Gov. Wolf Grants Waiver to Suspend CRNA Supervision Requirement

Pennsylvania Association of Nurse Anesthetists

FOR IMMEDIATE RELEASE

CONTACT: Kurt Knaus, P: 717-724-2866

E: kurt@ceislermedia.com

Gov. Wolf Grants Waiver to Suspend CRNA Supervision Requirement

Temporary blanket waiver affects many advanced practice nurses

Removing physician supervision requirement will expand the capacity of both physicians and CRNAs to meet growing demand and enhance hands-on care

HARRISBURG (May 6, 2020) --- Gov. Tom Wolf today announced a temporary blanket waiver that will enable advanced practice nurses, including certified registered nurse anesthetists (CRNAs), to practice to the fullest extent of their education and training to enhance the state’s response to the health-care crisis caused by the COVID-19 pandemic.

The waiver was included in an executive order he signed to protect health-care practitioners for good-faith actions taken in response to this crisis.

“We’re grateful to the administration for recognizing the value of CRNAs,” said Angelarosa G. DiDonato, DNP, CRNA, president of the Pennsylvania Association of Nurse Anesthetists (PANA), which represents more than 3,700 CRNAs and students in the state. “CRNAs are uniquely qualified to care for critically ill patients who are suffering from this respiratory pandemic. Patient health and safety is paramount, and we’re eager to put our skills to work to help.”

The governor’s action mirrors steps taken by several other states like New York, West Virginia, Maine, Michigan, New Jersey and Arizona to remove barriers that allow them to better utilize all available health-care providers without risking patient safety. The Centers for Medicare and Medicaid Services also removed the national physician supervision requirement in response to COVID-19.

Pennsylvania regulations still require physician supervision of a CRNA in a hospital setting. The governor’s waiver temporarily suspends that requirement, however, giving health-care facilities more flexibility to tap into the unique skillset of CRNAs to fulfilling critical roles outside the operating room during this crisis.

Removing the supervision requirement of CRNAs, and allowing them to practice to the fullest extent of their education and training, avails more physicians to provide hands-on care, expands the capacity of both CRNA and physician providers, and augments the state’s health-care system to continue to meet the growing demands of this pandemic.

CRNAs possess a skillset uniquely suited to aid in management of this crisis. Most have cared for patients as sick as, or even more acutely ill than, the COVID-19 patient. In the operating room, the nurse anesthetist serves as the frontline, critical care intensivist; surveilling, assessing and implementing appropriate interventions.

Much has been said about the importance of ventilators during this crisis, and CRNAs not only routinely use them, but they tailor their complex settings to each patient. Due to a nurse anesthetist’s science-based education and clinical experience, CRNAs understand the why and how of their equipment, allowing them to manage complex patients.

CRNAs also possess hands-on skills extending far beyond their already vast critical care experiences. CRNAs perform rapid physical assessments, airway and ventilatory management, volume resuscitation and hemodynamic management, patient triage, emergency preparedness, and procedural skills that include central and arterial invasive line placement.

“As frontline health-care professionals, CRNAs play a crucial role in the state’s response to this pandemic, especially one related specifically to respiratory failures,” DiDonato said. “With our medical community facing unprecedented challenges, this waiver gives facilities the ability to fully utilize the unique skill set of CRNAs.”

For more information, 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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Two-thirds of Pa. Voters Support Professional Designation for CRNAs

Pennsylvania Association of Nurse Anesthetists

FOR IMMEDIATE RELEASE

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

Two-thirds of Pa. Voters Support Professional Designation for CRNAs

Pennsylvania is one of just two states that fails to recognize nurse anesthetists in some form

HARRISBURG (April 20, 2020) --- Two-thirds (67%) of Pennsylvania voters support professional designation for certified registered nurse anesthetists (CRNAs), including those who identify as Republican (59%), Democrat (75%) and Independent (62%), according to results of a statewide public opinion poll conducted by G. Terry Madonna Opinion Research.

Pennsylvania is one of just two states that fails to recognize CRNAs in some form. Because there is no definition for “certified registered nurse anesthetist” under the state’s Professional Nursing Law, CRNAs are recognized only as registered nurses, not as CRNAs. That brings logistical and financial burdens, and it continues to inhibit our full response to this health-care pandemic.

In response to COVID-19, many CRNAs want to contribute more in the facilities where they work but can’t. Likewise, hospitals and other health-care institutions want to use CRNAs to their fullest capacity but can’t. Many of these facilities feel restricted by the way the state licenses CRNAs and will not allow nurse anesthetists to provide advanced, critical care services, even though it is within their education, training, clinical experience and scope of practice --- meaning this valuable health-care resource remains untapped during a time of crisis.

There are other challenges as well. Pennsylvania nurse anesthetists who serve in the military must secure designation in another state to provide anesthesia in the armed services. They cannot assist on rapid response teams in states affected by natural disasters because they lack formal credentials. And, after receiving training in Pennsylvania, many nurse anesthetists relocate to states with full credentialing, contributing to the state’s “brain drain.”

Bipartisan measures have been introduced in both chambers to recognize nurse anesthetists as “CRNAs” under Pennsylvania statute, with one bill (S.B. 325), sponsored by Sen. John R. Gordner (R-Columbia), receiving Senate approval last year. The legislation remains under consideration in the House Professional Licensure Committee.

“Broad support like this should give lawmakers the confidence they need to advance this measure and finally provide CRNAs with the professional designation they deserve,” said Angelarosa G. DiDonato, DNP, CRNA, president of the Pennsylvania Association of Nurse Anesthetists (PANA), which represents more than 3,700 CRNAs and students in the state.

