HOUSE OF REPRESENTATIVES

H.R. NO.

78

TWENTY-FIRST LEGISLATURE, 2002

  

STATE OF HAWAII

  
   

HOUSE RESOLUTION

 

REQUESTING THE DEPARTMENT OF HEALTH TO ESTABLISH A TASK FORCE TO MAKE RECOMMENDATIONS TO THE GOVERNOR CONCERNING WHETHER THE STATE OF HAWAII SHOULD "OPT-OUT" OF THE FEDERAL REQUIREMENT THAT PHYSICIANS SUPERVISE CERTIFIED REGISTERED NURSE ANESTHETISTS (CRNA’s) IN THE ADMINISTRATION OF ANESTHESIA.

 

 

WHEREAS, the Health Care Financing Administration recently issued a new rule that defers to state professional practice laws and hospital by-laws the determination as to which licensed professionals can administer anesthesia; and

WHEREAS, the old rule required supervision of Certified Registered Nurse Anesthetists (CRNA’s) by physicians, whether or not the particular supervising physician had any expertise in the delivery of anesthesia; and

WHEREAS, Congress has left this licensure function to states, and Medicare recognizes the scope of practice for which health professionals are licensed by the individual states; and

WHEREAS, Medicare’s hospital conditions of participation do not have a federal requirement that physicians oversee the practice of other state-licensed independent practitioners, with the sole exception relating to physician supervision of CRNA’s; and

WHEREAS, the new rule removes the federal requirement for physician supervision of the administration of anesthesia by CRNA’s in hospitals, critical access hospitals and ambulatory surgical centers; and

WHEREAS, the new rule allows CRNA's to practice without physician supervision where state laws permit; and

WHEREAS, the new rule allows an appropriate level of regulatory flexibility without compromising patient health or safety; and

WHEREAS, the new rule increases overall flexibility by letting states and hospitals, who are closer to patient care delivery, make decisions about the best way to deliver care; and

WHEREAS, there is no evidence that the independent practice of CRNA’s would cause adverse outcomes for Hawaii’s healthcare consumers; and

WHEREAS, under the new rule, the current physician supervision requirement would be maintained, unless the Governor of a State, in consultation with, at the very least, the State’s Boards of Medicine and Nursing, exercises the option of exemption from this requirement; and

WHEREAS, the changes contained within the new rule are an integral part of the Federal administration’s efforts to improve the quality of care furnished through Federal programs; and

WHEREAS, the new rule gives to the Governor the ability to exercise the right of exemption from the physician supervision requirement relating to CRNA’s, if it is in the "best interest" of the particular State; and

WHEREAS, the new rule leaves to the individual States the ability to develop the process by which consultation shall be provided to the Governor concerning what is in the "best interest" of a particular State and the Federal requirement relating to physician supervision of CRNA’s; now, therefore,

BE IT RESOLVED by the House of Representatives of the Twenty-first Legislature of the State of Hawaii, Regular Session of 2002, that the Department of Health is requested to establish a "Task Force" which will be charged with determining whether it is in the "best interests" of our State to have the Governor request that Hawaii be exempted from the Federal requirement specific to physician supervision of CRNA’s; and

BE IT FURTHER RESOLVED that the "Task Force" shall be administered and staffed by the Department of Health; and

BE IT FURTHER RESOLVED that said "Task Force" shall consist of representatives from, at least, the following areas:

    1. One representative from the State Board of Medicine; and
    2. One representative from the State Board of Nursing; and
    3. One representative from the Hawaii Association of Nurse Anesthetists; and
    4. One representative from Hawaii Nurses Association; and
    5. One representative from HMSA; and
    6. The Hawaii Medical Association; and
    7. The Hawaii Association of Hospitals and Health Systems (or applicable state organization); and
    8. The Hawaii Society of Anesthesiologists (or applicable state organization); and
    9. One state consumer advocacy organization; and

BE IT FURTHER RESOLVED that the "Task Force" shall, in providing consultation to the Governor, take into consideration, examine and provide recommendations that are consistent with the following:

    1. the State nursing code; and
    2. the State medical code; and
    3. various applicable institutional codes; and
    4. various applicable controlled substances codes; and

shall, where possible, reconcile the various terms with one another; and

BE IT FURTHER RESOLVED that the Department of Health is requested to submit a report of the "Task Force’s" findings and recommendations, including any necessary proposed legislation, to the Governor and the Legislature no later than twenty days prior to the convening of the Regular Session of 2003; and

BE IT FURTHER RESOLVED that certified copies of this Resolution be transmitted to the director of the Department of Health.

 

 
 

OFFERED BY:

_____________________________

Report Title:

Task force; "Opt-out" of federal requirement for physician supervision of CRNA's in anesthesia administration