05/31/2024

Op-Ed: OAPA President Matthew Freado, MBA, PA-C, on the Realities of Legislative Progress, Why It Matters, and How You Can Help

Serving as OAPA President this past year has been a great honor. It has provided me with firsthand insight into the efforts required to advance our profession in Ohio. OAPA’s vision is for Ohio to be the premier state for PAs. However, the past year has underscored the numerous legislative barriers that must be overcome to achieve this goal.

The Realities of Legislative Progress 

Five years ago, we celebrated a significant milestone with the passage of SB259, which eliminated the PA Formulary. This regulatory list limited the medications and treatments physician assistants in Ohio could prescribe. Eliminating this practice barrier was a significant achievement that enabled us to offer more comprehensive care. Over the past five years, many Ohio PAs, myself included, have been curious about our progress and why we haven't accomplished more. I can assure you it’s not for lack of trying.

Between the challenges posed by COVID-19, the ramifications of the Householder scandal, leadership changes within the Ohio State Medical Association, and a noticeable shift in the political climate, our ability to pass meaningful legislation has been severely compromised. However, the current environment within the Ohio General Assembly has reached a point where partisan gridlock and internal conflicts within the chambers have become significant obstacles to progress. The inability to find common ground on pressing issues means that many important bills, including those related to healthcare, remain stalled. This reality not only impedes OAPA’s legislative efforts but also undermines the state's ability to address its citizens’ needs effectively.

Over the past year, navigating the legislative process has revealed its complexity. We've encountered variability in the number of hearings for bills we've supported or provided testimony for, with some having as many as six hearings and others as few as three. Additionally, the scheduling of hearings, sometimes closely spaced, leaves our small volunteer team at the OAPA challenged to meet the demands of the subsequent hearings. Likewise, we've experienced the unpredictability of legislative support, where legislators who initially seemed aligned with our goals suddenly change their stance without apparent justification, as seen with our Title Change bill or an amendment concerning the PA’s authority to enact an Application for Emergency Admission, or pink slip, for patients. Even seemingly simple bills, like SB28, the PA Licensure Compact Bill, introduced early in the session, have been inexplicably delayed, hampering their progress to the governor's desk.

Lastly, in modern-day politics, the landscape is undoubtedly shaped by robust financial backing and substantial membership numbers, which often determine the success and influence of advocacy efforts. Regrettably, the OAPA is an underdog in this dynamic environment compared to similar associations. This puts us at a disadvantage for attention and support amidst the clamor of competing interests. Despite these challenges, we remain steadfast in our commitment to advancing the interests of Ohio PAs and will continue to persevere in our advocacy efforts.

Why This Matters

It's crucial for every Ohio PA to understand that legislative issues, even if they don't directly apply to their specialty, still hold significant importance. Legislative decisions affect not just individual specialties but the profession as a whole. The impact of legislation on the day-to-day responsibilities of Ohio PAs is substantial. Current barriers, such as restrictions on dermatology PAs to use specific lasers, the inability of psychiatric PAs to pink slip patients, and limitations on emergency medicine and critical care PAs performing rapid sequence intubation (RSI), not only hinder our employment and professional growth but also impede our ability to provide optimal patient care. These restrictions affect our professional autonomy and create unnecessary burdens for both PAs and their supervising physicians, often without clear rationale.

While past advancements have been celebrated, there is still progress toward achieving Optimal Team Practice (OTP) and beyond, and there's no assurance that legislation favorable to us today will remain unchanged indefinitely. With 17 PA schools in Ohio and a rising number of PAs, coupled with healthcare professional shortages, PAS must be empowered with the authority they deserve to provide high-quality, cost-effective, and accessible healthcare throughout Ohio. It is essential for every PA to actively engage in advocacy efforts, ensuring that their voices are heard and their interests are represented in legislative discussions.

How You Can Help

Although understanding the basics of state government operations is helpful, you don’t have to be a policy expert to engage with or show your support for OAPA’s legislative efforts. Here are five ideas to get you started:

1. JOIN IN: We are forming an ad hoc committee to plan a PA Advocacy Day at the Ohio Statehouse. Indicate your interest to help organize it.
2. SUPPORT MEMBERSHIP: Become an OAPA member, maintain your membership through dues renewal, and encourage others to join. Strength in numbers is critical when it comes to government advocacy.
3. SHARE EXPERTISE: Show what you know as one of OAPA's specialty experts. If you have strong expertise in one or more specialty areas of PA practice, fill out this form so we can turn to you when pertinent legislation comes along.
4. STAY INFORMED: Stay current on PA practice issues in Ohio, share legislative news with your colleagues or employer committees, and make your voice heard when OAPA alerts our membership community to take action on impending legislation. Please take a look at our advocacy talking points.
5. GIVE GENEROUSLY: Provide additional financial support through OAPA Legislative Fund and OAPA PAC contributions.

As I said in my last Op-Ed, your membership matters, and it is your vote for advancing the PA profession in Ohio. It signals to policymakers, healthcare institutions, and the public that PAs are not just healthcare providers but advocates for optimal patient care. It is an investment, a vote for, and a symbol of your dedication to elevating the standards of PA practice in Ohio.

As I transition from the role of President, I am confident in the leadership of President-Elect Nathan Hart and our Board of Directors, who will continue OAPA's mission to advance our profession and hold the line on our priorities in the Statehouse. 

It's essential to recognize that OAPA is the sole association dedicated to advocating and defending the PA profession in Ohio. If we don't champion our cause, who will? 

Your membership, engagement, and support are crucial in shaping the future of PA practice in Ohio. I urge every Ohio PA to get involved, stay informed, and contribute to our advocacy efforts. With our collective engagement, we have the power to advance PA practice in Ohio and provide high-quality, cost-effective, and accessible healthcare for all Ohioans. Thank you all for trusting me to lead our association over the last year and for your dedication and commitment to advancing our profession.

Matthew P. Freado, MBA, PA-C
OAPA President