHP-3800.2.1The American Academy of Physician Assistants believes that fair and comprehensive reform of the medicalliability insurance system is needed. The goals of a fair medical liability insurance system include:Compensation for injured patientsReduction of medical errorsAssurance that quality and access to care will not be compromisedFairness to patients and providersSupport for the use of apologiesTimely and accurate reporting of adverse eventsAssurance of affordable medical liability insuranceAssurance of the availability of medical careMinimal impact on the cost of health careThe American Academy of Physician Assistants also believes that caps on non-economic damages areappropriate only if they are part of comprehensive medical liability insurance reform whose impact is borneequitably by attorneys, insurers, providers, and patients.[Adopted 2004, amended 2009]HP-3800.2.2Acknowledging and Apologizing for Adverse Outcomes (PP tab 35)[Adopted 2007, reaffirmed 2012]HP-3900.00PA HealthHP-3900.1.1The AAPA believes that all physician assistants should use the standard and transmission-based precautionsrecommended by the Centers for Disease Control and Prevention (CDC) for preventing the spread of infectiousdiseases. AAPA believes employers should establish procedures to ensure that standard precautions and otherapplicable infection control measures are enforced and that educational programs covering proper infectioncontrol procedures are available for all health care workers. Employers should ensure that timely post-exposurecounseling and prophylaxis, in accordance with relevant CDC and OSHA guidelines, are available to health careworkers after an exposure.59

[Adopted 2006, amended 2011]HP-3900.1.2AAPA believes physician assistants have a responsibility to maintain their own health and wellness, includingmental health, by preventing and treating acute and chronic disease including mental illness, disabilities andoccupational stress.[Adopted 2006, amended 2011]HP-3900.1.3AAPA strongly recommends that all physician assistants be appropriately vaccinated per the recommendationsof the Advisory Committee on Immunization Practice (ACIP) of the Center for Disease Control and Prevention(CDC).[Adopted 1992, amended 2003, reaffirmed 2008]HP-3900.1.4AAPA believes that all PAs engaging in activities that have placed or will place them at risk of acquiring ortransmitting HIV should periodically and voluntarily test for it. Further, AAPA believes that the ability of HIVinfectedphysician assistants to perform their patient care responsibilities should be determined on an individualbasis by PAs, their personal physicians, and their supervising physicians. Additional resources, such as hospitalreview panels, may be consulted for professional advice regarding the avoidance of any activity that could placepatients or the practitioners themselves at risk.See: HIV-Positive Health Care Workers (PP tab 7)[Adopted 2003, reaffirmed 2008]HX-4000.00HX-4100.00HX-4100.1.0EXTERNAL POLICYHUMAN RIGHTSGeneralHX-4100.1.1The American Academy of Physician Assistants believes that patients have the right to be free of all forms ofseclusion and physical and chemical restraint that are not medically necessary. Seclusion and restraint shouldnot be used as a means of coercion, discipline, convenience, or retaliation. Seclusion and restraint should onlybe used according to accepted medical standards for the purpose of protecting the patient or others and toimprove a patient's functional well being and only if less intrusive interventions have been determined to beineffective.[Adopted 2000, reaffirmed 2005, 2010]HX-4100.1.2The American Academy of Physician Assistants encourages all of the nations' correctional facilities to seekaccreditation through on-site evaluation using the National Commission on Correction Health Care’s (NCCHC)Standards for Health Services in Jails and Standards for Health Services in Prisons.The American Academy of Physician Assistants encourages all juvenile confinement facilities to seekaccreditation using NCCHC's Standards for Health Services in Juvenile Confinement Facilities.The American Academy of Physician Assistants encourages all correctional health professionals to maintaintheir professional credentials and seek recognition through NCCHC's Certified Correctional Health ProfessionalProgram.[Adopted 1992, reaffirmed 1997, 2002, 2007, amended 2012]HX-4100.1.3AAPA opposes all forms of sexual harassment and gender discrimination.[Adopted 2000, reaffirmed 2005, 2010]HX-4100.1.460

