ADVANCED PRACTICE NEWSLETTER
December 2019
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CELEBRATING
NURSE PRACTITIONERS
NURSE ANESTHETISTS
PHYSICIAN ASSISTANTS
NURSE MIDWIVES
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AHP = APP ADVANCED PRACTICE PROVIDERS
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HAPPY HOLIDAYS EVERYONE AND BEST WISHES IN THE NEW YEAR TO YOU AND YOUR FAMILIES
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IN THIS ISSUE
Highlighting APP Practice at UCSF Health
Advanced Practice in the United Kingdom
APP UPDATES
Recording of APP Grand Rounds
Migrant Health
SB697 - Update for PAs
Inbox Management Plans
Urgent Need for SON Preceptors
The New UCSF Health APP Website
The Women of UCSF
The Recognize Application
RECOGNITION, PUBLICATIONS, AND PRESENTATIONS
Courtney Gordon, DNP, GNP and Tom Baker, RN
Jay Beebe, PhD, CRNA and Kathleen Beebe, PhD, RN
Carlos Mendoza, Sr. Compensation Analyst, UCSF Health HR
TOOLS AND NEWS
Links to other UCMC's APP Practice
BCH/BCHO Monthly Noon Conference at MB
Reminder for Providers regarding Diabetes Supplies Ordering
APP Academic Stipend
ONE GOOD THING
Schwartz Rounds
GME Grand Rounds
Medi-Cal SPA Time Study for Ambulatory Providers
New APPs to UCSF Health for the 10th Cohort in 2019
Advisory Board Minutes - October 2019
California Healthcare News
UCSF Health Events Calendar
Center for the Enhancement of Communication in Healthcare
New APP AHA Re-Certification Workflow
True North Metrics
APP Students at UCSF Health
Sharing your Expertise across the State and Nation
Caring for the Caregiver
RESOURCES
Fun Discounts for UCSF Employees
Pager Box Update
2019/2020 APP Advisory Board
Required Training in LMS
Face Card Process
How To Correct The Staff Directory
APP Resource Manual Link
Adding New Privileges
Scope Of Practice Details
Licensing and Certification Responsibilities
CURES Sign Up for Scheduled Medication Prescribing
BRN Link
DEA
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HIGHLIGHTING THE ADVANCED PRACTICE PROVIDERS
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ADVANCED PRACTICE IN THE UNITED KINGDOM by Mitchel Erickson
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Collaboration between UCSF HEALTH and NOTTINGHAM UNIVERSITY HOSPITAL
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I wanted to share my extraordinary experience in England at the Nottingham University Hospital called "The Queen" for short. This collaboration began when I was introduced to Kate Knowles who is an ACP (=NP) from the inpatient services at NUH when she was touring a select group of health systems in United States. The purpose was to better understand APP practice in the United States. UCSF Health was one of the health systems she hoped to learn from during her US tour.
Following her time at UCSF Health I had wanted to experience the same investigation in the UK. Professionals can only benefit from learning about each other's scope of practice, APP education, health system integration of APPs, and any national conversation regarding health access and how APPs can be part of the solution. Retirement offered me the chance to embark on this fact finding mission through the generosity of coordination and time of Kate Knowles, James Pratt, Frank Coffey, Clare Sutherland, Sue Haines, and Sophie Jefferies.
I was able to engage in the national conversation around advanced practice over a beer, participate in APP education, review strategies around hiring a new APP to a clinical service, spend clinical time in the ED, meet with a university faculty leader to learn about academic/health system partnerships, and discuss challenges in the UK for PAs. It is clear the UK has challenges with a paucity of health care providers, no national standard for ACP (APP) educational requirements or certification or licensing standard. PAs have no recognized license which creates challenges for prescribing in outpatient and inpatient settings.
The result of these challenges and lack of national continuity has created a potential patchwork of educational standards and competency assessment based on those established by any Shire in the country. England is divided into 83 official metropolitan and non-metropolitan counties. This creates the potential for a similar situation in the United States with states having the rights over state licensees requirements. The US has 50 states with 50 different laws guiding APP practice, all with some similarities. England's counties are working together in some regions to create common ground within their health county system around ACP educational and competency evaluation standards. Sharing each other's work will become the national standard optimally. The future is bright if national licensing agencies embrace a common language and standard to meet the health care needs of the UK population through well trained ACPs.