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, podiatrists, ophthalmologists, and plastic surgeons; pain management centers and more.

Pennsylvania is recognized as a leader in anesthesia education and training, with 13 university-led programs. Yet, without an official CRNA designation in the state, many students leave the state. Some graduating students have to wait as long as six months to get credentialed in out-of-state facilities, as state boards must verify that the students meet the requirements necessary to be classified appropriately there.

According to the poll findings, respondents agree (47% agree to 28% disagree) that students who graduate from one of Pennsylvania’s education and training programs ultimately may leave the state because of issues with designation, going to a state that fully recognizes their profession. In the same respect, respondents agree (51% to 23%) that having professional designation would help to attract and retain these professionals.

According to the poll, respondents agree (45% to 40%) that there is no difference in patient outcomes when a CRNA provides treatment compared to an anesthesiologist. Numerous medical studies back them up. In fact, studies by nationally recognized health-care policy and research organizations prove that outcomes are nearly identical in these cases and that CRNAs provide high-quality care, even for rare and difficult procedures.

Not only are CRNAs critical to patient care, but they also help to reduce the cost of health care. Respondents also agree (46% to 40%) that CRNAs help to keep down health-care costs.

That is especially true in rural areas, where CRNAs are the main providers of anesthesia care, delivering essential health care and preventing gaps in services. CRNAs are far less costly for hospitals to employ, so rural hospitals, for example, are able to staff emergency services with in-house CRNAs 24 hours a day, 7 days a week, so that every Pennsylvania resident has access to these needed services.

The poll, conducted by ProBusinessConnection, interviewed 650 registered voters in the state and includes both landline and cellular households. The margin of error is +/-4.8 percent.

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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Important Message to PANA Members

March 25, 2020

Dear PANA Members:

Earlier today, the Pennsylvania Association of Nurse Anesthetists sent a letter to Gov. Tom Wolf and state Health Secretary Dr. Rachel Levine, urging them to formally recognize certified registered nurse anesthetists and to act swiftly to give our professionals the ability to practice to the full extent of our education and training to help Pennsylvania respond to the COVID-19 health-care crisis.

You can read the entire letter here: https://bit.ly/3akUMb0.

As frontline health-care professionals, we play a crucial role in the state’s response to this pandemic. Unfortunately, the full contribution of CRNAs is being limited.

First, in Pennsylvania, education and training for CRNAs is extensive. Yet, there are limits placed on our practice, even though those limits are not based on any data or research, and CRNAs can safely practice beyond these limits. New York, West Virginia, Maine and Arizona already have acted to remove barriers on CRNAs to better utilize all available providers to respond to this health-care crisis without risking patient safety. Pennsylvania should do the same.

Second, Pennsylvania remains one of only two states (New York is the other) that fails to recognize CRNA professional designation in some form, meaning we are recognized only as registered nurses. In times of need, CRNAs are in demand to help with crisis response. But Pennsylvania-based CRNAs cannot be part of response teams in other states that are asking for help --- and so many are --- simply because we lack the formal credentials that nearly every other state recognizes. That needs to change.

Now, we need you to take action, too.

First, send a personal message to Gov. Wolf and urge him to act on the health-care proposals PANA included in its letter. Fill out the form here: https://www.governor.pa.gov/contact/#OnlineForm.

This is all you need to say (there is a 1,000-character limit):

Gov. Wolf: As a certified registered nurse anesthetist (CRNA) in Pennsylvania, I stand ready to help our commonwealth address the health-care crisis caused by the COVID-19 pandemic. Recently, PANA, our statewide association, sent you a letter (which you can access here: https://bit.ly/3akUMb0), urging you to formally recognize CRNAs and allow us to practice to the full extent of our education and training to help Pennsylvania respond in this time of need. Other states already have acted to remove barriers on CRNAs to better utilize all available providers to respond to this health-care crisis without risking patient safety. Pennsylvania should do the same. As frontline health-care professionals, we play a crucial role in the state’s response to this pandemic. Please make these changes so we can help even more. Thank you.

Next, contact your local legislators. Ask them to please contact the governor and secretary and urge them to take fast action on the proposals made by PANA to address this health-care crisis. You can find your lawmakers here: https://www.legis.state.pa.us/cfdocs/legis/home/findyourlegislator.

This is all you need to say:

As your constituent, I wanted to be sure you knew that PANA, our statewide association, sent a letter (which you can access here: https://bit.ly/3akUMb0) to Gov. Tom Wolf and state Health Secretary Dr. Rachel Levine, urging them to formally recognize CRNAs and allow us to practice to the full extent of our education and training to help Pennsylvania respond to the COVID-19 health-care crisis. As a certified registered nurse anesthetist (CRNA), we play a crucial role in the state’s response to this pandemic, along with other frontline health-care professionals. Unfortunately, too many barriers are blocking our work. There are limits placed on our practice, even though those limits are not based on any data or research, and the state’s lack of credentialing limits emergency response. Please read our letter and urge the governor and his administration to act swiftly. Other states are acting. It is time for Pennsylvania to do the same. Thank you.

Like the rest of the country, we are watching with deep concern as the COVID-19 pandemic continues to affect a world already brought to a standstill. PANA continues to monitor the situation. But our culture is built on helping people. I hope we can count on you to do your part to advocate for our profession so we can get these changes made and fulfill our mission of keeping residents healthy and safe.