ALCOAST 189/23 - MAY 2023 PERMANENT CHANGE TO UNCERTIFIED ADVANCED PRACTICE PROVIDER OVERSIGHT

united states coast guard

R 111540Z MAY 23 MID600053008049U
FM COMDT COGARD WASHINGTON DC
TO ALCOAST
BT
UNCLAS
ALCOAST 189/23
SSIC 6000
SUBJ: PERMANENT CHANGE TO UNCERTIFIED ADVANCED PRACTICE PROVIDER
OVERSIGHT
A. Coast Guard Medical Manual, COMDTINST M6000.1F
B. Coast Guard Officer Specialty Management System Manual,
COMDTINST M5300.3A
1. This ALCOAST updates policy in REF (A).
2. Senior Advanced Practice Providers (APPs) are authorized to
provide clinical supervision to uncertified APPs working in CG
facilities. To qualify as a senior APP, an individual must:
    a. hold a competency code of HS18 or hold a Journeyman or Master
level Officer Specialty Code IAW REF (B),
    b. have provided care for at least five years and worked in a CG
clinic for two years,
    c. hold a valid certification by the National Commission on
Certification of Physician Assistants (NCCPA) or American Academy
of Nurse Practitioners (AANP),
    d. be currently licensed, and
    e. have active CG clinical privileges.
3. Physician Assistants (PAs) who are not certified by the NCCPA,
recent graduates who have not taken or passed the NCCPA examinations
and Nurse Practitioners (NPs) who do not have an active unrestricted
Registered Nurse (RN) license and who have not passed a specialty
board examination offered by the AANP or American Nurses
Credentialing Center may practice in CG facilities only under the
following conditions:
    a. All health record entries entered by these individuals shall
be co-signed by a licensed physician or Senior APP by the end of the
following duty day.
    b. When a supervisory physician or Senior APP is not present or
able to respond as needed at the same location, then non-certified
APPs shall be restricted to providing medical care, except for
emergencies, to uniformed personnel only.
    c. Non-certified APPs may stand clinic watches provided a
licensed physician or Senior APP is available for consultation to
discuss any questions or concerns.
    d. Non-certified APPs are ineligible for independent TAD
assignments at locations where a supervisory physician or Senior APP
is not present. This restriction may be waived by COMDT (CG-11) or
designee.
4. These changes will be made to the next revision of REF (A), which
will be released within the next year.
5. This message is cancelled on 10 MAY 2024.
6. POC: LCDR Bridget Metcalf, Physician Assistant Force Manager,
COMDT (CG-1121), (202) 475-5183 or email Bridget.A.Metcalf@uscg.mil.
7. RADM Dana Thomas, Director of Health, Safety and Work-Life
(CG-11), sends.
8. Internet release is authorized.