I was was very impressed with the collaboration and passion between Kate Knowles, Frank Coffey, and James Pratt. Notably, the commitment of Frank Coffey, MD to all of the efforts around standardizing ACP education and competency assessment. He is an Emergency Medicine physician that personally is involved in student clinical education with ACPs. His partnership, through a School of Nursing faculty position and acting as a voice at the table where health system leaders converse about maximizing the value of APPs in Nottingham University Hospital is invaluable. Kate and James' dedication to standards is remarkable and how they have teamed together to ensure ACP practice attains the highest quality. All those I was able to meet demonstrated an invaluable commitment to success.
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Inaugural APP Grand Rounds recording if you missed the event.
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MIGRANT HEALTH
Op-Ed
| November 10, 2019
Medical Professionals Must Be Advocates for Migrant Patients
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There is currently an effort underway to recruit health care providers, APPs, to volunteer and evaluate migrants in the Bay Area via an H&P but provide no medical care. Acting only to document any evidence of torture or abuse and potentially act as expert witness. There is an 8 hour training session required. More details to follow.
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PASSAGE OF SB 697
Effective January 1, 2020
to be implemented in the month of January 2020 at UCSF Health.
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UCSF Health Inbox Management
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Thank you for your commitment and tirelessness in providing outstanding care for our patients. We know that “In Basket” work brings a unique, and sometimes daunting, set of challenges. We are writing today to share with you a multi-pronged approach to improving the In Basket experience for FY2020, and to ask for your partnership.
Why focus on In Basket?
· Quality: We want to be responsive to the needs of our patients.
· People: In Basket should be a team sport, shared between clinic management, staff and providers.
· Safety: We need to assure ourselves that all results have been reviewed and acted on.
What will we work on together?
1.
Beginning on December 11, 2019, we will address the backlog of results by clearing old messages from our In Baskets.
There are currently almost 300,000 old
r
esults in our collective In Baskets that may not have been reviewed. In addition, there are a large number of old refills, phone messages, etc. UCSF will employ a phased approach to reduce this volume and enable physicians and staff to better manage In Baskets going forward.
On December 11, 2019, most In Basket messages (excluding results) older than 6 months will be automatically completed and removed from our In Basket (includes refill requests, telephone messages, MyChart messages, staff messages and Cc’d charts). Results older than 6 months will be auto-completed only if they have an associated result note, telephone encounter, MyChart message or letter.
2.
Between December 11, 2019 and February 5, 2020, we hope all remaining results can be cleared from our In Baskets.
In order to assure that no critical result, such as a new cancer diagnosis, has been missed, please work together with your Practice Manager, staff, and Medical Director to review and complete the backlog of results by February 5, 2020. Managers and Directors can request additional resources as needed. We also urge you to identify an ongoing process to ensure timely results review.
3.
Ongoing management of In Basket.
On February 5, 2020, most In Basket messages (excluding results) will start auto-completing at 60 days (includes refill requests, telephone messages, MyChart messages, staff messages and Cc’d charts).
Click here
for full list of affected messages. Please work with your administrative staff to efficiently route In Basket items.
4.
All our True North Boards will reflect our collective In Basket quality goals.
Reach out to Mitchel Erickson, Associate Chief of Advanced Practice if you are a per diem APP for possible extra hours of review work opportunity to resolve the backlog.
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Are you a Clinical Preceptor?
Are you interested in precepting or becoming volunteer clinical faculty?
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URGENT NEED FOR UCSF School of Nursing FNP PRECEPTORS
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Becca Neuwirth, FNP program clinical co-coordinator, is still in need of preceptors for the quickly approaching Winter quarter (early January to late March). Please contact her if you can help. She welcomes any outpatient NP practice. If you want to precept, but prefer a different program, feel free to reach out as well and she’ll put you in touch with the relevant faculty. She is of course happy for volunteers for other quarters, but is in particular need of more preceptors for Winter 2020.
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LAUNCH OF NEW UCSF HEALTH ADVANCED PRACTICE WEBSITE
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The APP Advisory Board and the Office of Advanced Practice would like you to explore the new Advanced Practice Website. This site continues to be configured for Advanced Practice and the health system. Please be patient.
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WOMEN OF UCSF
Explore the stories, resources, and events supporting and highlighting the Women of UCSF.
