AAPA House of Delegates
A New Perspective
by Ron Pace, PA-C

The last time I was involved with the AAPA House of Delegates (HOD) was in 1981 as President of the Naval Association of PA's. The Conference that year was held in San Diego. Of course being that long ago my memory is somewhat vague of the happenings then, but I do recall that things got somewhat chaotic at times on the floor and of course the HOD was much smaller in size as well. I am writing of this more recent experience to give the rest of you an idea of what the HOD does for the AAPA. Most PAs have no idea what the HOD does nor do they recognize its' importance to our profession. The HOD is the policy making body of the AAPA. The AAPA Board of Directors (BOD) is responsible to the House of Delegates. As our representatives, the Board of Directors needs policy statements on the multiple various issues facing our profession and health care in this country. They cannot really put forth a position or make statements on an issue unless we have a policy statement that has been adopted by the House to give them guidance on the issue. The standing committees, constituent organizations, Board of Directors, and House officers can submit resolutions to the House for consideration. The House of Delegates is vital to our profession in this manner. These committees, Board members, constituent organizations, and you and I as Academy members, all play a major and equal role in identifying concerns and issues. These are then addressed through the House of Delegates in deciding policy and the direction we want the Academy through our Board of Directors to proceed in throughout the year.

This year as President Elect, as per our by-laws, I was a delegate along with Jayne Mittan, our President. We had three elected delegates as well. All of whom had previous experience with the HOD. Next year due to the reapportionment policy adopted this year, Florida will have seven delegates to the HOD. Every constituent organization has at least two delegates and the rest is based on membership numbers in the Academy. When you join the AAPA, or renew your AAPA membership one of the questions asked is which constituent organization do you want to represent you in the AAPA. This is why it is important that you indicate your choice of FAPA as your representative organization. It gives us a greater voice in the HOD. There are only five or six other constituent organizations that have as many or more delegates than Florida. Not only are state constituent chapters represented in the HOD, but also other constituent organizations recognized by the Academy such as PAs in Addictive Medicine, and other specialty areas. Some PAs feel that a state chapter might not be the best organization to represent their views so we have a number of other "constituent organizations" that have been recognized and have representation in the HOD. Through this method each AAPA members has a choice of who represents them in the Academy.

I have to admit that I was somewhat intimidated when I received the HOD Handbook in the mail as it was a two-inch three ring binder and fully packed with all these various tabs and sections. And of course one is expected to devour the whole thing prior to the conference. And this year they also included a CD-ROM with all the HOD Handbook material on it so you could load it into your laptop computer (doesn't everyone have one of those now?). The HOD has moved into the electronic age now and in a few short years will be completely electronic I am told. We send a letter to the AAPA telling them who our delegates are for the sessions and when you arrive there you have to be credentialed and given a pass to allow you to enter the floor of the House. The delegates are seated classroom style and each year the organization's position is rotated so that everyone gets a chance to be up front. House business is conducted in a very formal manner according to strict parliamentarian procedure and House rules. Over the year the various committees of the Academy do their research on various issues and then present reports to one of three Reference Committees. The Reference Committees are composed of six to nine members and they review all the data, pro and con, then make a recommendation to the full House in a report.

The Reference Committee Reports are presented in a formal fashion and the issue is debated on the House floor. But the Committee Chairs are very good and allow only new testimony on the issue and do not do committee work at the session. After the resolutions are debated and reviewed in the Committee Report session, the Reference Committee then submits a final report to the House of Delegates. They recommend either adoption or rejection of the resolution. If a resolution is recommended for adoption and there were no objections to it, then it is placed on what is called the "Consent Agenda". No further discussion is made on these issues if there is no objection from the House, and these issues are voted on in a block vote. If there is an objection to the Committees recommendation on an issue, then it comes back before the full House for discussion and review.

In a final session of the HOD, the Reference Committees present their final report and recommendations. The House then votes on each issue. At this time there can be further discussion and debate. But once again, the Speaker of the House is strict in allowing only new information to be presented and limits debate so as not to do committee work on the floor of the house. The last thing considered is the Consent Agenda, all those resolutions to which there was no further debate. The House members get one last chance to discuss them and then vote.

Of course there are award ceremonies and speeches during the House session. At this year's session, the President of the American Academy of Family Practice gave a short address to the HOD. He was most gracious and very pro PA. And he was complimentary of our Hose procedures and made note that he wished the AAFP House functioned as well as we have done. We were also honored to have the President of the AMA there to make a short address. And the U. S. Surgeon General was there and made a few remarks also. Having these three gentlemen there is indicative of the growing esteem and respect that our profession is getting in mainstream medicine. We are every day being viewed as one of the major players. AAPA representatives are now included in most major discussion groups and task forces on health care issues in Washington and around the nation. Our opinions do matter where it counts.

Participation in the House of Delegates made me very proud to be a PA and part of the American Academy and the Florida Academy. It was impressive to see this body in action and the highly professional manner in which it functions. It gave me confidence in our profession to know and see that our profession is in the hands of capable and competent leadership. It made me feel and understand that all the years of paying dues has been one of the wisest investments that I could make in my profession.