Virginia AA Bill

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blockstar said:
Both house have passed AA legislation in the great state of Virginia. With a supermajority in both houses.

LIS

lis.virginia.gov lis.virginia.gov
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It’s weird. Some states like South Carolina it’s 1:2

And some states like Florida ifs 1:4 AA

What’s the virginia proposal?
 
secretasianman said:
Why is 1:3 never thrown around? Should be a standard.
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1:4 max is the CMS guideline for medical direction. Any lower statutory ratio is a handicap. No sense in legislating a lower max ratio than CMS. If the group wants to run lower ratios that can be decided locally.
 
Are they legally max ratio of 1:2? This is likely from CRNA advocacy I would imagine; it's essentially dead in the water with that ratio at most places. It also is going to be hard to change the law after it's already set, really limiting it getting off the runway. Local ASA chapters need to get on this, unfortunately the nurses working 2-3 days a week have a lot more time for this.

Washington recently allowed AAs...the CRNAs are smart, can't say 'we don't want a competing person who can do the same job' when there's a national shortage. Apparently they pushed really hard with lawmakers to allow them to supervise AAs, didn't pan out. Even lawmakers understand having a nurse supervise someone during surgery would be a total PR nightmare with one bad outcome in the newspapers.

Good for the local people in VA who made this happen, open up the market and let the chips fall where they may


Action Needed to Stop AAs and End Supervision of CRNAs - Virginia Association of Nurse Anesthetists

We need urgent action from our Virginia CRNAs on legislation in the General Assembly. Please contact your legislators today and tell them to: Support HB 2287 – which ends supervision for CRNAs in Virginia! Oppose HB 1925 & SB 1342 – which allows AA’s to practice in Virginia. We need[...]
virginiacrna.org virginiacrna.org
 
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Maverikk said:
Are they legally max ratio of 1:2? This is likely from CRNA advocacy I would imagine; it's essentially dead in the water with that ratio at most places. It also is going to be hard to change the law after it's already set, really limiting it getting off the runway. Local ASA chapters need to get on this, unfortunately the nurses working 2-3 days a week have a lot more time for this.

Washington recently allowed AAs...the CRNAs are smart, can't say 'we don't want a competing person who can do the same job' when there's a national shortage. Apparently they pushed really hard with lawmakers to allow them to supervise AAs, didn't pan out. Even lawmakers understand having a nurse supervise someone during surgery would be a total PR nightmare with one bad outcome in the newspapers.

Good for the local people in VA who made this happen, open up the market and let the chips fall where they may


Action Needed to Stop AAs and End Supervision of CRNAs - Virginia Association of Nurse Anesthetists

We need urgent action from our Virginia CRNAs on legislation in the General Assembly. Please contact your legislators today and tell them to: Support HB 2287 – which ends supervision for CRNAs in Virginia! Oppose HB 1925 & SB 1342 – which allows AA’s to practice in Virginia. We need[...]
virginiacrna.org virginiacrna.org
Click to expand...

To my knowledge the only jurisdiction that placed a 1:2 ratio on CAAs was South Carolina, and as you mentioned it has been a pain to switch to 1:4 since then. I think Florida actually passed their law at 1:2 back in 2004/2005 but the law granted an automatic process to increase to 1:4 after a certain period of time as guided by the Florida Board of Medicine, so there was no legislative involvement needed.
 
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Maverikk said:
Are they legally max ratio of 1:2? This is likely from CRNA advocacy I would imagine; it's essentially dead in the water with that ratio at most places. It also is going to be hard to change the law after it's already set, really limiting it getting off the runway. Local ASA chapters need to get on this, unfortunately the nurses working 2-3 days a week have a lot more time for this.

Washington recently allowed AAs...the CRNAs are smart, can't say 'we don't want a competing person who can do the same job' when there's a national shortage. Apparently they pushed really hard with lawmakers to allow them to supervise AAs, didn't pan out. Even lawmakers understand having a nurse supervise someone during surgery would be a total PR nightmare with one bad outcome in the newspapers.

