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Testimony: House Bill 789, Certified Registered Nurse Anesthetists, House Professional Licensure Committee

Statement of The Hospital and Healthsystem Association of Pennsylvania For the

House Professional Licensure Committee

Submitted by

Scott Bishop
Senior Vice President for Legislative Advocacy
The Hospital and Healthsystem Association of Pennsylvania (HAP)

Harrisburg, Pennsylvania

April 18, 2018

Chairman Mustio, Chairman Readshaw, thank you for inviting The Hospital and Healthsystem Association of Pennsylvania (HAP) to submit this written statement regarding House Bill 789.

HAP does not support House Bill 789 because it would amend the Medical Practice Act of 1985 (a physician scope of practice act intended to regulate physicians) to regulate physician/nurse interaction in a hospital facility. Hospitals are regulated by the Department of Health under the Health Care Facilities Act and the regulations promulgated in accordance with that statute.

House Bill 789 conflicts with this process by placing a single issue––related to the role certified registered nurse anesthetists (CRNA) play in a hospital setting––under the purview of both the State Board of Medicine and the Pennsylvania Department of Health. This could lead to inconsistent and conflicting oversight of these health care practitioners in hospitals.

House Bill 789 also is not necessary because the issue of how anesthesia is administered in a hospital setting is already addressed by Section 123.5 in Chapter 123 in Title 28 of the Pennsylvania Code. Further, the bill seemingly conflicts with Section 21.17 in Chapter 21 of Title 49 (Professional and Vocational Standards), which regulates nurse practice and does allow CRNAs to function in cooperation with and under the direction of physicians.

As is the case with any legislative effort to place a current standard of care or best practice relating to patient care into statute, hospitals believe the General Assembly should tread very carefully because standards of care and best practices in patient care are constantly evolving, advancing, and improving.

While Section 123.5 of the current hospital regulations calls for a specific relationship between physicians and CRNAs, cementing the language in statute would be in direct conflict with national trends to advance a more collaborative approach between physicians and CRNAs.

Collaboration does not mean physicians abrogate their responsibilities to a patient, or that nurses usurp the role of a physician. Rather, collaboration means both physicians and CRNAs operate to the full scope of their license and training to provide patients with the very best in care.

Ultimately, a stronger collaborative approach enables access to anesthesia and other important services in smaller and rural communities and engenders more timely and appropriate response to care needs in these communities. House Bill 789 could prevent Pennsylvania hospitals from following the practices in the evolving team approach to care and the relationship between CRNAs and physicians in patient care.

Thank you again for allowing HAP to share why Pennsylvania hospitals do not support House Bill 789.


Topics: Regulatory Advocacy, State Advocacy, Workforce

Revision Date: 4/18/2018

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