AAPA supports equal rights for all persons and supports policy guaranteeing such rights.[Adopted 1982, reaffirmed 1990, 1995, 2000, 2005, 2010]HX-4100.1.5AAPA supports laws, policies, regulations, and judicial precedents regarding people living with HIV/AIDS thatare in accordance with the following principles:(1) should not place unique or additional burdens on such individuals solely as a result of their HIV status;and(2) should instead demonstrate a public health-oriented, evidence-based, medically accurate, andcontemporary understanding of—(A) the multiple factors that lead to HIV transmission;(B) the relative risk of HIV transmission routes;(C) the current health implications of living with HIV;(D) the associated benefits of treatment and support services for people living with HIV;and(E) the impact of punitive HIV-specific laws and policies on public health, on peopleliving with or affected by HIV, and on their families and communities.[Adopted 1992, reaffirmed 1997, 2002, 2007, amended 2012]HX-4100.1.6AAPA believes that genetic information should not be used to discriminate against individuals or their families.The AAPA supports state and federal legislation designed to protect the confidentiality of genetic informationand to prevent discrimination based on that information.[Adopted 2001, reaffirmed 2006, 2011]HX-4100.1.7AAPA opposes participation of physician assistants in the torture or inhuman treatment or punishment ofindividuals in relation to detention or imprisonment.[Adopted 1987, reaffirmed 1992, 1997, 2003, 2008]HX-4100.1.8AAPA endorses the 1975 World Medical Association Declaration of Tokyo which provides guidelines forphysicians and, by nature of their dependent relationship, for physician assistants, in cases of torture or othercruel, inhuman or degrading treatment or punishment in relation to detention and imprisonment.[Adopted 1987, reaffirmed 1992, 1997, 2003, 2008]HX-4100.1.9A physician assistant, as a member of a health care profession, should not participate in an execution.Participation in an execution includes, but is not limited to, the following actions: (1) prescribing oradministering medications or substances that are part of the execution procedure; (2) monitoring vital signs onsite or remotely (including monitoring electrocardiograms); (3) attending or observing an execution as aphysician assistant; and (4) rendering technical or professional advice regarding execution.In a case where the method of execution is lethal injection, the following actions would also constituteparticipation in the execution: (1) selecting injection sites (2) starting intravenous lines as a port for an injectiondevice (3) prescribing, preparing, administering, or supervising lethal injection drugs or their doses or types (4)inspecting, testing, or maintaining lethal injection devices and (5) consulting with or supervising lethal injectionpersonnel.The following actions do not constitute participation in an execution: (1) certifying death, provided that thecondemned has been declared dead by another person who is legally authorized to declare death in thatjurisdiction (2) witnessing an execution in a totally non-professional capacity (3) witnessing an execution atthe specific voluntary request of the condemned person, provided that the PA observes the execution in a nonprofessionalcapacity (4) relieving the acute suffering of a condemned person who is awaiting execution,61

including providing medication at the specific voluntary request of the condemned person to help relieve pain oranxiety in anticipation of the execution.[Adopted 1984, amended 2000, reaffirmed 1990, 1995, 2005, 2010]HX-4100.1.10AAPA is committed to a policy that respects the ethnic and cultural diversity of all people. The Academy'scommitment to diversity is a belief in the value and worth of each individual and a recognition that whendifferences in cultures and ethnic groups are understood and respected everyone in society benefits. Acceptingdiversity is not an attempt to eliminate or dilute the rich heritage that exists in all peoples. Accepting diversitydoes require an understanding and respect for the differences that exist among all physician assistants and thepatients they serve.[Adopted 1995, amended 1997, reaffirmed 2003, 2008]HX-4100.1.11The AAPA believes that physician assistants should provide culturally effective care, which is defined as thedelivery of care to a diverse population within the context of appropriate knowledge, understanding, andappreciation of all cultural distinctions leading to optimal health outcomes.[Adopted 2006, reaffirmed 2011]HX-4100.2.0DisabilitiesHX-4100.2.1AAPA supports the full integration of persons with disabilities into society and supports their full participation ineducational, employment, community living, and health opportunities.[Adopted 1983, reaffirmed 1990, 1995, 2005, amended 2000, 2010]HX-4100.2.2AAPA supports national, state, and community efforts that enhance the quality of life for persons withdisabilities. [Adopted 1983, amended 2000, reaffirmed 1990, 1995, 2005, 2010]HX-4200.00HX-4200.1.0HEALTH PROMOTIONGeneralHX-4200.1.1AAPA endorses the use of the U.S. Department of Health and Human Services’ report Healthy People and itssubsequent initiatives which serve as a guide to improve the health of the nation.All physician assistants should become familiar with the goals and objectives of Healthy People initiatives toimprove health promotion, health equity, and disease prevention in their communities.[Adopted 2002, amended 2007, 2012]HX-4200.1.2AAPA encourages patient and health care provider awareness and education as to the dangers in the use ofanabolic steroids, steroid supplements, and performance-enhancing products and procedures (PEPS) for bodybuilding and sports performance.[Adopted 2002, reaffirmed 2005, amended 2010]HX-4200.1.3AAPA supports systems of personal medical identification containing an individual’s key medical information,and encourages all physician assistants to promote their use to patients.[Adopted 1979, amended 2000, 2007 reaffirmed 1990, 1995, 2012]HX-4200.1.4AAPA recognizes the U.S. Preventive Services Task Force recommendations as unique and innovative in thefield of preventive medicine and supports their utilization as one resource in the practice of preventive medicine.[Adopted 1991, reaffirmed 1996, 2001, 2004, 2009]62