Good for the local people in VA who made this happen, open up the market and let the chips fall where they may


Action Needed to Stop AAs and End Supervision of CRNAs - Virginia Association of Nurse Anesthetists

We need urgent action from our Virginia CRNAs on legislation in the General Assembly. Please contact your legislators today and tell them to: Support HB 2287 – which ends supervision for CRNAs in Virginia! Oppose HB 1925 & SB 1342 – which allows AA’s to practice in Virginia. We need[...]
virginiacrna.org virginiacrna.org
Click to expand...
Its only 1:2 in SC. It took one legislator in a small area to kill the bill that would have made it 1:4.

They still have employment opportunities here at a couple of the bigger hospitals and a school is opening in the Upstate so hopefully Anesthesiologists back them up more next go around.
 
The aana lies, “Currently, AAs do not practice in Virginia, due in large part to their scarcity. There are only about 3,000 AAs practicing in the entire country. AAs have a limited role and would be required to be supervised by a specific type of physician—anesthesiologists—in order to practice”

I find it hard to believe 3000 AA…I looked it up. Something Iike 150k AAs in USA?
 
aneftp said:
The aana lies, “Currently, AAs do not practice in Virginia, due in large part to their scarcity. There are only about 3,000 AAs practicing in the entire country. AAs have a limited role and would be required to be supervised by a specific type of physician—anesthesiologists—in order to practice”

I find it hard to believe 3000 AA…I looked it up. Something Iike 150k AAs in USA?
Click to expand...
The truth is whatever you can get people to believe
 
aneftp said:
We all know the AANA and the rest of the arnp organizations just want to be in equal footing as doctors.

Life is about short cuts.
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We have had partners in our group on the board of the Nevada Society of Anesthesiologist for well over a decade. It has not been an easy task to get here and the AANA continues to lie and be deceitful to our state legislators. It is a job that has zero finances tied to it and it’s a lot of work.
 
So how do anesthesia groups navigate employing AA's without pissing off CRNAs? should the employ one or the other? Could definitely see some tension in groups with both AAs and CRNAs.
 
AppTrail said:
So how do anesthesia groups navigate employing AA's without pissing off CRNAs? should the employ one or the other? Could definitely see some tension in groups with both AAs and CRNAs.
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i wouldnt concern myself with their opinion personally
i think as long as the crna gets out at 3pm and makes market rate they dont care about anything else
AAs would be amazing if it catches on in other states
I think that would really help decrease cost of services while also preserving quality and safety
 
AppTrail said:
So how do anesthesia groups navigate employing AA's without pissing off CRNAs? should the employ one or the other? Could definitely see some tension in groups with both AAs and CRNAs.
Click to expand...
There was a thread a while back about a group that was bringing in their first AAs and the crnas tried to revolt, threatened to leave, etc. In the end they only crnas that left were the ones they were glad to lose anyway. They'd hired on some more AAs and everything going well.

I think the proof is in the pudding. You hire them, some crnas will lose it and leave, but you'll easily make up for the attrition with a new hiring pool that is generally WAY easier to work with. Even if they all leave, you can replace them entirely with AAs.

It seems like having too much of a majority of one or the other could be hard for the minority in the group, but I'd imagine people would get over it pretty quickly.

Our group hires only AAs. It's great!
 
Deregulation of the medical industry with the current administration could likely mean more independent practice from CRNAs. I wouldn’t be surprised if we see CRNAs supervising AAs in the next decade. The only thing keeping our status quo is regulation. That can be stripped away at any point.
 
