Summer has (almost) officially arrived, and as we head into the home stretch of fiscal year 2024, we have some fantastic news to report!
Last week Massachusetts Governor Maura Healey wrote to Centers for Medicare & Medicaid Services, “I am exercising the option to remove the requirement that [CRNAs] be supervised by a physician. I believe this exemption is in the best interest of the citizens of Massachusetts regarding access to and the quality of anesthesia services in the state.” This makes Massachusetts the 25th state, along with Guam, to exercise a full or partial opt-out!
In more great news, Washington, D.C., Mayor Muriel Bowser signed House Bill 25-0545, also known as the Health Occupations Revision General Amendment Act of 2024, which removes collaboration requirements for all advanced practice registered nurses, including CRNAs and grants CRNAs the authority to work independently in the delivery of anesthesia.
Congratulations to Massachusetts Association of Nurse Anesthetists and the DC Association of Nurse Anesthetists and all of the CRNAs and Advocacy staff whose hard work and dedication led to these victories.
As you can see from the collection of news items below, our efforts to advance and protect our profession are finishing strong for the year and laying the groundwork for a successful term ahead.
We are continuously striving to oppose legislation harmful to our members and patients, secure educational funding, ensure reimbursement parity, achieve full practice authority within the Veterans Health Administration, and establish a robust provider nondiscrimination rule. These initiatives are vital to the future of nurse anesthesiology, and your support and involvement are crucial to our success.
Summer is also a time of new beginnings. We are thrilled to congratulate our recent graduates and welcome you to our esteemed profession. Your dedication and perseverance have brought you to this moment, and we are excited to see the impact you will make!
We look forward to continuing our work together, advocating for our profession, and supporting each other through the challenges and triumphs ahead.
Massachusetts Patients Now Have Increased Access to Anesthesia Care
Mayor Bowser Signs Legislation Removing Collaboration Requirements for CRNAs AANA Reports to Federal Agencies How Drug Shortages Affect Anesthesia Practice
AANA Continues to Push for Promulgation of a Provider Nondiscrimination Regulation
Help Elect Nurses and Nursing Champions to Office
AANA Leadership and Staff Attend AVANA Annual Meeting
43 Senators Send Letter Supporting Title VIII
Oppose Legislation Harming Veterans' Access to Care
AANA Issues Updated Practice Considerations for Ketamine Therapy for Psychiatric Disorders and Chronic Pain Management
COA Launches Call for Comments on the Standards
CRNA Hopes to Inspire Others to Learn CPR and Save Lives
AANA Applauds Election of CRNA Dee Bender as Hospital Commissioner for Snohomish County, Washington
ADVOCACY UPDATES
Massachusetts Patients Now Have Increased Access to Anesthesia Care
Massachusetts patients now have increased access to safe, affordable anesthesia care. The state is the latest to opt out from federal regulations that require physician supervision of CRNAs, also known as nurse anesthesiologists or nurse anesthetists.
In a letter to the U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services, Massachusetts Gov. Maura Healey (D) wrote, “I am exercising the option to remove the requirement that [CRNAs] be supervised by a physician. I believe this exemption is in the best interest of the citizens of Massachusetts regarding access to and the quality of anesthesia services in the state.”
The American Association of Nurse Anesthesiology (AANA) reports that the governors of 25 states and Guam have exercised such exemptions for either full or partial opt-out. Read more.
Mayor Bowser Signs Legislation Removing Collaboration Requirements for CRNAs
Patients at Washington, D.C. healthcare facilities now have increased access to safe, affordable care with the signing of House Bill 25-0545 by Mayor Muriel Bowser. The law, also known as the Health Occupations Revision General Amendment Act of 2024 (HORA) removes collaboration requirements for all advanced practice registered nurses, including Certified Registered Nurse Anesthetists (CRNAs) and grants CRNAs the authority to work independently in the delivery of anesthesia.
HORA, passed unanimously by the city council, clarifies the scope of practice for CRNAs, also known as nurse anesthesiologists or nurse anesthetists, and who are advanced level nurses who specialize in administering anesthesia and other medications to patients. This legislation aligns the District with other states in allowing CRNAs to provide safe, high-quality anesthesia care without unnecessary restrictions. Read more.
