Collaboration Relationship & Plan

12 AAC 40.410

• licensed PA may not practice without a least one collaborating relationship documented by a collaborative plan on form provided by the SMB.  Must include: 
• name, license number, specialty for primary supervising physician and at lease one alternate
• name, place of of employment, both residence and mailing addresses of PA
• beginning date of employment, and physical location of practice
• compliance if remote (see 12 ACC 40.415), and 
• prescriptive authority being granted by collaborating physician
• collaboration plan must be filed with division within 14 days of effective date or any changes
• receipt by SMB will be considered evidence of an established plan
• any PA subject to a board order must have collaborative plan approved by board in advance of effective date
• copy must also retained at place of employment specified in the plan and available for inspection by the public
• change in collaboration plan automatically suspends PAs authority to practice, unless change is only to replace primary collaborating physician with an existing alternate and at least one collaborating physician remains in place
• nothing in regulations prohibits periodic board review and assessment of the collaborating physician and plan
• collaborating physician must hold a current, active, and unrestricted license to practice in Alaska and be in active practice (at least 200 hrs each year with direct patient contact).
• primary collaborating physician must keep in their record a copy of each DEA form 222 official order form submitted by each PA they collaborate with.

Remote Practice

12 AAC 40.415

If PA has less than 2 years of full-time clinical experience:

• must work 160 hrs in direct care under direct & immediate supervision of collaborative physician or alternate.
• first 40 hrs must be completed before PA begins practice in remote location
• remaining 120 hrs must be completed within 90 days after date of starting in remote location
• *if change in collaborating physician: must work 40 hrs under direct & immediate supervision of new collaborating physician within 60 days after effective date of new collaboration plan, unless change is only to replace primary collaborating with existing alternate collaborating physician

If PA has more than 2 years full time clinical experience:

must submit (with collaboration plan):

• detailed CV documenting the PA's previous experience as a PA is sufficient to meet requirements of the location assignment, and
• a written letter of recommendation and approval from the collaborating physician

**Remote Practice Location means a location in which a PA practices that is 30 or more miles by road from the collaborating physician's primary office

Performance & Assessment of Practice 12 ACC 40.430

• PA may practice only if licensed by SMB and only within scope of practice of the collaborating physician
• periodic method of assessment of quality of practice must be established by collaborating physician
• assessment must include annual direct personal contact @ primary worksite of PA or collaborating physician
• collaborating physician documents evaluation on form from SMB  
• If collaboration plan has been in effect less than 2 years: must include at least one direct personal contact visit with primary or alternate per calendar quarter for at lest 4 hr duration
• if collaboration plan has been in effect for 2 years or longer: must include 2 direct personal contact visits with primary or alternative per year,  each visit at least 4 hr duration & 4 months apart
• PA practicing under collaborative plan for a continuous period of less than 3 months each year: must have at least one direct personal contact with primary or alternate annually
• collaboration plan (regardless of duration) must include:
• at least monthly telephone, radio, electronic, or direct personal contact, dates of active practice under collaborative plan and monthly contact must be documented
• contacts either direct personal or by telephone, radio, or other electronic means, must include:  
• review of patient care & review health care records,
• kept by primary collaboration physician for at least 7 years after date of evaluation (including those completed by alternate), and
• may be audited by the SMB
• *During urgent situations (determined by SMB) direct contact may be met by audio or video means

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