PANA Testifies Before House Committee on CAA Legislation

Department of State opposes licensing CAAs in Pa.

Members of the Pennsylvania Association of Nurse Anesthetists (PANA) testified today before the House Professional Licensure Committee to oppose legislation (H.B. 1956) that would license Certified Anesthesiologist Assistants (CAAs) for the first time in Pennsylvania.

Testifying were Jessica Poole DNAP, CRNA, director of State Government Affairs for PANA and lead Certified Registered Nurse Anesthetist (CRNA) at BPW Medical Associates, P.C.; Matthew McCoy DNP, CRNA, past president of PANA and assistant director of the Crozer Chester Medical Center/Villanova University Nurse Anesthesia Program; and Christopher A. Heiss, MSN, CRNA, a PANA trustee and a CRNA practicing everywhere from large tertiary care facilities to rural critical access hospitals throughout Pennsylvania.

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PANA’s testifiers urged the committee to oppose the legislation. House Bill 1956 will not improve patient safety or enhance care. It will not reduce health-care costs, but instead, contribute to costlier care models. And it will not improve access to anesthesia services or address critical care shortages in underserved areas.

There is no meaningful research data concerning CAA anesthesia safety. Because CAAs must be directly supervised by an anesthesiologist, the provider redundancy of the CAA/anesthesiologist team is one of the costliest anesthesia delivery models. That also greatly limits their utilization in rural and underserved communities where anesthesiologists don’t practice.

GET ALL THE FACTS ABOUT H.B. 1956 HERE

The Pennsylvania Department of State also testified and opposed the licensing standards, noting that the agency “views creating another licensure class for professionals who are already nationally credentialed as repetitive and unnecessary.” The department also made clear that “CAAs would appear to fall within the definition of technician. While the practice acts and board regulations do not prohibit CAAs from practicing in the Commonwealth, the Department of State and the State Board of Medicine do not have the authority to regulate hospitals and other health care facilities. That authority falls under the Department of Health, in the Health Care Facilities Act.

A representative from the Hospital and Health System Association of Pennsylvania (HAP) also testified. Although HAP did not oppose the legislation, the organization did call for allowing CRNAs to practice to the fullest extent of their education and training to increase the number of qualified anesthesia providers in Pennsylvania.

Out-of-state CAAs also testified with Pennsylvania-based anesthesiologists.

VIEW ALL TESTIMONY

JESS POOLE

Poole Final

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Download PDF • 152KB

MATT MCCOY

Matt McCoy Final

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Download PDF • 164KB

CHRISTOPHER HEISS

Heiss - HPLC Testimony - Final

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Download PDF • 73KB

PA DEPARTMENT OF STATE

4.25.22 - HPLC Testimony -DOS HB1956

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Download PDF • 106KB

This is only the first step in a long legislative process. The hearing was informational only and the committee did not vote on the measure, which means under consideration. (Legislation must be approved by the committee before it goes to the full House for consideration.) No legislation has been introduced in the state Senate.

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Some nurses finally get the recognition they deserve | PennLive Opinion

July 28, 2021

By Matt McCoy

It used to be that certified registered nurse anesthetists (CRNAs) were the best-kept secret in health care. Not anymore.

Right before the General Assembly adjourned for its summer recess, lawmakers passed and the governor signed into law Act 60 of 2021, which grants formal title recognition to CRNAs in Pennsylvania.

The enactment marks the end of a legislative review that stretched more than a decade, and it brings tremendous professional satisfaction to the state’s 3,700 CRNAs and students, who will finally be recognized for their advanced education, specialized training, and clinical skills.

Until that moment a few weeks ago, Pennsylvania remained just one of two states (New York is now the lone holdout) that failed to formally recognize “certified registered nurse anesthetist” in some form.

Because there was no definition for nurse anesthetists under the state’s Professional Nursing Law, CRNAs were recognized only as registered nurses, despite clear differences between the two health-care professionals.

CRNAs are the hands-on providers of anesthesia care, operating safely in every setting where anesthesia is administered, including hospital operating and delivery rooms; ambulatory surgical centers; the offices of dentists, ophthalmologists, and plastic surgeons; pain management centers, and more.

Act 60 also expands the providers that CRNAs are permitted to work with to include podiatrists.

While many CRNAs practice with physician anesthesiologists, increasingly, CRNAs practice on their own in collaboration with other health-care professionals.

Act 60 also reinforces that nurse anesthetists are able to perform the full scope of anesthesia services without the involvement of physician anesthesiologists and embraces the existing patient care model of collaboration between CRNAs and their physician colleagues.

More than 49,000 CRNAs safely administer well over 34 million anesthetics nationwide each year --- and Pennsylvania remains at the forefront.

With 13 university-led programs, including York College’s WellSpan Health Nurse Anesthetist Program, our commonwealth is a national leader in anesthesia education and training. So, it has always been frustrating that our state didn’t even officially recognize these professionals.