AANA Reports to Federal Agencies How Drug Shortages Affect Anesthesia Practice
In response to a Request for Information (RFI) on drug shortages from the Federal Trade Commission (FTC) and the Department of Health and Human Services (HHS), the AANA responded with how the shortages affect both CRNA practice and patient care. The RFI asked about causes and solutions for drug shortages and requested that healthcare stakeholders comment on the lack of competition and contracting practices by large healthcare group purchasing organizations and drug wholesalers.
In its letter, AANA stated that anesthesia and pain medications are among the most common classes of drugs affected by shortages; some of the most acute shortages are for injectable drugs used for pain control, sedation, and chemotherapy. CRNAs are not given much notice about drug shortages and sometimes must revise well-understood and established medication protocols and implement new practices that are less familiar. These changes or drug shortages can lead to increased risk of morbidity and mortality; delays or cancellations in care; rationing of specific medications and prioritizing patients to receive limited supplies; providing alternative medications that may be less effective; transfer of patients to facilities that have the drugs available; and increased length of hospitalizations.
AANA also requested to be directly included in discussions to resolve drug shortages because they can severely impact CRNAs and the patients they serve.
AANA Continues to Push for Promulgation of a Provider Nondiscrimination Regulation
The AANA commented in response to a request for information (RFI) from the Centers for Medicare & Medicaid Services (CMS) on aspects of Medicare Advantage (MA) data; our recommendations focused on beneficiary access to care, including information on healthy competition and health equity in the MA market. To maintain access and competition in the MA market, AANA recommended prompt promulgation of the provider nondiscrimination regulation to prohibit private health plans from discriminating against qualified licensed healthcare professionals, including CRNAs, based on their licensure.
We reminded the agency that CRNAs continue to face barriers to providing care due to discrimination from insurers, including MA plans, because of their licensure even though they are the clinicians of choice for many patients, especially those in rural and underserved areas. Such discrimination impairs access to needed healthcare services, increases patient cost-sharing, limits patient choice and healthcare market competition, and inhibits efforts to control healthcare cost growth. AANA urged the promulgation of a strong and enforceable provider nondiscrimination rule that protects the needs of patients in MA plans, enabling CRNAs to practice to their full scope without having to face barriers from health plan policies and practices.
Help Elect Nurses and Nursing Champions to Office
Electing nurses and nursing champions to public office is a top goal of the CRNA-PAC’s Nursing Votes initiative. Now, we are making it easier for AANA members and the public at large to help us achieve this goal. Click here to make a direct contribution to CRNAs, other nurses, and nursing champions who understand the value that you bring to patients and the U.S. healthcare system. Will you do your part to help elect our leaders to state and federal office today?
AANA Leadership and Staff Attend AVANA Annual Meeting
On May 16-18, AANA leadership and staff attended the Annual Meeting of the Association of Veterans Affairs Nurse Anesthetists (AVANA). During the meeting, both AANA President Dru Riddle, PhD, DNP, CRNA, FAAN, and President-elect Janet Setnor, MSN, CRNA, Col. (Ret), USAFR, NC, gave updates about the AANA's ongoing efforts around CRNA National Standards of Practice (NSPs) within the VA. Officials from both the VA's Office of Nursing Services and the National Anesthesia Program gave updates related to the NSP process, as well as other initiatives and changes in the VA that affect CRNA practice. The AANA continues to work with the VA and to support AVANA as we seek to ensure that all veterans have timely access to the high-quality care that CRNAs provide.
43 Senators Send Letter Supporting Title VIII
On May 14, 43 members of the U.S. Senate sent a letter to lead appropriators in support of Title VIII Nursing Workforce Development Programs. The letter calls for appropriators to provide $530 million in funding for Title VIII for the fiscal year 2025. Currently, Title VIII programs have received $305 million for FY24. The letter pointed out the need for additional funding and highlighted how these programs help thousands of nurses every year, many of whom work in rural and underserved communities. The AANA continues to work with Congress and the administration to highlight the need for more resources for nursing education and programs.
