House and Senate Committees Pass Appropriations Bill with Nursing Handbook Language

Last week, the House and Senate Appropriations Committees passed FY2017 Military Construction, Veterans Affairs, and Related Agencies (MilCon-VA) Appropriations Bills, including report language concerning the proposed VHA Nursing Handbook and the independent practice of advanced practiced registered nurses (APRNs) within the Department of Veterans Affairs (VA). This is the third year that these appropriations bills have included report language raising concerns about the VHA Nursing Handbook proposal, which would remove physician anesthesiologists from Veterans’ anesthesia care.  The report language for both the House and Senate bills is listed below.  Once these bills have been considered by both the House and Senate, the next step will be to work out differences in the report language.   ASA continues to monitor this legislation and will keep members posted as the process moves forward.

Simultaneously, The VA Nursing Handbook is expected to be released soon by the Office of Management and Budget (OMB) as a proposed regulation.  ASA members are strongly urged to submit personalized comments opposing any change to physician-led anesthesia care for Veterans at www.SafeVACare.org and encourage their friends and family to also participate.

In the U.S. Senate, report language reads:

“Nursing Handbook. – The Committee is aware the VHA Nursing Handbook is under review at OMB as part of a VHA proposed rule.  The Committee understands this proposed rule will directly conflict with the anesthesia team based care language as set forth in the current VHA Anesthesia Service Handbook.  The Committee strongly encourages VHA to carefully and thoughtfully seek additional input from internal and external stakeholders prior to any VHA final rule that would seek to dismantle team-based anesthesia care.  The Committee believes all possible outreach efforts should be used to communicate the changes contained in the proposed rule, gather public comment, and collaborate with Congress, affected stakeholders, VA physician and nursing staffs, and external organizations. The VA should also consider the benefits to veterans of having more VA healthcare staff able to provide services at the full scope of their training and how this will affect veterans, particularly in rural communities. The Committee also requests VHA ensure any VHA handbooks and policies adopted by rule not conflict with other handbooks and policies already in place within VHA."

In the U.S. House of Representatives, report language reads:

“Nursing full practice authority.--The Committee understands that VHA will soon publish a proposed regulation to recognize the full practice authority of advanced practice registered nurses working at VHA. The Committee encourages VHA to seek input from appropriate external professional stakeholders and to give consideration to the policies of existing Handbooks, prior to publishing the final regulation. The Committee believes all possible outreach efforts should be used to communicate the proposed changes, to gather public comment, and to collaborate with Congress, stakeholders, VA medical staff, and external organizations.” 

Read about the ASA-supported, Congressionally-passed language from last year here: http://www.asahq.org/advocacy/fda-and-washington-alerts/washington-alerts/2014/12/senate-joins-house

Read more about the vote in the Senate Committee vote here: http://www.appropriations.senate.gov/news/majority/senate-appropriations-committee-approves-fy2017-milcon-va-bill- 

Read the text of H.R. 4974 here: https://www.congress.gov/bill/114th-congress/house-bill/4974?q=%7B%22search%22%3A%5B%22military+construction+and+veterans+affairs%22%5D%7D&resultIndex=1

Read more about the vote in the House Committee vote here: http://appropriations.house.gov/news/documentsingle.aspx?DocumentID=394491