HX-4200.1.5AAPA endorses human breastfeeding when possible and when it is the choice of the nursing mothers.[Adopted 1982, amended 2000, reaffirmed 1990, 1995, 2005, 2010]HX-4200.1.6AAPA recognizes that substance abuse is a major public health problem and encourages physician assistants(PAs) to take an active role in eliminating substance abuse. The AAPA supports the education of all PAs in theearly identification, treatment and prevention of substance abuse.[Adopted 2005, reaffirmed 2010]HX-4200.1.7AAPA strongly recommends that physician assistants promote the health benefits of regular physical activity asan important part of health promotion and disease prevention.[Adopted 2005, reaffirmed 2010]HX-4200.1.8Physician assistants should educate patients and families about the physiological and psychological benefits ofphysical activity and encourage everyone to establish a lifetime commitment to a regular physical activityroutine.”[Adopted 2005, reaffirmed 2010]HX-4200.1.9The AAPA believes that timely access to ongoing prenatal care is essential to optimizing pregnancy outcomes.Physician assistants should be aware of programs within their communities that provide access to culturallycompetent care and promote a full range of preconception and pregnancy support services.[Adopted 2006, reaffirmed 2011]HX-4200.1.10Routine Vaccination for Human Papillomavirus (PP tab 36)[Adopted 2008, amended 2012]HX-4200.2.0Human Immunodeficiency VirusHX-4200.2.1The American Academy of Physician Assistants supports needle/syringe exchange programs and legal access tosterile injection equipment as effective public health measures for reducing the transmission of bloodbornepathogens. In particular, the AAPA endorsesEstablishment of needle/syringe exchange programs by public health departments and other organizationsto support the use of sterile needles/syringes by individuals who inject drugs and other substances;Government funding to support access to sterile needles and syringes;Amendment of state paraphernalia laws and needle/syringe prescription and dispensing laws to allow legalaccess to and possession of injection equipment; andPhysician assistant involvement in direct patient education and counseling regarding the attainment ofsterile needles/syringes either through established exchange programs, or by prescription or over-thecounterin states where allowed.[Adopted 2003, reaffirmed 2008, amended 2009]HX-4200.2.2Global Epidemic HIV/AIDS (PP tab 28)[Adopted 2005, amended 2010]HX-4200.2.363

The AAPA believes that providing prophylaxis for non-occupational exposures to HIV, in keeping with Centersfor Disease Control and Prevention guidelines, should be the standard of care.[Adopted 2006, reaffirmed 2011]HX-4200.2.4HIV Prevention (PP tab 6)[Adopted 2003, amended 2008]HX-4200.3.0AlcoholHX-4200.3.1AAPA advocates responsible behavior concerning alcohol use and encourages public education efforts regardingits potential for abuse.[Adopted 1985, amended 2000, reaffirmed 1990, 1995, 2005, 2010]HX-4200.3.2AAPA supports legislation that encourages states to impose minimum mandatory sanctions against convicteddrunken drivers and that encourages states to establish comprehensive alcohol-traffic safety programs whichwould help to assure stronger laws, stringent enforcement, and effective rehabilitation programs.[Adopted 1982, reaffirmed 1990, 1995, 2000, 2005, 2010]HX-4200.3.3AAPA supports the following recommendations to reduce under-age access to alcohol and to save lives:1. That it be illegal for individuals under the age of 21 to drive with any measurable amount of alcohol in theirbodies.2. That retailers and individuals be held accountable/liable for negligently providing alcohol to a minor.3. That advertisers promoting alcoholic beverages be required to provide balanced time for the promotion ofresponsible alcohol use.[Adopted 1995, reaffirmed 2000, 2005, 2010]HX-4200.3.4The AAPA encourages all PAs to support legislative efforts to maintain the legal drinking age at 21 years.[Adopted 2006, reaffirmed 2011]HX-4200.4.0TobaccoHX-4200.4.1AAPA shall support the position of the Surgeon General and encourage PAs to increase patient awareness as tothe dangers in the use of tobacco products. All PAs should strive to eliminate the use of tobacco products fromtheir personal lives and the lives of their colleagues and patients.[Adopted 1986, amended 2001, 2005, reaffirmed 1991, 1996, 2006, 2011]HX-4200.4.2AAPA recognizes the public health hazards of tobacco as a leading cause of preventable disease and encouragesefforts to eliminate tobacco use in this country and around the world.[Adopted 1982, reaffirmed 1990, 1995, 2000, amended 2005, 2010]HX-4200.4.3AAPA encourages physician assistants to work to eliminate the public’s exposure to secondhand smoke,eliminate minors’ access to tobacco products and prohibit advertising of tobacco products.[Adopted 1991, reaffirmed 1996, 2001, amended 2005, 2010]HX-4200.4.4The American Academy of Physician Assistants supports state utilization of tobacco settlement money forprevention and treatment of tobacco use. The Academy urges its constituent organizations to work with stategovernments and other health care and advocacy organizations to assure appropriate use of tobacco settlementfunds.64

