Summary: Safe anesthesia care in VA is again at risk, with the combined threat of the VA's existing "Stone Memo" and the new "supremacy initiative," where VA declared federal supremacy over state licensure and scope-of-practice laws. Find resources below to preserve safe care for Veterans.
Last year, during the height of the pandemic, prior to his recent resignation, former Acting VA Under Secretary for Health, Richard Stone, M.D. issued a memorandum (“Stone Memo”) that put a process in place to change how anesthesia is delivered in VA, from an anesthesia team model (physician anesthesiologist working with Certified Registered Nurse Anesthetists (CRNA)) to a CRNA, nurse-only model.
Now, VA is in the process of undertaking a new Federal Supremacy Initiative. This initiative was announced last November through an Interim Final Rule and requires VA to “standardize” care through new VA-only “national standards of practice” for all health professionals who work in VA facilities. Under the federal supremacy initiative, VA will supersede established state health care practice laws and regulations – the vast majority of which represent a higher standard of care.
Under VA’s new federal supremacy initiative, the Stone Memo could become permanent and subvert the previous federal rulemaking that affirmed physician-led, team-based anesthesia care, unless we act quickly. To safeguard Veterans’ health and lives, and to ensure that Veterans continue to receive high-quality anesthesia care in VA facilities, ASA members are urged to advocate for safe anesthesia care in VA by engaging Congress and VA Secretary McDonough. Our Veterans have earned and deserve the best care, and your engagement is needed to ensure that physician-led anesthesia care is maintained in the VA.
Following are resources developed to make your engagement with your Congressional Representatives and Senators successful. Please contact [email protected] with any questions.