AANA Federal Government Affairs
HOTLINE
Number 2005-08, Week of Monday, April 18, 2005
In This Issue:
* Louise Hershkowitz, CRNA, MSHA, Testifies About Nurse Anesthesia Education
Funding Before House Appropriations Subcommittee
* House and Senate Seeking to Negotiate Medicaid Deal
* Senate Turns Back $2 Billion Increase for VA Hospitals
* Bill to Propose Extension of Moratorium on Specialty Hospitals Forthcoming
* Amendments
>> Louise Hershkowitz, CRNA, MSHA, Testifies About Nurse Anesthesia Education
Funding Before House Appropriations Subcommittee
At the direction of AANA President Frank Maziarski CRNA MS CLNC, and through the
work of the AANA Washington office, Louise Hershkowitz , CRNA, MSHA, testified
April 15 before a key House Appropriations panel on the importance of nurse
anesthesia education funding. Hershkowitz, sitting before the House
Appropriations Subcommittee on Labor, Health and Human Services, and Education,
told Chairman Ralph Regula (R-NM), "Our chief request before you today is to
reserve at least $3 million for nurse anesthesia education from HHS Title VIII
nurse education budget. In challenging budget times, maintaining this modest
level of funding is crucial to patient care. A 2003 AANA workforce study
concluded that in 2002 there was a 12% vacancy rate in hospitals for CRNAs, with
a slightly lower vacancy rate in ambulatory surgical centers. The supply of
CRNAs has increased in recent years, as our programs have increased the number
of new graduates."
She continued, "We need to produce more nurse anesthetists. With the help of
Title VIII funding, CRNA graduate programs in 2004 produced 72 percent more
graduates than they had just five years ago. But the challenge is that our 94
nurse anesthesia programs - including programs in California, Connecticut,
Florida, Illinois, Kentucky, Maryland, New York, Ohio, Pennsylvania, Rhode
Island, Texas and Wisconsin, among others - each continue to turn away well
qualified applicants in the face of increasing need. Providing Title VIII
funding cost-effectively expands the number of CRNAs, so Americans will have
access to safe anesthesia care in the future."
Hershkowitz also added, "Mr. Chairman, the AANA joins nurses and others in
support of securing a total of $210 million in Fiscal Year 2006 for nursing
shortage relief through Title VIII. However, America will spend $1.7 trillion on
healthcare this year. A lot of that care is funded through Medicare."
Concluding, Hershkowitz told the subcommittee, "We believe it is important for
the federal government to allocate at least $ 3 million for nurse anesthesia
education, $85 million for advanced practice nursing education, and at least
$210 million for nursing education. These appropriations amount to a tiny
fraction of America's total healthcare spending. But they are necessary to
ensure we have enough nurses, and safe anesthesia care when and where it will be
needed."
>> House and Senate Seeking to Negotiate Medicaid Budget Deal
A letter signed by 44 Republican members of Congress urging House Budget
Committee Chairman Jim Nussle (R- IA) to restore $20 billion in Medicaid funds
over five years to the chamber's budget "could give senators more leverage" in
their negotiations with the House over a budget for fiscal year 2006 (AP/San
Francisco Chronicle, 4/14). The reversal is important to CRNAs, especially those
working in obstetrical and childbirth settings, since the Centers for Medicare &
Medicaid Services (CMS) estimates a third of US childbirths are paid-for by the
federal-state joint funded program. In some areas, Medicaid pays a far larger
share of childbirths.
The House FY 2006 budget resolution instructs the House Energy and Commerce
Committee to find $20 billion in savings over five years, most of which is
expected to come from Medicaid. The Senate budget plan originally included $15
billion in Medicaid cuts but senators approved an amendment to eliminate all
Medicaid reductions (American Health Line, 4/14). In their letter to Chairman
Nussle, the Republican lawmakers said the Medicaid cuts would "negatively impact
people who depend on the program and the providers who deliver healthcare to
them" (San Francisco Chronicle, 4/14). The letter states that the House should
create a bipartisan commission, an idea already approved by the Senate, that
would recommend changes to Medicaid (Philadelphia Inquirer, 4/15).
