Sadly - but not unexpectedly - the Senate Health Policy Committee approved HB 4359 for CRNA "independence" by a vote of 7-3. They did pass a slightly modified bill which requires a CRNA to have 3 years of experience OR a "doctorate" degree (which they all soon will be graduating with as we know and is utterly meaningless). Further the CRNA has to be a part of a "Care Team" but that's just idiotic window dressing to make the senators think they can sleep at night - the "Care Team" is not supervising the CRNA. Lastly the substitution calls for CRNAs to carry "malpractice insurance" but no explanation or requirements are elaborated in the bill.
From Gongwer News Service - Michigan:
Sen. John Bizon on Thursday said he could not support a House bill voted out of the Senate Health Policy and Human Services Committee Trackas it would lower the level of care for Michigan residents receiving surgical anesthesia while also adding the measure is "crazy" and "insane."
HB 4359 would modify the scope of practice for certified registered nurse anesthetists. Under the bill, a CRNA would be able to develop a plan of care, perform all patient assessments, procedures and monitoring to implement that plan as well as provide the authority to administer prescription drugs or controlled substances.
It was the subject of divided testimony during a previous meeting of the committee (See Gongwer Michigan Report, May 27, 2021), which reported the bill Thursday with S-3 substitute 7-3. Sen. Kim LaSata (R-Bainbridge Township) and Sen. Sylvia Santana (D-Detroit) joined Mr. Bizon in voting no.
While it passed the House in late March, HB 4359 saw groups divided on the bill as the chamber prepared for a vote (See Gongwer Michigan Report, March 23, 2021).
Before the committee voted to report HB 4359, Mr. Bizon, a Republican from Battle Creek and a retired physician, said that the sponsors and various committees have worked with advocates on both sides but have yet to gain input from the residents of Michigan. As a Senate committee that is a gatekeeper of pending health policy, Mr. Bizon said reporting and passing this bill would fail them.
"When applied to level one trauma centers, which this does, it can only be described as being insane to get rid of an anesthesiologist, for someone who is trauma one level patient, that has significant trauma, is crazy," Mr. Bizon said. "Lowering the bar to the lowest common denominator may be great for profits, but it is terrible for the care of our constituents. Nurses are not doctors. Their training differs and the courts agree and hold the professions to a different professional standard and different professional liability."
Requiring malpractice insurance, as the bill prescribes, does not change the fact that the problems addressed by the bill, and Mr. Bizon said that could be better handled through the wider use of telemedicine.
"This is one of the lessons that we have learned and that we are moving to in all other fields of medicine, except apparently in anesthesia," he said. "We have learned how to work better oftentimes from home, and we should learn from our experiences with this pandemic and push forward with good policy for our citizens. This current version of the bill is not that. Telemedicine could address access even in rural communities and make it much easier to extend the reach of medicine throughout the entirety of this state."
In a statement, the Michigan Society of Anesthesiologists shared Mr. Bizon's sentiments.
"We are deeply disappointed the Senate Health Policy and Human Services Committee Trackignored patient safety concerns and advanced irresponsible legislation that will dismantle anesthesia care teams and put lives at risk," said Dr. Neeju Ravikant, president of the Michigan Society of Anesthesiologists. "House Bill 4359 jeopardizes the health and safety of Michigan patients, provides zero cost savings to taxpayers and threatens to increase health care costs at a time when Michiganders can least afford it. We urge the full Senate to wake up and see HB 4359 for what it is: dangerous and reckless legislation that will compromise patient safety and make it harder for doctors with the training and expertise to respond to life-threatening emergencies to do their jobs."
Dr. Pino Colone, president of the Michigan State Medical Society, in a statement also said the vote undermines patient care.
. One can only dream.
pubs.asahq.org
www.legislature.mi.gov