Oppose Legislation Harming Veterans' Access to Care
Last year, Representatives David Scott (D-GA), Mike Turner (R-OH), Andrew Garbarino (R-NY), and Yvette Clarke (D-NY) and Senators Maria Cantwell (D-WA) and Bill Cassidy (R-LA) introduced a bill ironically named the Protect Lifesaving Anesthesia Care for Veterans Act of 2023 (H.R. 3347/S. 2070), which will harm access to critical healthcare services for our veterans.
Tell your U.S. Representative and Senators that you oppose this harmful legislation today.
You will be directed to a prewritten email to your legislators. Please personalize the email so that it’s not seen as a form letter. Be sure to keep the tone professional.
Click “send email.”
Share the link with your friends and family so they can contact their legislators as well.
SIGNIFICANT NEWS
AANA Issues Updated Practice Considerations for Ketamine Therapy for Psychiatric Disorders and Chronic Pain Management
The AANA recently updated its practice considerations addressing ketamine therapy to cite the most current studies, as AANA continues to support a patient-centered, interdisciplinary approach to providing care and treatment to persons with psychiatric disorders or chronic pain. Included in these revised considerations is the use of esketamine nasal spray, an FDA-approved treatment for treatment-resistant depression (TRD) in adults and depressive symptoms in patients with major depressive disorder (MDD). Read more.
COA Launches Call for Comments on the Standards
At its January 2024 meeting, the Council on Accreditation of Nurse Anesthesia Educational Programs (COA) approved the opening of a Call for Comments on the Standards for Accreditation of Nurse Anesthesia Programs – Practice Doctorate. The COA now asks its community of interest to provide feedback as to whether the Standards are valid, reliable, and relevant indicators for measuring the quality of a nurse anesthesia program. To provide feedback, please take the Call for Comments survey on the COA’s Standards survey available on the COA website.
The survey will take approximately 45 minutes to complete in one sitting; however, respondents will be able to save their progress and return to the survey via an emailed link. The COA will consider survey feedback, as well as comments gathered at Open Hearings held at the Assembly of Didactic and Clinical Educators, Mid-Year Assembly, and Annual Congress in 2024, to determine whether revisions to the Standards are needed. All Call for Comments survey responses will be confidential; COA will review the results of the survey in aggregate.
Please note: The survey includes the text of the Standards and Clinical Experience requirements only. Respondents should have a copy of the Standards on hand while completing the survey in order to reference footnotes and Glossary definitions.
The Call for Comments will remain open until June 28, 2024. Contact the COA at 224-275-9130 or by email at accreditation@coacrna.org with any questions.
MEMBER HIGHLIGHTS
CRNA Hopes to Inspire Others to Learn CPR and Save Lives
June 1-7, 2024, is National CPR and AED Awareness Week. Sponsored by the American Heart Association, the annual event highlights how many lives could be saved by more Americans knowing cardiopulmonary resuscitation (CPR) and how to use an automated external defibrillator (AED).
Maria van Pelt, PhD, CRNA, CNE, FAAN, FAANA, a CRNA and Clinical Professor, knows firsthand the importance of these life-saving skills and wants to encourage lay people to get CPR-certified. In the past nine years, she’s saved two people’s lives with CPR outside of the clinical setting — and one of those lives was — and one of those lives was her husband’s.
“I feel so honored and privileged that two times in a lifetime, I’ve gotten to save somebody’s life with CPR,” said van Pelt, an AANA member since 1998. Read more.
AANA Applauds Election of CRNA Dee Bender as Hospital Commissioner for Snohomish County, Washington
The AANA congratulates Dee Bender, DNAP, CRNA, MNNA, for her election to Snohomish County Public Hospital District 1, Commissioner-at-Large Position 3. Bender has been a member of AANA since 2010.
Snohomish County Public Hospital District #1 (SCPHD #1) was formed in 1960 to serve the healthcare needs of east Snohomish County. The five-member Board of Commissioners provides oversight and counsel, ensuring the public hospital district fulfills its mission and values and provides high-quality care for everyone in the community. In her newly elected role as a public health commissioner, Bender will oversee all public health practices and make sure that hospital operations are being carried out smoothly, effectively, and efficiently. Her current term extends to 2029. Read more.
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