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Please use the UCSF Health Recognize application to tell any staff member or provider how much your appreciate their expertise or support or guidance. It is free and easy and meaningful to the recipient. It functions through MyAccess.
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Presentations, Publications, and Recognition
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COURTNEY GORDON, NP and TOM BAKER, RN presenting at the AAHCM
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Courtney Gordon DNP, GNP-BC presented at the American Academy of Home Care Medicine (AAHCM) October 18, 2019 in Chicago along with Tom Baker, RN. The title of their talk was “Leveraging Skills of RNs, NPs, and CNAs to Support Triage and Facilitate Patient Consults via Telehealth”. The talk addressed the need for home care medicine and innovation. Home care medicine has proven to be an effective mechanism for managing high risk patient populations. As demand for home-based services continues to scale, technology like TeleHealth visits will become increasingly important. This session addressed innovations in utilizing non-providers and providers in the provision of TeleHealth services in a busy Housecalls Practice. It looked at an innovative RN- driven process that works collaboratively with a multidisciplinary team and maximizes new communication technologies in the delivery of home based primary care.
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October 5
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, 2019 Drs. Jay J. Beebe and Kathleen R. Beebe presented at the Association for Vascular Access Annual Scientific Meeting in Las Vegas, Nevada. Their presentation was titled: Vascular Access in Obstetrics: Is it Enough or Too Much?
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Drs. Jay and Kathleen Beebe highlighted the intrapartum period, when vascular access device insertion is common, whether or not it is indicated. Their session addressed the unique considerations of using vascular access devices in the obstetric patient including: physiologic changes affecting the vasculature of pregnant and birthing women, processes and effects of anesthetic administration on the maternal-fetal unit related to PIVC necessity, and the impact of selected pregnancy complications on clinical decision-making regarding vascular access requirements. Controversies, challenges, and gaps in knowledge about PIVC use in obstetrics were also introduced.
Jay J. Beebe, PHD, APRN, PHN, CCRN, CRNA, VA-BC, CRNI, CPAN, CAPA is a senior nurse anesthetist employed at UCSF for over 34 years.
Kathleen R. Beebe, PHD, RNC-OB is an alumna of UCSF and currently Professor of Nursing at Dominican University of California.
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Carlos Mendoza
Sr. Compensation Manager at UCSF Human Resources
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Carlos Mendoza receives his delayed recognition award following the November 2019 Open Forum which he was unfortunately unable to attend following the date change. Carlos was being recognized for his efforts in supporting and aligning APP compensation both as new providers enter our workforce and for recognizing regional challenges. He has been a great partner with these challenges and has worked closely with the Associate Chief of Advanced Practice to improve APP HR issues. Our thanks is extended to Carlos on behalf of all UCSF Health APPs.
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ADVANCED PRACTICE AT UC Medical Centers in California
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A UC wide Advanced Practice Leadership Strategy Committee was formed a couple years ago to create a dialogue and share common processes that were more mature at some health systems than others and support each other in our collective efforts. The Committee includes members from all professions as well as senior leadership and advanced practice faculty and administrators. The following logos are links to activities at each campus that may relate to advanced practice. These may include conferences and grand rounds. You will note that some are more mature in their online presence.
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BCH/BCHO Noon Conference
Monthly Education Meeting with light refreshments at Mission Bay
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Reminder Regarding Education and Diabetes Discharge Supplies
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Provider education about how to order correct discharge supplies for patients with diabetes.
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The UCSF Health Office of Advanced Practice Academic Stipend
15 Academic stipends are offered each fiscal year to offset the cost of APPs presenting at a conference in their specialty. Podium/poster/panel presentations will be eligible. Other requirements listed in link below.
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Compliments of Diane Sliwka, MD
One Good Thing
Improving the Work Experience at UCSF
Issue 87
To make our True North "Our People" efforts more visible at UCSF, this communication provides a highlight of one enhancement, story or tip intended to improve the work experience for clinicians and faculty at UCSF Health.
Getting Started with Telehealth
Getting into San Francisco for a patient visit (or work) is not always easy. For patient visits that don't need a hands-on physical exam, video visits can now help patients access our care more efficiently and easily. In the five years since video visits first became available at UCSF, they’ve saved patients almost 9 million miles of commuting. As a physician, in addition to performing video visits from your clinical office, you can use telehealth to save on your own commute by offering telehealth visits from home. Learning video below.