[Adopted 2001, amended 2005, 2010]HX-4200.4.5AAPA encourages all PAs to be actively involved in community outreach that is directly involved in educatingpeople of all ages about the dangers of smoking with the goal of eliminating tobacco use.[Adopted 2005, reaffirmed 2010]HX-4200.4.6.0Smoking CessationHX-4200.4.6.1The American Academy of Physician Assistants supports (a) development and promotion of smoking cessationmaterials and programs to advance consumer health-awareness among all segments of society, but especially foryouth; (b) dissemination of evidence-based clinical practice guidelines concerning the treatment of patients withnicotine dependence; (c) effective use of both smoking cessation materials and evidence-based clinical practiceguidelines by PAs, for the treatment of patients with nicotine dependence.[Adopted 2006, amended 2011]HX-4200.4.6.2AAPA encourages physician assistants to model smoking cessation activities in their practices, including (a)quitting smoking and assisting their colleagues to quit; (b) inquiring of all patients at every visit about their useof tobacco in any form; (c) at every visit, counseling those who smoke to quit smoking and eliminate the use oftobacco in all forms; (d) working to prohibit all smoking in the office by patients, clinicians, and office staff; anddiscouraging smoking in hospitals where they work; (e) providing smoking cessation pamphlets in the waitingroom; (f) becoming aware of smoking cessation programs in the community and of their success rates and,where possible, referring patients to those programs.[Adopted 2006, reaffirmed 2011]HX-4200.4.6.3AAPA supports national, state, and local efforts to help physician assistants and physician assistant studentsdevelop skills necessary to counsel patients to quit smoking identify gaps, including (a) identifying gaps, if any,in existing materials and programs designed to train physician assistants and physician assistant students in thebehavior modification skills necessary to successfully counsel patients to stop smoking; (b) supports theproduction of materials and programs that would fill gaps, if any, in materials and programs to train physicianassistants and physician assistant students in the behavior modification skills necessary to successfully counselpatients to stop smoking; (c) encourages constituent organizations to sponsor, support, and promote efforts thatwill help physician assistants to more effectively counsel patients to stop smoking; and (d) encourages physicianassistants to participate in education programs to enhance their ability to help patients quit smoking.[Adopted 2006, reaffirmed 2011]HX-4200.4.7The AAPA supports third-party coverage for the treatment of nicotine addiction and the management ofbehavioral dependence associated with tobacco use.[Adopted 2006, reaffirmed 2011]HX-4200.5.0Organ DonationHX-4200.5.1AAPA supports multi-organ and tissue donation.[Adopted 1985, amended 2005, reaffirmed 1990, 1995, 2000, 2010]HX-4200.5.2AAPA support the concept that organs and tissue for transplantation should be made available based on need,rather than ability to pay.[Adopted 1986, amended 2006, reaffirmed 1991, 1996, 2001, 2011]HX-4200.6.0“Conversion or Reparative’ Therapy65

HX-4200.6.1The American Academy of Physician Assistants opposes any psychiatric treatment directed specifically atchanging sexual orientation, such as “conversion” or “reparative” therapy which is based upon the assumptionthat homosexuality per se is a mental disorder or based upon the a priori assumption that the patient shouldchange his/her sexual orientation.[Adopted 2007, reaffirmed 2012]HX-4300.00HX-4300.1.0SAFETYGeneralHX-4300.1.1AAPA encourages and supports accurate and appropriate labeling of foods, dietary supplements, herbalpreparations over-the-counter and prescription medications, cosmetics, and personal care products that clearlyillustrate ingredients, potential health hazards, indications for usage adverse reactions and contraindications.[Adopted 1982, amended 2000, 2004, reaffirmed 1990, 1995, 2009]HX-4300.1.2AAPA encourages its membership to be aware of medical consequences of toxic waste.[Adopted 1982, reaffirmed 1990, 1995, 2000, amended 2005, 2010]HX-4300.1.3AAPA is opposed to the use of tanning beds by adolescents and young adults under 18 years of age.[Adopted 2012]HX-4300.1.4AAPA encourages state chapters to pursue and support legislation to restrict the use of tanning beds byindividuals under 18 years of age.[Adopted 2012]HX-4300.1.5Physician assistants should educate patients of all ages about the dangers of tanning and the importance of fullskin exams yearly.[Adopted 2012]HX-4300.2.0Motor VehiclesHX-4300.2.1AAPA encourages all citizens to follow the manufacturer's guidelines regarding the use of all safety features onmotorized vehicles.[Adopted 1992, amended 1997, reaffirmed 2003, 2008]HX-4300.2.2AAPA shall support state laws requiring helmets for individuals participating in activities that put them at risk oftraumatic head injury (recreational/transportation). In addition, the AAPA shall encourage all physicianassistants to educate their patients, parents/guardians and the public on the value of the appropriate headgear/helmets as protection from traumatic head injury. Such education should address activities in which the riskof traumatic head injury is increased, such as motorcycles, ATV’s, bicycles, horses, scooters, skateboards,snowboards, skis and inline roller skates.[Adopted 1986, amended 2001, 2006, reaffirmed 1991, 1996, 2011]HX-4300.2.3AAPA and its constituent chapters actively encourage all states to enact mandatory seatbelt legislation for bothfront and rear occupants of a vehicle. AAPA supports effective motor vehicle passenger safety programs forchildren including enforcement of child restraint laws and enactment of belt-positioning booster seat laws in allstates. The AAPA also supports booster seat loaner programs and encourages PAs to discuss motor vehiclepassenger safety with their patients.66