Read more,
http://www.sfgate.com/cgi-bin/article.cgi?f=/n/a/2005/04/14/national/w232416D24.DTL
Also see,
http://www.philly.com/mld/philly/living/health/11397725.htm
>> Senate Turns Back $2 Billion Increase for VA Hospitals
The Senate on Tuesday (April 12th) voted 54-46 to defeat an amendment to a
military appropriations bill that would have provided an additional
$1.98 billion for Department of Veterans Affairs (VA) hospitals. This is
important to CRNAs because it would have increased funding for the VA Hospitals
in which many CRNAs practice. Senator Patty Murray (D-WA) introduced the
amendment as part of an $80.6 billion emergency appropriations bill for the wars
in Iraq and Afghanistan and other military operations. According to Senator
Murray, VA hospitals are overcrowded and require additional funds. "There's a
train wreck coming," she said. Senate Republicans, who opposed the amendment,
denied that VA hospitals had such serious problems and said that the facilities
had adequate funds to address emergencies (AP/Los Angeles Times, 4/13).
Read more,
http://www.latimes.com/news/printedition/asection/la-na-va13apr13,1,4556733.story?coll=la-news-a_section
>> Bill to Propose Extension of Moratorium on Specialty Hospitals Forthcoming
Senate Finance Committee Chairman Chuck Grassley (R-IA) and Senator Max Baucus
(D-MT), the committee's ranking member, plan to introduce a bill that would
extend a moratorium on the construction of new specialty hospitals (The Hill,
4/12). This is important since a significant number of CRNAs provide anesthesia
care in such settings. An amendment in the new Medicare law imposed a ban until
June 8th on the construction of new specialty facilities, in part because some
larger, full-service facilities say that specialty centers cater to patients
considered the most profitable to treat, leaving full-service hospitals to care
for more uninsured patients and Medicaid beneficiaries. In a committee hearing
on March 8th, the Medicare Payment Advisory Commission (MedPAC) recommended that
Congress extend the moratorium until January 1, 2007.
Read more,
http://www.thehill.com/thehill/export/TheHill/Business/041205.html
>> Amendments
* The House and Senate will be in session this week. The House will be taking up
the Energy Policy Act of 2005 (HR 6), while the Senate will be focusing on the
Iraq/Afghanistan Supplemental Appropriations bill sent over from the House (HR
1268).
* Medical Pay-for-Performance. By the end of the year approximately 600,000
Medicare recipients will be in "test" programs that provide financial rewards to
practitioners for meeting their healthcare goals.
Read more,
http://www.nytimes.com/2005/04/15/business/15medicare.html?ex=1114228800&en=7916a313b1496777&ei=5070
* The will be no Hotline next week! The Hotline will not be published next week
due the AANA Mid-Year Assembly in Washington, DC.
* AANA FPDs, this is crunch time to complete your Capitol Hill appointments for
AANA lobbying days April 26-27 during AANA Midyear Assembly. Be sure to email
your completed appointments list, with legislators, dates, times and locations,
to AANA Political Affairs Manager Brian Kelley,
bkelley@aanadc.com. If you have any
questions, please send Brian an email.
* For up-to-date Congressional floor & committee schedule information, see
http://thomas.loc.gov/.
>> For More Information
The AANA Federal Government Affairs Hotline is published for the nurse
anesthetist members of AANA each week Congress is in session by the AANA Office
of Federal Government Affairs, Washington DC, 202-484-8400,
info@aanadc.com,
Frank Purcell, Senior Director. C 2005 American Association of Nurse
Anesthetists.
If you have recieved this email in error please reply with the word "remove" in
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or 202-484-8403.