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Schwartz Rounds offer healthcare providers a regularly scheduled time during their fast-paced work lives to openly and honestly discuss the social and emotional issues they face in caring for patients and families. The focus is on the human dimension of patient care. Clinicians and staff have an opportunity to share their experiences, thoughts and feelings on thought-provoking topics drawn from actual patient cases. The premise is that health care providers are better able to make personal connections with patients and colleagues when they have greater insight into their own responses and feelings
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GME Grand Rounds - inter-professional opportunity to share experiences.
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AMBULATORY APP Providers ONLY
Please complete the LMS module AT THE LINK BELOW
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The dates are randomly selected and to gain this valuable source of revenue, the time sheets must be completed and returned after signature in blue ink in a timely manner. We must have an 85% participation rate.
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Timestudies can be scanned or a picture of the timesheet can be emailed to Andrina Ong. They can be processed immediately where inter-campus mail can take a week.
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The following training link provides information that ALL ambulatory APPs must review to be included. ONLY APP providers that completed the LMS module will receive a link to the TIME SHEET when the next date is announced.
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APP NEW HIRES COHORT 10 2019
Please welcome these new APP professionals
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STARTING APP Cohort 10 for ONBOARDING October 2019
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THEY ARE A GROUP OF NP AND PA PROVIDERS COMING INTO MANY DIFFERENT CLINICAL SPECIALTIES ACROSS THE UCSF HEALTH ENTERPRISE.
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APP ADVISORY BOARD MINUTES
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CALIFORNIA HEALTHCARE NEWS
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A COUPLE ARTICLES RELEVANT TO ADVANCED PRACTICE. YOU CAN SUBSCRIBE IF YOU WISH.
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Enhancing Relationship Centered Communication Skills Professional Development for Clinicians
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AMERICAN HEART ASSOCIATION CERTIFICATION WORKFLOW FOR APP PROVIDERS RENEWING THEIR BLS, ACLS PALS THROUGH SAFETY TRAINING SEMINARS
They have a list of authorized APP providers. All others will be denied.
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UCSF HEALTH UPDATES REGARDING TRUE NORTH METRICS
Includes an article on price transparency.
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For more information, contact Mitchel Erickson, NP
Associate Chief of Advanced Practice
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ALL APP STUDENTS AT UCSF HEALTH FACILITIES
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All preceptors are required to ensure all students from ALL educational institutions have been vetted by UCSF prior to any educational activities, including employees. UCSF has many parts of the organization involved in this process. Their school needs an affiliation agreement with UCSF, they need health screening to be completed, they require online training for Health and Safety and APEX, and sign a HIPPA form.
Laura Frahm, RN in INEX is leading the effort to improve the on-boarding of all students and is building a portal that all schools and students must work through.
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WANT TO SHARE YOUR EXPERTISE WITH APP COLLEAGUES ACROSS THE STATE, THE NATION, OR THE WORLD?
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MORE INFORMATION AND TO BE A PEER SUPPORTER, EMAIL THE FOLLOWING LINK.
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RESOURSE INFORMATION AND LINKS
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UCSF HEALTH EMPLOYEE DISCOUNTS AND BENEFITS FOR WORK, LIFE, AND FAMILY
IMPORTANT LINKS:
Six Flags
- when buying tickets enter promo code UCSF
Tickets
California Academy of Sciences
- when buying tickets for 20% off use promo code UCSF
Tickets
SF Zoo
- use discount code 75001 for $3 off adults, $2 off children with one free train or carousel ride for each ticket
Tickets
Monterey Bay Aquarium
- discount using Store Name UCSF1002
Tickets
Travel discounts
- hotels, packages, cruises. Register for UCSF Passport Discounts, search UCSF Get Away Today
Site for information
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UPDATING YOUR PAGERBOX CONTACT INFORMATION IS IMPORTANT
I
n order for other providers to reach you or contact you outside the messaging feature in apex, pagerbox is another mechanism to utilize. This is an internal system and not available to patients. If you do not have a pager, please consider adding your contact information to the pagerbox system. You are only required to respond to pagerbox messages during your normal working hours. All Pagerbox services are now managed by UCSF IT Services. Feel free to let me know of any problems.