The AAPA supports further research on the safety of seatbelts in school busses.[Adopted 1985, reaffirmed 1990, 1995, 2000, 2005, amended 2010]HX-4300.2.4AAPA supports legislation that bans the non-emergent use of hand-held telecommunication devices whileoperating a moving vehicle.[Adopted 2011]HX-4300.2.5AAPA supports national and state legislative initiatives to require mandatory drug and alcohol screening by lawenforcement officials of all drivers in fatal and serious injury motor vehicular crashes.[Adopted 2003, reaffirmed 2008]HX-4400.00HX-4400.1.0VIOLENCEGeneralHX-4400.1.1AAPA believes that physician assistants should be familiar with social and cognitive skills that foster nonviolentconflict resolution. In addition, physician assistants should support the incorporation of age-appropriate schooland community-based curricula that recognize racial, ethnic, and cultural diversity and that teach the skills ofnon-violent conflict resolution.[Adopted 1992, reaffirmed 1997, 2003, 2008]HX-4400.1.2Physician assistants are encouraged to address bullying as a component of violence prevention. The AmericanAcademy of Physician Assistants encourages appropriate public and private funding agencies to support researchon cyberbullying, bullying behavior and anti-bullying intervention.[Adopted 2002, reaffirmed 2007, amended 2009]HX-4400.1.3AAPA will seek to develop pro-active, collaborative working relationships with groups committed to preventingpediatric and adolescent violence by utilizing programs that reflect multifaceted, multidisciplinary approaches toeffectively address the problem of children’s violence in our communities and schools.[Adopted 2000, amended 2005, 2009]HX-4400.1.4AAPA supports the right of access to medical care and opposes all acts of violence and intimidation and reprisaldirected against physician assistants, other health care providers, patients and their respective families. TheAAPA opposes violence directed against medical facilities as an infringement of the individual’s right of accessto medical care.[Adopted 1996, amended 2001, reaffirmed 2006, 2011]HX-4400.1.5Physician assistants support missing children awareness activities for parents and children alike. AAPA supportsthe promotion of patient education and prevention on issues dealing with missing children such as abuse,runaways, and kidnapping.[Adopted 1985, amended 2000, reaffirmed 1990, 1995, 2005, 2010]HX-4400.1.6AAPA supports efforts in the prevention, early recognition, reporting, and management of children who arevictims of child abuse, including neglect, emotional, physical and/or sexual abuse. Physician Assistants shouldbe familiar with the risk factors, clinical presentations, as well as, short and long-term consequences related tochild abuse.AAPA supports the use of community resources in the management of child abuse, including appropriate localand state reporting agencies.67

[Adopted 1985, reaffirmed 1990, 1995, 2000, 2005, amended 1991, 2006, 2011]HX-4400.1.7AAPA recognizes that family abuse is a public health epidemic in the United States.AAPA supports medical care of abused and battered individuals which emphasizes linkages with communitybasedfamily abuse programs and referral agreements whenever possible.AAPA encourages its members to participate in community-based efforts to increase the awareness of theepidemic of child, intimate partner, and elder abuse.AAPA encourages its members to recognize that a relationship exists between substance abuse and family abuse.AAPA supports the development of educational programs addressing prevention, early recognition, reporting,treatment and the appropriate referral to prevent family abuse.[Adopted 1994, reaffirmed 2000, amended 2006, 2011]HX-4400.1.8Physician assistants are encouraged to be familiar with multi-disciplinary educational resources and public health& safety efforts directed at pediatric and adolescent violence prevention. AAPA believes that access andavailability of reliable information in these areas can enhance the efforts of PAs to address the problem ofviolence as it relates to the pediatric and adolescent population.[Adopted 2000, reaffirmed 2005, 2010]HX-4400.1.9AAPA supports a national commitment, including legislative and other local, state, and national efforts that havethe expressed purpose of reducing the risk of violence by and against children and improving the physical,psychological, socioeconomic and cultural status of children.[Adopted 2000, reaffirmed 2005, 2010]HX-4400.1.10AAPA supports public and private efforts that strive to decrease the incidence and effect of family violence.[Adopted 1994, amended 2004, reaffirmed 1999, 2009]HX-4400.1.11The AAPA believes that all physician assistants should be knowledgeable about the spectrum of elder abuse andneglect. PAs should be aware that the problem is likely to be encountered in their medical practices. In addition,PAs should be cognizant of barriers to the proper identification and management of elder mistreatment.[Adopted 2006, reaffirmed 2011]HX-4400.1.12The AAPA believes that physician assistants should be aware of the potential effects of media violence toinclude cyberbullying on their patients and within their community. PAs should consider involvement inprofessional organizations and community activities that seek to reduce the amount of violence, cyberbullying,and other problematic content in media materials. PAs should encourage increased parental involvement in theirchildren’s computer activities, media exposure and game-playing decisions. PAs should make information onmedia literacy available to patients and families.[Adopted 2006, amended 2009]HX-4400.2.0WeaponsHX-4400.2.1AAPA opposes the proliferation of chemical, biological, radiological, and nuclear weapons and agents andsupports the immediate pursuit of global nuclear disarmament. AAPA supports the continued education of itsmembership and the public at large of the public health and medical ramifications of chemical, biological, andnuclear warfare and terrorism.[Adopted 1982, reaffirmed 1990, 1995, 2005, amended 2000, 2010]68