GravelRider said:
Deregulation of the medical industry with the current administration could likely mean more independent practice from CRNAs. I wouldn’t be surprised if we see CRNAs supervising AAs in the next decade. The only thing keeping our status quo is regulation. That can be stripped away at any point.
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AAs would need to fall under nursing with state boards.
 
aneftp said:
AAs would need to fall under nursing with state boards.
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Doesn’t seem like a hard regulation to unravel. That’s the thing, most anesthesiologists don’t realize how rickety the edifice of our profession is. It’s entirely reliant on regulations that can be undone with the swipe of a pen. If an administration…whether state or federal…is looking to create more efficiency in the healthcare system, anesthesia services is definitely one area to tackle. Don’t pretend that it isn’t.
 
GravelRider said:
Doesn’t seem like a hard regulation to unravel. That’s the thing, most anesthesiologists don’t realize how rickety the edifice of our profession is. It’s entirely reliant on regulations that can be undone with the swipe of a pen. If an administration…whether state or federal…is looking to create more efficiency in the healthcare system, anesthesia services is definitely one area to tackle. Don’t pretend that it isn’t.
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The board of medicine regulars docs
The board of nursing regulates arnp like crna.

What board regulates AAs? The board of medicine.

It would take a crazy shift in power to have AAs under the board of nursing.

This is not something like the governor will approve crnas to be independent and the board of nursing rubber stamps it.
 
GravelRider said:
Doesn’t seem like a hard regulation to unravel. That’s the thing, most anesthesiologists don’t realize how rickety the edifice of our profession is. It’s entirely reliant on regulations that can be undone with the swipe of a pen. If an administration…whether state or federal…is looking to create more efficiency in the healthcare system, anesthesia services is definitely one area to tackle. Don’t pretend that it isn’t.
Click to expand...
Exactly, just look at PA independence movements in various states.
 
aneftp said:
The aana lies, “Currently, AAs do not practice in Virginia, due in large part to their scarcity. There are only about 3,000 AAs practicing in the entire country. AAs have a limited role and would be required to be supervised by a specific type of physician—anesthesiologists—in order to practice”

I find it hard to believe 3000 AA…I looked it up. Something Iike 150k AAs in USA?
Click to expand...

~4,000 people currently.
 
Correct only around 4000. 50,000 CRNAs. AAs couldn’t replace CRNA’s in Florida let alone the USA. This legislation is pretty meaningless unless they can increase numbers 5 fold

www.beckersasc.com

The anesthesia workforce in 2025: 4 numbers to know - Becker’s ASC

"Discover the latest report from the American Society of Anesthesiologists on the number of Medicare-paid anesthesia professionals in the workforce, including a
www.beckersasc.com www.beckersasc.com
 
aneftp said:
The aana lies, “Currently, AAs do not practice in Virginia, due in large part to their scarcity. There are only about 3,000 AAs practicing in the entire country. AAs have a limited role and would be required to be supervised by a specific type of physician—anesthesiologists—in order to practice”

I find it hard to believe 3000 AA…I looked it up. Something Iike 150k AAs in USA?
Click to expand...
There's actually a little over 4,000 practicing CAAs in the US. But the number grows every year. We're graduating over 400 students per year and that number keeps going up as more programs start up. There are currently 23 accredited programs and at least three more in active development.
 
jwk said:
There's actually a little over 4,000 practicing CAAs in the US. But the number grows every year. We're graduating over 400 students per year and that number keeps going up as more programs start up. There are currently 23 accredited programs and at least three more in active development.
Click to expand...
I thought there were more. Good to know
 
AppTrail said:
So how do anesthesia groups navigate employing AA's without pissing off CRNAs? should the employ one or the other? Could definitely see some tension in groups with both AAs and CRNAs.
Click to expand...
My group has had both for nearly 40 years so we're way past the political disagreements. Strong physician group leadership is the key. You're the boss, you make the rules, Period. If you're already a medically directed practice, there should be no difference in job descriptions/scope of practice or compensation for comparably experienced CAAs or CRNAs.

