Timeline: VAPAA's History and Accomplishments
1965: The PA Profession is born
1967- First PAs Graduate - Duke University
- VA hired first PA in Durham, NC
1971:
- The PA Certificate Program is developed, a collaborative effort by Michael E. DeBakey VAMC & Baylor University
- First PA Qualifications are established for positions GS-7 through GS -11
- Comprehensive Health Manpower Act of 1971: Congress includes $4 million for establishment of new PA educational programs
- First “PA Utilization Guidelines” are established - VA standardizes the role of PAs by defining specific hospital departments and the functions in which PAs can be utilized
- First Bachelor’s Degree program for PAs is established at Alderson-Broaddus College (West Virginia)
1975:
- NCCPA is established, the national PA certifying exam is created, PA-C becomes the new credentials
1980:
- PAs are granted prescriptive authority in 10 states
1984: VAPAA is founded 
1986: 717 PAs employed by the VA
1988:
- 869 PAs employed by the VA
- Master’s Degree in PA Studies is first awarded, Duke University
1989: VAPAA is chartered as a constituent chapter of the AAPA
1991:
“General Guidelines for Physician Assistants” (VA circular 10-91-117) is published:
- PAs have “managing” physicians required to be available for immediate consultation via telephone
- All PA orders require physician co-signature
1993:
- First Chairperson of the VA’s PA Field Advisory Committee is appointed and involved in writing the
- PA Qualification Standards, including the ability for PAs to advance to Grade 13
1994: VAPAA holds its first independent CME conference in Minneapolis, MN
1995:
- VAPAA meets with Under Secretary for Health (USH) to advocate signing of a revised utilization policy
which restructures VA PA practice
- “PA Guidelines for Utilization” (VA Directive 10-95-020) is signed and published
-PAs have a SOP and “supervising” physicians that require daily contact by phone or in person
-All initial inpatient/outpatient H&Ps and discharge summaries require co-signature
-PAs have Rx authority and orders written by PAs no longer require co-signature
1997:
- VAPAA works with DEA to allow controlled substance prescriptive authority
- VHA utilizes a national “Lead PA,” an informal position that advises on policy and gives guidance on PA practice 2000:
- National PA Advisor role is established, reports to the USH within VHA, advises on PA employment and utilization (Public Law 106-419
- 1,100 PAs employed by the VA
- National PA Advisor role is established, reports to the USH within VHA, advises on PA employment and utilization
2002
- Educational Debt Reduction Plan (EDRP) is established which includes PA
- First PA Doctoral Program is established at Nova Southeastern University (Florida)
2004:
- A Field Advisory Committee (PA-FAC) is established
- PA Advisor and PA-FAC makes comprehensive revisions to Directive 2004-029: “Utilization of PAs:”
-Lists specific duties PAs can perform
-Provides requirements for PAs to prescribe controlled and non-controlled medication
-PAs are considered to be “supervised” by physicians
2007: PAs have prescriptive authority in all 50 states, DC and Guam
2008: Over 1,600 PAs employed by the VA
2010: 1,878 PAs employed by the VA
2011:
- First PA residency program established
- Congress promotes the VHA PA Advisor to Director of PA Services, a full-time position reporting on PA education, training, employment, utilization, and optimal participation of PAs in the VA (H.R. 1302)
- NCCPA administers first “Certificate of Added Qualifications” (CAQ), developed to credential PAs in specialty fields
2013:
- “Utilization of Physician Assistants” (Directive 1063) is revised and published:
-the term "collaborate" is used to describe the relationship between PAs and Physicians instead of the term “supervise”
-Physician co-signature is not required on PA notes or orders-PA autonomy levels established
-Facility Lead PA positions are established
2015:
- 2,020 PAs employed in the VA
- VAPAA Conference held in Houston, TX (October)
- VAPAA Legislative Committee Member provides testimony to Congress; recommendation highlights:
-Convert PAs to LPS to remain competitive with the private sector
-Include education debt reduction incentive (EDRP) in all PA job postings
-Include PAs in the hierarchy for funding allocation for scholarship program (EISP)
-Streamline PA hiring process at VA
2017:
- VAPAA Conference held in Houston (February)
- The Choice and Quality Employment Act of 2017 is approved and allows for competitive pay for VA PAs by adding
- VA’s Health Professional Scholarship Program (HPSP) awards scholarships to PAs
2018:
- 2,400+ PAs employed by VA
- Federal Rule: “Anywhere to Anywhere Care” is established and allows VA providers (including PAs) ability to provide care to Veterans across state lines when using telehealth technology
2019:
- VAPAA Conference held in San Antonio (November)
2020:
- 2,600+ PAs employed by VA
- Implementation of “The Choice and Quality Employment Act of 2017”: PAs in the VA are converted from GS scale
2021:
- PA profession is named best overall job in US News & and World Report
- PA title is changed to “Physician Associate” by AAPA
2022:
- 2,700 PAs employed by VA
- R.A.I.S.E (Retention and Income Security Enhancement) Act signed into LAW and increases PA and nurse pay caps
2023
- 2,850 PAs employed by VA
- VAPAA CME Conference & Annual Meeting in Orlando, FL (November)
2024:
- 3,097 PAs employed by VA
2025:
- VAPAA CME Conference & Annual Meeting in Sant Fe, NM (November)
The stars above signify the tremendous dedication and effort made by VAPAA which has successfully advanced the PA profession in the VA system