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MCNP and MANA Testify and are Joined by Lawmakers and Others to Advocate for H. 1996/S. 1207

Friday, November 20, 2015  
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Boston: On November 17, 2015 the Joint Committee on Public Health (JCPH) held a hearing on more than forty bills dealing with "Scope of Practice and Professional Licensure."  Of those, H. 1996/S. 1207 An Act to Remove Restrictions on the Licenses of NPs and CRNAs as Recommended by the Institute of Medicine and the Federal Trade Commission, was heard. Gardener Auditorium at the State House was packed with more than 200 people in attendance, and our bill consumed 1.5 hours of the morning session. 

In the words of New England Patriot's Coach, Bill Belichick, we delivered on all three phases of the game: offense, defense and special teams. In a well-executed game plan, we had powerful panels who:
. Discussed why the change in law for NP and CRNA licensure is needed;
. Addressed the arguments raised by opponents of the bill; 
. Corrected false claims made related to the educational preparation of NPs 
  and CRNAs;
. Voiced opposition to S. 1170, the Mass Medical Society's Team Based Care
  bill, and S. 1163, the APN bill filed by Senator Keenan that has provisions we 
  cannot accept. 

Key legislators appeared throughout the morning session to voice their support, including House Bill Sponsor, Representative Kay Khan, who testified and presented a letter co-signed by 35 representatives urging that the bill get released. Representative Denise Garlick gave her "unequivocal and unwavering" support along with our Senate bill sponsor, Senator Marc Pacheco. Results from a survey obtained by MCNP and MANA related to public perception surrounding our legislation (results which clearly support the removal of restrictive APN practice requirements) were presented by Second Assistant Majority Leader and our house bill sponsor, Representative Paul Donato. And in some of the more lively testimony of the morning, House Speaker Pro-Tempore Representative Pat Haddad, who was also there supporting legislation for optometrists, said "Let's be blunt. This is a turf war...we have had enough ... and this obstruction must stop." 

Nursing and other organizational supporters also testified including the state director of AARP of MA, Dr. Richard Lopez Chief Medical Officer of Atrius Health, Jackie Somerville Chief Nursing Officer of Brigham & Women's Hospital, and President of ANA of Mass Myra Cacace. Additional testimony was given by MCNP and MANA leadership including MCNP President Stephanie Ahmed, MANA President Brian Campbell and MANA Past-Presidents Steve Alves and Bob Gauvin. Countless others testified and submitted written testimony and with many MCNP and MANA members in attendance, the support in the auditorium was palpable.

As anticipated, powerful testimony was also presented by a panel from the Massachusetts Society of Anesthesiologists (MSA) who argued that "when seconds count, an anesthesiologist is the one needed." They suggested that CRNAs do not have the critical skills to handle unexpected complications of anesthesia, and that patients would be harmed if CRNAs are not supervised. When this was challenged by JCPH Chair, Senator Jason Lewis, who asked for the evidence to support this claim, they cited 2 studies, one from 2000 and another from 2013. Senator Lewis also chided them for obstructive practices that prevent CRNAs from exercising their prescriptive authority. To justify this trend, MSA argued that CRNAs using their prescriptive authority would add to the opioid crisis, at which point Senator Lewis quickly admonished them for suggesting this without any evidence. The MSA concluded their testimony by stating that since the decisions made by NPs practicing primary care are less critical and generally allow time for physician consultation, removal of supervision for NPs is less concerning than for CRNAs.

After a long day of testimony and as the hearing was winding down at close to 5 pm, Dr. Hugh Taylor testified for the Massachusetts Medical Society (MMS) and made it clear that the MMS is opposed to our bill in its totality and also opposed to H. 1889, the bill filed by Representative Jennifer Benson, which is about removal of supervision for NPs only. While it had been loosely implied that the Massachusetts Society of Anesthesiologists would be less opposed to splitting our bill for NPs and CRNAs, it is clear that this is only a tactic to divide us and that fierce opposition to both options would remain.

So colleagues, this was a major step, but we are far from done. As you can plainly see from this summary, if we don't educate our lawmakers, those who oppose the bill will be the only voices they hear. 

Our game clock is ticking, as we only have until the end of this legislative session on July 31, 2016 to get this bill passed, and everyone has a role in helping to move our bill along.

Many thanks to all of you who have supported our efforts and continue to do so!. Let's build on the momentum from our hearing and help this energize our work in the months ahead. 

We will keep you updated on the deliberations of the Joint Committee on Public Health and will let you know as soon as we hear their decision regarding our bill. We remain optimistic that it will be released favorably and will continue on in the session.

Please look for updates, action alerts, regional meetings and other ways to get involved and be a part of this history to change the law so patients can have improved access to your care and so that you can practice to the full extent of your education, training and national certification. 

The MCNP and MANA Legislative Team

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