CRNAs frequently will threaten to leave if CAAs are hired. Leaving the illegal anti-competitive nature of that threat aside, most of the time it's just talk. Why would they leave a perfectly good job, potentially uproot their family, etc., just to make a political statement. .

caligas said:
gotcha. I just wonder if there’s some medical board BS it has to pass or something
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The medical board will still typically have to write the actual regs, design an application form, decided which of their professional staff will deal with CAA applications, etc. It's not unusual for that to take a year, which is what happened in Nevada. The first CAAs in Las Vegas started in the last 6-8 months. Washington state is still working on their administrative process.

As we continue to move into more states, what will frequently happen is a CAA program will be opened in that new state. That happened in Florida, Indiana, and now South Carolina. More are on the way and I would not be at all surprised to see them pop up in Nevada and Washington. It's the quickest way to get CAAs into the state.
 
GravelRider said:
Deregulation of the medical industry with the current administration could likely mean more independent practice from CRNAs. I wouldn’t be surprised if we see CRNAs supervising AAs in the next decade. The only thing keeping our status quo is regulation. That can be stripped away at any point.
Click to expand...
It'll never happen.
 
jwk said:
CRNAs supervising CAAs will never happen.
Click to expand...

Never is a definitive thing to say in a world where the rules are just writings on paper and can be changed with similar writings on paper. In any case, the spirit of my post remains true. An environment of deregulation would benefit CRNAs because our standing as anesthesiologists is based solely on regulations.
 
Howard888 said:
Correct only around 4000. 50,000 CRNAs. AAs couldn’t replace CRNA’s in Florida let alone the USA. This legislation is pretty meaningless unless they can increase numbers 5 fold

www.beckersasc.com

The anesthesia workforce in 2025: 4 numbers to know - Becker’s ASC

"Discover the latest report from the American Society of Anesthesiologists on the number of Medicare-paid anesthesia professionals in the workforce, including a
www.beckersasc.com www.beckersasc.com
Click to expand...
Yes, but one of the reasons they aren’t growing is because they have a limited number of states to practice in. Fix that and more people will consider going the AA route, more programs can open, etc.
 
Howard888 said:
Correct only around 4000. 50,000 CRNAs. AAs couldn’t replace CRNA’s in Florida let alone the USA. This legislation is pretty meaningless unless they can increase numbers 5 fold

www.beckersasc.com

The anesthesia workforce in 2025: 4 numbers to know - Becker’s ASC

"Discover the latest report from the American Society of Anesthesiologists on the number of Medicare-paid anesthesia professionals in the workforce, including a
www.beckersasc.com www.beckersasc.com
Click to expand...
If the CRNAs would stop opposing us we'd have been in 50 states decades ago. But they're scared of the competition, both CAA and physician, so they are at war on two fronts. So we go state by state. Quite a few are in play this year. Virginia was just the first for 2025.

We have increased the numbers of programs drastically in the last 6-7 years. We're now at 23 accredited programs, with several others ramping up, and several others in the planning stages. The only way to increase the number of CAAs is to train more. We're doing that. In the next year or so we'll be graduating 500 students per year, not an insignificant number, and that number will continue to grow as even more programs get started.

We don't have any problem attracting students. And job placement of graduates is, and has been, 100%.
 
jwk said:
If the CRNAs would stop opposing us we'd have been in 50 states decades ago. But they're scared of the competition, both CAA and physician, so they are at war on two fronts. So we go state by state. Quite a few are in play this year. Virginia was just the first for 2025.

We have increased the numbers of programs drastically in the last 6-7 years. We're now at 23 accredited programs, with several others ramping up, and several others in the planning stages. The only way to increase the number of CAAs is to train more. We're doing that. In the next year or so we'll be graduating 500 students per year, not an insignificant number, and that number will continue to grow as even more programs get started.

We don't have any problem attracting students. And job placement of graduates is, and has been, 100%.
Click to expand...

Facts, I would like to see more CAAs around - practicing with them I find them to be more astute, initially have the better mind set unless they are corrupted by CRNAs lol and show more reliability and responsiveness.
 
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