HX-4400.2.2AAPA supports handgun control legislation and other legislation that effectively reduces the criminal ownershipand use of handguns. AAPA supports policies and educational programs that will effectively reduce homicide,suicide, and other violence.[Adopted 1993, reaffirmed 1998, 2005, 2010]HX-4400.2.3Proliferation and Dispersal of Anti-personnel Weapons (PP tab 38)[Adopted 2012]HX-4400.3.0TerrorismHX-4400.3.1AAPA supports continued research and development to ensure the following:to improve understanding of the epidemiology, pathogenesis, and treatment of the diseases caused bychemical, biological, radiological, and nuclear agentsnew and more effective medical countermeasures such as vaccines, pharmaceuticals, and antidotesenhancing the shelf life of existing vaccines, pharmaceuticals, and antidotesto improve the detection and defense capabilities against chemical, biological, radiological, and nuclearagents.[Adopted 2005, amended 2010, 2011]HX-4500.00TECHNOLOGYHX-4500.1AAPA believes that telemedicine can improve access to cost-effective, quality health care and improve clinicaloutcomes by facilitating interaction and consultation among providers. Because of the potential of telemedicineto enhance the practice of medicine by physician-PA teams, AAPA encourages physician assistants to take anactive role in the utilization and evaluation of this technology. AAPA supports further research and developmentin telemedicine, including resolution of problems related to regulation, reimbursement, liability, andconfidentiality.[Adopted 1997, reaffirmed 2002, 2007, 2012]HX-4500.2AAPA endorses a legally enforceable ban on the cloning of human beings for the purpose of reproduction.However, AAPA supports stem cell research, including the use of nuclear transplantation techniques (alsoknown as research or therapeutic cloning) in order to realize the enormous potential health benefits thistechnology offers.[Adopted 2003, reaffirmed 2008]HX-4500.3AAPA supports a patient-centered health care system in which there is an open exchange of information forpatients with their health care professionals, hospitals, and other agencies providing care for those patientsthrough mutually interfacing health information technology (H.I.T.) systems.[Adopted 2005, amended 2010]HX-4500.4Scientific Integrity and Public Policy (PP tab 29)[Adopted 2005, amended 2010]HX-4500.5Physician Assistants (1) advocate the appropriate placement of automated external defibrillators; (2) supportincreasing government and industry funding for the purchase of automated external defibrillator devices; (3)encourage the American public to become trained in CPR and the use of automated external defibrillators; and(4) advocate for legislation to be passed to provide immunity from liability for those who, in good faith, andwithout expectation of compensation, provide and use AEDs in emergency situations.[Adopted 2008]69

HX-4500.6AAPA believes that genetic testing for the presence of or susceptibility to disease should be available to thepublic only through the services of a qualified health care provider.[Adopted 2008]HX-4500.7The AAPA believes that additional clinical research should be conducted on the therapeutic value and efficacyand safety of marijuana and related cannabinoids.[Adopted 2009]HX-4600.00HX-4600.1.0ACCESS TO CAREGeneralHX-4600.1.1Informed teams that include patients and their providers should make health care decisions. AAPA opposes anyintrusion into the provider-patient relationship that inhibits the provider's ability to deliver appropriate andnecessary medical services.[Adopted 1997, amended 2007, reaffirmed 2002, 2012]HX-4600.1.2AAPA supports the free exchange of information between the patient and provider and opposes any intrusioninto the provider-patient relationship through restrictive informed consent laws, biased patient education orinformation, or restrictive government requirements of medical facilities.[Adopted 1992, reaffirmed 1997, 2002, 2007, 2012]HX-4600.1.3Health plan coverage for the treatment of mental health and substance abuse/dependencies should benondiscriminatory and covered at the same benefit level as other medical care.[Adopted 2003, reaffirmed 2008]HX-4600.1.4AAPA recognizes the unique needs of underserved populations and encourages physician assistants to providecare to all patients.AAPA supports the development of programs and elimination of barriers to care for all patients. Any incentivesoffered by government or private entities promoting more equitable and accessible care should be available to allhealth care practitioners.[Adopted 2002, reaffirmed 2007, amended 2012]HX-4600.1.5AAPA believes that PAs should endorse and support policies and programs that address the elimination of healthdisparities and commit to activities that will achieve this goal. AAPA supports forming “strategic partnerships”with other organizations that will help advance the elimination of health disparities.[Adopted 2001, reaffirmed 2006, 2011]HX-4600.1.6AAPA supports legislative and health policies that will eliminate the social, education, employment and housinginequities that contribute to disparities in health.[Adopted 2001, amended 2006, 2011]HX-4600.1.7Second And Co-Parent Adoption: Improving Children’s Access to Health Care (PP tab 24)[Adopted 2004, reaffirmed 2009]HX-4600.1.870