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2018/2019 APP ADVISORY BOARD
Feel free to reach out to them through global Outlook
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Alisa Yee, NP
Mercy Vigil, CRNA
Shelley Gierat, CRNA
Jennifer Kerney, NP
Laura Kirk, PA
Maura O’Day, NP
Brandon Sessler, PA
Stacy Wong, NP
Eliana Agudelo, PA
Dana Morgan, PA
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Laura Weil, CNM
Annette Carley, NP
Gerri Collins Bride, NP
Lissa Gray, NP - Chair
Danielle Krieger, NP
Tara Valcarcel, NP - Co-Chair
Stacie Rohovit, NP
Michelle Klosterman, NP
Ryan Wilson, PA
Samantha Shenoy, NP
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Check for any Required Training
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THE APEX SMART PHRASE FOR AMBULATORY AND EMERGENCY DEPARTMENT ENCOUNTERS
This phrase MUST be present in ALL encounter notes. ONLY this phrase will work to capture your wRVU attribution. The billing logic was designed for ONLY THIS DOT PHRASE (.ahpvisittype)
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FACE CARDS FOR APP PROVIDERS
Use the following web-link to complete the ordering process. The instructions are self explanatory. You do not pay but do need to create an account. You may upload a professional photo of your choice or use departmental professional photos for this purpose.
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Making yourself more visible at UCSF Health
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In an attempt to ensure all Advanced Health Providers are visible to the public, your patients, and your colleagues at UCSF, please check and to ensure your working title and contact information are correct. Click the link below and complete the log in process and correct what you can. If your title is incorrect then an additional step will be required as this function is controlled by HR. If you find your title needs to be corrected, email me at
mitchel.erickson@ucsf.edu
with your hire title and I will collect information in batches and forward to the correct person. The "Find a Doctor or staff member" portal update is delayed. UCSF Health is building a new web portal and is challenged with migrating data from the old platform to the new platform. Once ready, we will have capacity to add all the AHPs with photos and CV related data. We have been authorized to develop a dedicated AHP Web portal at UCSF Health. More to come.
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This link will bring you to the UC ME login page. Use the button on the far left at the bottom to access the APP Resource Manual.
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This can be completed at the UC Me page by clicking on REQUEST NEW PRIVILEGE.
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Look up your credentialed standardized procedures: Must be through VPN or UCSF computer.
Look up all the standardized procedures:
OMAG POLICIES
CIDP
FPPE/OPPE
This link will work from a any computer with/without VPN enabled using IE or Chrome.
Click on Professional Organization Links:
All prescribers of Scheduled Medications will need to register and review upon writing Scheduled Prescriptions
IMPORTANT - RELATED TO YOUR DEA LICENSE
If your DEA license was issued in another state, you need to go online to the DOJ website and change the location to California. Your DEA needs to be in the state where you practice as all state laws are different. YOU
DO NOT
HAVE TO PAY FOR DEA LICENSE OR RENEWAL AS YOU WORK FOR A PUBLIC INSTITUTION.
Very IMPORTANT message from BRN: They will no longer alert you via mail regarding license expiration. They will only contact you via email. It is your regulatory responsibility to ensure your contact information is accurate and up to date and you can be fined. As of Jan 1st, 2016 if you were licensed in California
prior
to March 1st, 2009 you are required to resubmit fingerprints via the new Live Scan Service. If your renewal seems to be in limbo for unclear reasons, this may be why. After Jan 2018, you will no longer receive a card license. Verification if online only.
This information was extracted directly from State organizations and agencies but does not infer any authority as to its content and you are reminded to check with your state authorities regarding statutes of practice in California.
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Renewal Applications Online to the DEA
REVISED ANNOUNCEMENT REGARDING RENEWAL APPLICATIONS
Starting January 2017, DEA will no longer send its second renewal notification by mail. Instead, an electronic reminder to renew will be sent to the email address associated with the DEA registration. At this time, DEA will otherwise retain its current policy and procedures with respect to renewal and reinstatement of registration. This policy is as follows: If a renewal application is submitted in a timely manner prior to expiration, the registrant may continue operations, authorized by the registration, beyond the expiration date until final action is taken on the application.
DEA allows the reinstatement of an expired registration for one calendar month after the expiration date. If the registration is not renewed within that calendar month, an application for a new DEA registration will be required. Regardless of whether a registration is reinstated within the calendar month after expiration, federal law prohibits the handling of controlled substances or List 1 chemicals for any period of time under an expired registration.
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