To Expand Veterans Access to Quality Healthcare, Veterans Administration Publishes Proposed Rule Recognizing Veterans Health Administration CRNAs, APRNs to their Full Practice Authority
Long-awaited, AANA-backed action triggers 60-day public comment period; CRNAs urged to prepare to participate in advocacy campaign
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To expand Veterans access to quality healthcare, the U.S. Department of Veterans Affairs on May 24 published a proposed rule extending Full Practice Authority to CRNAs and other Advanced Practice Registered Nurses (APRNs) serving in the Veterans Health Administration, triggering a 60-day public comment period. The AANA and its coalition partners have long sought this outcome – and much more work remains to be done to make it final.
The VHA proposal appears here, and is anticipated to appear in the Federal Register on May 25. The rule would establish Full Practice Authority in VHA facilities for CRNAs, NPs, CNSs and CNMs. It defines Full Practice Authority as meaning APRNs working within the scope of VA employment would be authorized to provide services as described without the clinical oversight of a physician, regardless of state or local law restrictions on that authority. Under the rule, a CRNA in the VHA would have Full Practice Authority to provide a patient’s anesthesia care and anesthesia related care, including planning and initiating anesthetic techniques (general, regional, local) and sedation; providing postanesthesia evaluation and discharge; ordering and evaluating diagnostic tests; requesting consultations; performing point-of-care testing; and responding to emergency situations for airway management. It defines APRN as a person who has successfully completed an accredited graduate-level educational program in one of the four distinct APRN roles (CRNA, CNP, CNS and CNM), has passed a national certification exam, and possesses licensure.
“The AANA and its 49,000 members are one of many groups cheering the VHA’s actions today,” said AANA President Juan Quintana, DNP, MHS, CRNA, a nine-year veteran of the Air Force Reserve. “Veterans are waiting entirely too long to receive the quality healthcare they deserve and have earned in service to our country. The AANA strongly supports the VHA’s plan to solve this problem by utilizing readily available healthcare resources—such as CRNAs, nurse practitioners, and other APRNs—to the full extent of their practice authority.”
The proposed rule has also drawn support from Capitol Hill. One news release stated, “U.S. Senators Jeff Merkley (D-OR), Mike Rounds (R-SD), Mark Warner (D-VA) and Thom Tillis (R-NC) today welcomed the news that the Veterans Health Administration (VA) is moving to voluntarily implement one of the key proposals from their bipartisan Veterans Health Care Staffing Improvement Act, helping to ensure that veterans can get the care they need in a timely fashion at VA facilities.” Read the whole statement here.
Publication in the Federal Register triggers a 60-day public comment period which concludes on July 23 or 24 (we should know for certain tomorrow). While the AANA analyzes the proposal in further detail, leaders in national and state associations of nurse anesthetists should be aware that this action triggers the AANA’s plans to secure final approval and publication of this proposal as a binding final rule. AANA state leaders should expect to receive additional information on the following activities in the coming days:
- Issuing a CRNAdvocacyCall to Action for all members and updating our advocacy content on www.CRNA-PAC.com and www.VeteransAccessToCare.com ;
- Undertaking public relations, social media and online advocacy efforts;
- Updating and distributing a State Action Packet for state associations of nurse anesthetists to use in advocacy;
- Scheduling a tele-townhall meeting in early June to educate and energize AANA members;
- Coordinating with our coalition partners; and
- Developing detailed comments in response to the proposal.
Opponents of Full Practice Authority can be counted on to strongly oppose this rule and to use all of the tools at their disposal to stop it. Securing Full Practice Authority for the CRNAs who serve our nation’s Veterans will require an ongoing focused effort by our dedicated AANA members, leadership and staff. Stay tuned for more information from AANA!