End of session is just the beginning of AA legislative fight

Only a few session days remain—six in the Senate, three in the House of Representatives—before Pennsylvania’s 2021-22 legislative session ends.

Any bill that hasn’t made it entirely through both chambers of the state General Assembly to get to the governor’s desk for his signature and enactment must be reintroduced and work itself through the whole legislative process again when the new two-year session starts in January 2023.

The end of session is good news when it comes to bad policy like House Bill 1956 and Senate Bill 1258, two companion measures that would license anesthesiologist assistants (AAs) for the first time in Pennsylvania.

Neither bill received consideration and no votes are pending in these waning days of session. But that doesn’t mean the issue is finished—far from it.

The Pennsylvania Association of Nurse Anesthetists (PANA) successfully pushed back against the legislation this year, but we fully expect the measures to be reintroduced in the 2023-24 session.

We’ll be ready, too. We have to be, because we’ve already seen some of tactics proponents will use to advance their bills. Consider the lengths they’ll go:

• Certified Registered Nurse Anesthetists (CRNAs) and SRNAs heard rumors that the legislation passed. Nope. Never happened. In fact, on April 25, PANA testified against the legislation during a House Professional Licensure Committee hearing. The measure never received a vote.

• In an unprecedented attempt to circumvent the legislative process, AAs began reaching out directly to both physician-owned and CRNA-owned anesthesia companies with notice that they are authorized to work in Pennsylvania under delegatory authority. The Pennsylvania Department of Health has made clear that anesthesiologist assistants are not recognized as an anesthesia provider in the state and therefore cannot operate as such in the commonwealth.

• Working with their state and national organizations, anesthesiology assistants also have been claiming publicly that AAs and CRNAs can be used interchangeably, alleging an anesthesia shortage, as part of an attempt to move AAs into facilities where CRNAs are already working. Nonsense. AAs are limited by their training to only provide support as a technical assistant to a physician anesthesiologist and cannot provide anesthesia care apart from their direct supervision. Any scenario that has an AA working apart from a physician anesthesiologist is in direct violation of federal law.

So, while this legislative session is ending, it’s really just the beginning of the fight against a misguided policy that will NOT improve patient safety or enhance care; will NOT reduce health-care costs, but instead contribute to costlier care models; and will NOT improve access to anesthesia services.

Learn more at www.PANAforQualityCare.com.

Pennsylvania Extends COVID-19 Waivers

Pennsylvania Association of Nurse Anesthetists

FOR IMMEDIATE RELEASE

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

E: kurt@ceislermedia.com

Among the waivers is a provision that temporarily suspends physician supervision of CRNAs in a hospital setting

HARRISBURG (April 1, 2022) --- Pennsylvania lawmakers once again have voted to extend several regulatory waivers put into place at the start of the pandemic to help health-care providers respond to COVID-19. Without action, the waivers would have expired March 31. Gov. Tom Wolf signed the legislation March 30, keeping the waivers in place through June.

Among the waivers is a provision that suspends the physician supervision requirement of a certified registered nurse anesthetist in a hospital setting, giving health-care facilities the flexibility to continue tapping into the unique skillset of CRNAs to fulfill critical roles inside and outside the operating room as the state continues its pandemic recovery.

The governor announced the original temporary blanket waiver for advanced practice nurses and CRNAs on May 6, 2020, as part of an executive order to enhance the state’s response to the emerging health-care crisis.

After the passage of two constitutional amendments dealing with executive power, the General Assembly ended the governor’s emergency order in June 2021 but allowed the waivers to remain in place until September 2021. Before they expired, lawmakers voted then to keep the waivers in place until March 2022. The latest legislative action keeps the waivers in effect for three more months.

The Pennsylvania Association of Nurse Anesthetists (PANA) represents more than 4,000 CRNAs and students across the commonwealth.

Removing the supervision requirement and allowing CRNAs 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 demands of this pandemic.

For more information, visit www.PANAforQualityCare.com or follow along on social media via Twitter at @PANACRNA, Facebook at www.facebook.com/PANACRNA, or Instagram at @PANACRNA.

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Spotlight PA: At last minute, Pa. lawmakers vote to extend dozens of COVID-19 waivers

This article was originally published on Spotlight PA.

by Danielle Ohl of Spotlight PA | Sept. 29, 2021

📷 FRED ADAMS / FOR SPOTLIGHT PA

HARRISBURG — The Pennsylvania legislature unanimously voted Wednesday to extend dozens of regulatory waivers put into place last year to help health-care providers fight COVID-19.

Without action, the waivers would have expired Thursday, potentially exacerbating ongoing staffing crises in hospitals and long-term care institutions, which are again facing rising COVID-19 cases. Health-care workers and their advocates had warned any lapse in the relaxed rules would have renewed administrative burdens and made fighting the ongoing pandemic more difficult.

Wednesday’s action will keep the waivers in place until March 2022 while the legislature considers a number of bills that would make the regulatory suspensions permanent. Gov. Tom Wolf will sign the bill.

“The governor is thankful the legislature engaged the administration and stakeholders and ultimately agreed with most of the administration’s recommendations on extending COVID-19-related waivers that are still in use,” spokesperson Lyndsay Kensinger said.

At the beginning of the pandemic, Wolf approved nearly 100 waivers to ease some of the rules governing health-care workers and ensure as many professionals as possible were on the ground in hospitals, vaccination clinics, and long-term care facilities.

The temporary changes were made under a disaster declaration that later became a target for legislative Republicans unhappy with the administration’s business closures.

Buoyed by two successful constitutional amendments that curtailed the executive’s power, the GOP-controlled General Assembly ended Wolf’s emergency order in June, while allowing the waivers to remain in place until Sept. 30.

Under the bill passed Wednesday, all suspensions under the Department of Health, Department of Human Services, and the Bureau of Professional and Occupational Affairs will remain in place until March unless Wolf and the agencies decide to terminate them sooner.

Among the waivers extended are those allowing out-of-state practitioners to treat patients in Pennsylvania, permitting retired or lapsed professionals to return to medicine, and expanding who can give a vaccine.

The waivers also allow patients to access care via telemedicine, which as of now is neither allowed nor prohibited in Pennsylvania law, creating a gray area for health-care providers and insurance companies.

Lawmakers have introduced bills in both the House and Senate to provide rules and regulations surrounding telemedicine, but past efforts have broken down over partisan disagreements. Wolf vetoed a telemedicine bill last year because it would have prevented health-care providers from prescribing abortion-inducing medicine.

As a number of other bills that would make regulatory suspensions permanent await consideration, two removing administrative barriers for physician assistants passed Wednesday.

The Joint State Government Commission is studying the impact of the waivers and which should stay in place to remove barriers to employment in the state. Glenn Pasewicz, executive director of the committee, said a report should be out by late October.

Separately, lawmakers on Wednesday directed various state agencies to post a report listing which waivers were and were not extended by Nov. 1.

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