Comprehensive Health Care Reform (PP tab 1)[Adopted 2005, amended 2010]HX-4600.1.9The AAPA opposes actions by pharmacists that limit or restrict patient access to care, such as refusing to fillprescriptions based on personal or religious beliefs.[Adopted 2006, reaffirmed 2011]HX-4600.1.10The American Academy of Physician Assistants believes that all patients deserve access to health care andopposes the establishment of local, federal, or state initiatives that require health care providers to refuse care toundocumented persons or to report suspected undocumented persons to authorities.[Adopted 2007, reaffirmed 2012]HX-4600.1.11AAPA believes physician assistants (PAs) should advocate and facilitate care for veterans of the uniformedforces of the United States and their families including National Guard and Reserve Forces. AAPA supportseducation for all PAs regarding the medical and psychosocial needs of all veterans and their families. AAPAencourages PAs to be aware of the services and resources in their communities that assist veterans and theirfamilies to obtain the most up to date care.[Adopted 2008]HX-4600.2.0Rural Health CareHX-4600.2.1AAPA supports the expansion of the national medical care safety net system by allowing rural health clinics tocontract with community health centers to provide medical care to uninsured patients at the rural health clinic.[Adopted 2004, reaffirmed 2009]HX-4600.2.2Rural Health Clinics (PP tab 16)[Adopted 1997, amended 2004, 2009]HX-4600.2.3The AAPA supports the current law which allows rural health clinics to maintain certification regardless of theshortage area designation status until such time as a process has been developed that ensures continuation ofaccess to appropriate care for the patients served by the clinics.[Adopted 1997, reaffirmed 2002 2007, amended 2012]HX-4600.2.4AAPA supports and takes steps to ensure the continuation of the rural health clinic (RHC) program to meet thegoal of improving access to care in rural medically underserved areas.[Adopted 1996, reaffirmed 2001, 2006, 2011]HX-4600.2.5AAPA supports retention of the original requirement that rural health clinics utilize PAs and NPs to extendaccess to primary care medical services in areas that have a shortage of physicians.[Adopted 1996, reaffirmed 2001, 2006, 2011]HX-4600.2.6The AAPA should make it a priority to promote the physician assistant profession to patients and leaders ofhealthcare facilities in underserved communities to improve access to care and reduce health disparities.[Adopted 2005, amended 2010]HX-4600.3.0WorkforceHX-4600.3.171

AAPA believes that health plans or provider networks should list physician assistants in their providerdirectories. Physician assistants should be included on the list of providers to allow patients the option ofseeking care from a physician-PA team.[Adopted 1999, amended 2000, reaffirmed 2005, 2010]HX-4600.3.2If Congress acts to require medical personnel to register with the selective service, prior to implementation, theCongress shall encourage all branches of the uniformed services to have in place their individual emergencywartime mission requirements which will allow physician assistants to provide health care services based ontheir training and, as closely as possible, in accordance with the current accreditation standards for physicianassistant education.[Adopted 1986, amended 2001, reaffirmed 1991, 1996, 2006, 2011]HX-4600.3.3Government and private employers should be encouraged to assure continued equality of pay for retired andreserve component physician assistants who are called to active military duty.[Adopted 1986, amended 2001, reaffirmed 1991, 1996, 2006, 2011]HX-4600.3.4AAPA urges all federal, state, local and privately funded programs to include and recruit physician assistants inall healthcare scholarship and loan repayment programs.[Adopted 1978, reaffirmed 1990, 1995, 2005, amended 2000, 2012]HX-4600.3.5AAPA encourages leaders of the U.S. Public Health Service and the National Health Service Corps to develop aNational Medical Coverage Relief Unit that can provide underserved facilities across America with qualifiedhealth professionals, including physician assistants, to meet short-term professional coverage needs. AAPAbelieves that such a national relief unit would help address the need for locum tenens at sites that supportAmerica’s health care safety net for the underserved and uninsured and would also address the need for coverageduring national disasters and national emergencies.[Adopted 2003, reaffirmed 2008]HX-4600.3.6The AAPA recognizes the shortage of health care services in the United States and its expected impact on thequality, availability, and cost of health care in this country. The AAPA is committed to raising awareness of thisissue nationally and to increasing the importance of this issue on the policy agenda at all levels of governmentand in the private sector. The AAPA supports efforts that promote and foster creative solutions to health careshortages that include expansion and access to physician-PA teams to meet anticipated requirements for healthcare services.[Adopted 2006, reaffirmed 2011]HX-4600.4.0Public Health Crisis/Disaster ResponseHX-4600.4.1The American Academy of Physician Assistants supports the National Health Service Corps Ready ResponderUnit, which deploys as needed throughout America to provide “all hazards” disaster medical assistance, andencourages the corps to continue its support of the interdisciplinary team approach to medical care by includingphysician assistants in the Ready Responder Unit.[Adopted 2003, reaffirmed 2008]HX-4600.4.2AAPA supports inclusion of all underserved facilities in the National Health Service Corps Ready ResponderUnit.[Adopted 2003, reaffirmed 2008]HX-4600.4.3The Physician Assistant in Disaster Response: Core Guidelines (PP tab 14)72