It was costly, too. Without an official CRNA designation here, many students left. And even after they left, some graduating students had to wait as long as six months to get credentialed in out-of-state facilities, because state boards had to verify that students met requirements to be classified appropriately there.

This new law stems the flow of this “health-care brain drain” and reinforces our reputation for education and training.

Act 60 also remedies issues with credentialing that meant logistical and financial challenges for CRNAs.

Pennsylvania-based nurse anesthetists who serve in the military, for example, had to secure designation in another state to provide anesthesia in the armed services. Our CRNAs could not assist on rapid response teams in states affected by natural disasters unless they served only as RNs because they lacked formal credentials.

But it was the pandemic that finally put this decades-long professional slight into perspective.

In response to COVID-19, many CRNAs wanted to contribute more to the facilities where they worked but couldn’t. Likewise, hospitals and other health-care institutions wanted to use CRNAs to their fullest capacity but couldn’t.

And they couldn’t because of the way the state-licensed CRNAs as RNs, which limited our role to provide the most advanced, critical care services during the biggest health-care crisis of our lifetime.

Of course, none of this would have been possible without the bipartisan cooperation of the administration and lawmakers, especially Rep. Tarah Toohil (R-Luzerne) and Sen. John Gordner (R-Columbia), whose measure ultimately was signed into law.

In the most ordinary situations, surgery and anesthesia can be frightening or intimidating. But nurse anesthetists provide comfort and reassurance by never leaving their patient’s side.

We’re usually the last people patients see before a procedure begins and the first to greet them when they awake. It’s humbling to realize that now they will get to know us for who we really are -- finally and officially -- as CRNAs in Pennsylvania.

Matt McCoy, DNP, CRNA, is president of the Pennsylvania Association of Nurse Anesthetists.

https://www.pennlive.com/opinion/2021/07/some-nurses-finally-get-the-recognition-they-deserve-opinion.html

CRNA Professional Designation Measure Passes General Assembly, Sent to Governor for Enactment

Pennsylvania Association of Nurse Anesthetists

CONTACT: Kurt Knaus; P: 717-724-2866; E: kurt@ceislermedia.com

CRNA Professional Designation Measure Passes through General Assembly, Sent to Governor for Enactment

HARRISBURG (June 25, 2021) --- Legislation that would finally grant formal title recognition to certified registered nurse anesthetists in Pennsylvania is on its way to Gov. Tom Wolf for enactment after the House passed a Senate-sponsored measure (S.B. 416) today.

Once the bill is signed into law, it will end Pennsylvania’s distressing status of being one of just two states (New York is the other) that fails to formally recognize “certified registered nurse anesthetist” in some form. Because there is no definition for nurse anesthetists under the state’s Professional Nursing Law, CRNAs are recognized only as registered nurses.

“We are so grateful to Sen. John Gordner and Rep. Tarah Toohil, both of whom have been longtime champions for CRNAs and worked so hard to get this legislation over the finish line,” said Matt McCoy, DNP, CRNA, President of the Pennsylvania Association of Nurse Anesthetists (PANA), which represents more than 3,700 CRNAs and students in the state.

“Finally, CRNAs in Pennsylvania will get the recognition they deserve for their advanced training, education and clinical skills,” McCoy said.

Both the House and Senate passed identical companion measures within days of each other last week. House Bill 931 is sponsored by Toohil (R-Luzerne), but it was Gordner’s (R-Columbia) legislation (S.B. 416) that ran the full course of the legislative process.

Gordner has had previous measures pass the Senate only to stall in the House --- until this year. The issue has been under legislative review and debate for more than a decade.

CRNAs are the hands-on providers of anesthesia care, operating safely in every setting where anesthesia is administered, including: hospital operating and delivery rooms; ambulatory surgical centers; the offices of dentists, ophthalmologists, and plastic surgeons; pain management centers and more.

Besides title recognition, the measure also expands the providers that CRNAs are permitted to work with to include podiatrists, and it clarifies regulatory language as it pertains to physician involvement with anesthesia services, formalizing the status quo. The measure also includes cooperation language to define the relationship CRNAs have with their physician colleagues.

Lack of professional designation brings logistical and financial challenges for CRNAs, who have to secure credentials in other states for some activities, including serving in the military. The pandemic revealed additional shortcomings, where health-care facilities wanted to use CRNAs to their fullest capacity but felt restricted by licensing standards.

But all that ends when Gov. Tom Wolf signs the measure into law. The governor has 10 days to sign the bill into law, veto it, or allow it to become law without his signature.

For more information about certified registered nurse anesthetists in Pennsylvania, visit www.PANAforQualityCare.com or follow along on social media via Twitter at @PANACRNA or on Facebook at www.facebook.com/PANACRNA.

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