[Adopted 2006, amended 2010]HX-4600.5.0Prescription MedicationHX-4600.5.1AAPA supports legislative efforts to block the diversion of prescription drugs to illicit channels and prevent thesale or trade of samples, while preserving appropriate access by physicians, physician assistants, and otherappropriate health care practitioners to samples of prescription drugs from pharmaceutical manufacturers.[Adopted 1987, reaffirmed 1992, 1997, 2002, 2007, 2012]HX-4600.5.2AAPA supports prescription drug benefit plans that are universal, mandatory for all beneficiaries, integrated intothe basic benefit package, are not a financial hardship to beneficiaries, include catastrophic coverage, have adefined, comprehensive benefit, and permit health care providers to select medications using appropriate medicaljudgment that includes consideration of cost effectiveness, safety, and efficacy.[Adopted 2001, reaffirmed 2006, amended 2011]HX-4600.5.3AAPA endorses the appropriate treatment of all types of pain. The treatment of pain should utilize a teamapproach that incorporates the following: appropriate medications, modalities, therapies and lifestyle changes,regular assessment and adjustments of treatment, and referral to pain management specialists when needed.[Adopted 2002, amended 2007, reaffirmed 2012]HX-4600.5.4AAPA believes that information technology software should enable Physician Assistants to write appropriate,legal electronic prescriptions that comply with all state and federal guidelines. Therefore, AAPA encourages allelectronic prescription software companies to incorporate the required parameters to facilitate efficient electronicprescribing by physician assistants and to ensure that physician assistants remain in compliance with both stateand federal laws and rules.[Adopted 2012]HX-4600.5.5AAPA endorses the prescribing and distribution of naloxone for secondary administration to opiate addictedpatients to prevent opiate overdose and supports the establishment of naloxone prescribing programs.[Adopted 2012]HX-4600.5.6AAPA advocates for legislative and regulatory changes as needed to remove legal and regulatory barriers toprescribing and dispending naloxone for secondary administration.[Adopted 2012]HX-4600.5.7State constituent chapters are encouraged to collaborate with public health agencies, addiction treatmentorganizations, local and state medical societies and other entities to seek legislative and/or regulatory changes forsecondary administration of naloxone.[Adopted 2012]HX-4600.5.8AAPA shall actively engage in efforts to educate health care advertisers about physician assistant prescribingauthority and practices. The AAPA shall encourage health care advertisers to avoid such language as "only yourdoctor can diagnose" or "only your doctor can prescribe."[Adopted 1994, reaffirmed 1999, 2004, 2006, 2011]HX-4600.5.9AAPA believes that safe and affordable prescription medications should be available for all patients.Reimportation of pharmaceuticals from countries such as Canada is not a long-term solution to the problem ofcostly medications in the United States. AAPA encourages pharmaceutical manufacturers to find ways to reduce73

the cost of their products and to expand their programs of assistance to those who cannot afford medication,particularly the uninsured. All health plans and government agencies should negotiate medication prices withsuppliers and manufacturers.[Adopted 2005, reaffirmed 2010]HX-4600.6.0ReproductiveHX-4600.6.1AAPA opposes attempts to restrict the availability of reproductive health care.[Adopted 1992, reaffirmed 1997, 2002, 2007, 2012]HX-4600.6.2AAPA supports over-the-counter non prescription status of emergency contraception pills.[Adopted 2004, reaffirmed 2009]HX-4600.6.3AAPA encourages its members to work with schools and parents within their communities to establish programsfor reproductive health education in schools.[Adopted 1987, amended 1997, reaffirmed 1992, 2005, 2010]HX-4600.6.4AAPA supports equitable and confidential access to sex education, family planning education, and birth controloptions.[Adopted 1983, reaffirmed 1990, 1995, 1999, 2005, 2010]HX-4600.6.5AAPA believes all physician assistants should advocate responsible sexual behavior including education onmethods to prevent unintended pregnancy and sexually transmitted diseases.[Adopted 2005, reaffirmed 2010]HX-4700.00QUALITY OF CAREHX-4700.1.1Quality Incentive Programs (PP tab 30)[Adopted 2005, reaffirmed 2010]HX-4700.2.0Care in Emergency DepartmentsHX-4700.2.1AAPA believes overcrowded emergency departments (ED) threaten access to emergency care for all patients.[Adopted 2007, reaffirmed 2012]HX-4700.2.2AAPA is opposed to the practice of boarding admitted patients in the ED as it threatens the safety and quality ofcare of all ED patients.[Adopted 2007, reaffirmed 2012]HX-4700.2.3AAPA recommends that hospital industry leaders develop boarding and diversion standards, as well asguidelines, measures, and incentives for implementation, monitoring and enforcement of these standards.[Adopted 2007, reaffirmed 2012]HX-4700.2.4AAPA supports regulatory oversight that requires reporting of boarding information to CMS, and that CMSmake the data publicly available, and that CMS ultimately develop a quality measure on boarding.[Adopted 2007, reaffirmed 2012]74

HX-4700.2.5AAPA recommends hospitals allocate staff so that the staffing ratios are balanced throughout the hospital toavoid overburdening the emergency department staff while maintaining patient safety.[Adopted 2007, reaffirmed 2012]HX-4700.3.0The Role of In-Store or Retail Health Clinics (PP tab 33)[Adopted 2007, reaffirmed 2012]HX-4700.4.0Medical HomeHX-4700.4.1AAPA actively supports and encourages inclusion of physician assistants without restriction in the AdvancedTrauma Life Support (ATLS) course provided by the American College of Surgeons and, upon successfulcompletion of course requirements, provision of documentation to physician assistants as ATLS providers.[Adopted 1983, reaffirmed 1990, 1995, 2000, 2005, 2010]HX-4700.4.2AAPA supports the medical home concept as a means to expand access and improve the quality of patient care.A medical home provides coordinated and integrated care that is patient- and family-centered, culturallyappropriate, committed to quality and safety, cost-effective, affordable, and provided by a health care team ledby a physician or physician assistant.The principles of the medical home can apply to any setting where continuing, longitudinal primary or specialtycare is provided. By virtue of their education, credentials, and fundamental support for team care, PAs arequalified to serve as patients’ personal providers in the patient-centered medical home. PAs are qualified to leadthe medical home and are committed to physician-PA team practice.AAPA believes that coordination of care has value that requires a reasonable level of payment.[Adopted 2008, amended 2010]75