Download this proposal as a PDF.

Commenting for this proposal will be open until the close of business on Monday, June 5.

Title of Proposal:

Licensure of Certified Anesthesiology Assistants

On behalf of:       

Virginia Society of Anesthesiologists

Describe the Idea or Issue:

The Virginia Society of Anesthesiologists (VSA) requests that the Medical

Society of Virginia advocate for a bill permitting the licensure of certified anesthesiologist assistants (CAAs) in the Commonwealth during the 2018 General Assembly Session.

Desired Outcome:

The VSA requests that the Medical Society of Virginia advocate for a bill permitting the licensure of CAAs in the Commonwealth during the 2018 General Assembly Session. This is an issue that should be important to the House of Medicine, not just to anesthesiologists, because it impacts:

  • Provider shortages
  • Access to care
  • Economic efficiencies and optimization
  • Selection of mid-level practitioner to best suit patient needs

Licensure of CAAs would help alleviate all of these issues, so we are seeking the support of the entire community of medicine in this endeavor.

Background/Supporting Information:

CAAs are highly skilled health professionals who work under the direction of licensed physician anesthesiologists to implement anesthesia care plans. All CAAs possess a premedical background, a baccalaureate degree and complete a comprehensive didactic and clinical program at the master’s level.

CAAs work exclusively within the anesthesia care team environment and, unlike nurse anesthetists; they must be supervised by a physician anesthesiologist.

Eighteen jurisdictions as well as the District of Columbia currently regulate CCAs. Virginia is surrounded by other states that have already adopted the CAA approach (North Carolina, Washington, D.C., Kentucky and Ohio).

There are 10 accredited CAA educational programs in the U.S. There are nearly 2,000 CAAs already practicing throughout the nation.

Eighteen jurisdictions as well as the District of Columbia currently regulate CCAs. Virginia is surrounded by other states that have already adopted the CAA approach (North Carolina, Washington, D.C., Kentucky and Ohio).

CAA students currently rotate through Virginia hospitals, but must go elsewhere to work when they finish training. There are currently about a dozen CAAs who reside in Virginia but travel to work elsewhere (including Arlington, Alexandria, Danville, Fort Royal and Williamsburg).

Anesthesiologists are the only physicians in the Commonwealth with only one physician-extender option (nurse anesthetists). CAAs would provide an additional choice of physician-extenders for anesthesiologists who adhere to the Anesthesia Care Team model of patient care.

CAAs are recognized by CMS, Tricare and all major commercial payers. Data from the Bureau of Labor and Statics shows that the cost of nurse anesthetists decreases in the states with the highest number of CAAs:

Mean Wage

Nationwide Rank in CAA Employment

  • Georgia - $137,940 - 1
  • Florida - $143,870 - 2
  • Ohio - $152,310 - 3
  • Texas - $161,740 - 4
  • Missouri - $151,330 - 5
  • Virginia - $171,160 - None

*Note – Texas is likely still above average because the 130 CAAs don’t compete significantly with the 32,000 nurse anesthetists statewide.

The VSA has been studying CAAs for several years, and has watched with interest as other states have adopted CAA licensure. The VSA surveyed its members in August of 2015, and found that:

  • 88% of its members thought that having CAAs as an available physician extender alternative to nurse anesthetists would be a good for anesthesiologists in Virginia.
  • 74% of members said that their current practice would use at least one CAA as an alternate physician extender.
  • 42% of members said that their current practice would use more than five CAAs as an alternate physician extender.

The Virginia Department of Health Professions is currently evaluating the feasibility of state licensure for CAAs. The Virginia Society of Anesthesiologists plans to pursue legislation licensing CAAs during the 2018 Genera Assembly Session.

Additional background materials in appendix.

Comments

I am writing to support Proposal 20: licensure of CAAs.  I think this is a worthwhile endeavor and a good option for many practices across the state.

I think Virginia would greatly benefit from the widespread use of CAAs working under the supervision of Anesthesiologists.

I think Virginia would greatly benefit from the widespread use of CAAs working under the supervision of Anesthesiologists.

The time has come for these individuals to be granted a right to work in the Commonwealth of Virginia. We face a shortage of qualified individuals that are capable of extending the care provided by Anesthesiologists. This is especially true in rural areas. 

 

I have worked with anesthesiology assistants for 9 years now at Children's National and have been amazed by their skills, their professionalism and dedication to their job. Their ability to practice in Virginia would help fill a practitioner shortage and would improve patient care in areas of need

 

As a licenced CAA working in DC and who was born and raised in the DMV I absolutely support the licensure of CAAs in Virginia.  It is well known that there is a shortage of anesthesia providers in the state and believe that the introduction of CAAs will only help the citizens of Virginia.  I strongly urge you to consider and support the passing of the bill licensing CAAs

I support CAAs being licensed in VA because my daughter is one of those competent anesthesia practitioners who lives in VA but has to work in DC because she is not allowed to work in Virginia. She deserves the right to work where she lives. Thank you for listening!

My daughter is a CAA and must go to another state in order to work.  Our entire family lives in Virginia and she can't work anywhere in the state.

Also, CAAs are a well qualified and valuable resource for medical teams - they lower costs and increase the ability of anesthesiologist to serve more patients.  Both of those things seem like pretty good ideas to me. 

 

My daughter is a CAA and must go to another state in order to work.  Our entire family lives in Virginia and she can't work anywhere in the state.

Also, CAAs are a well qualified and valuable resource for medical teams - they lower costs and increase the ability of anesthesiologist to serve more patients.  Both of those things seem like pretty good ideas to me. 

 

 My name is Nicole Cabell, I am a recent graduate from an Anesthesiologist Assistant program and am currently a Virginia resident. As of now I have to go out of state, into the District of Columbia, for work. I would love the opportunity to work in my home state of Virginia and therefore have less time commuting and more time to spend with family and loved ones as well as fill some of the needs of the Virginia community. I fully support the proposal for CAA licensure in Virginia and ask that the MSV continues to support the proposal for CAA licensure. 

I am in favor of licensing CAAs.  I have personal experience with them and find them well-educated and reliable.

I absolutely support the Virginia Society of Anesthesiologists proposal to license Certified Anesthesiologist Assistants (CAA's) in the great state of Virginia.  I have worked as a CAA for 20 years and would love to return to my home state; I was born and raised in Manassas, VA.  Licensure of CAA's in Virginia makes practical and economic sense for the health and well being of Virginians.  I'd like to thank the VSA and the Medical Society of Virginia for their support of this proposal.  

I am a CAA currently practicing in DC. I am a-resodent of VA  and would like to support licensure in VA.  Thank you. 

I am a Virginia resident and I wish to be able to return home in Virginia to work full time. I support the license of CAAs in VA and wish that the medical society would continue its efforts to make this possible. 

My name is Abigial Moore and I am currently a second year Anesthesiology Assistant student studying at Case Western University's AA program in Washington, DC. I am writing today to add my support for the bill to allow CAAs to be liscensed to work in Virginia. As a student soon to be looking for places of employment, I would like to see more states, especially a neighboring one, allow CAAs the ability to practice. This would allow us to provide Virginia residents more access to quality anesthesia care as we contribute to the anesthesia care team model. By supporting CAA liscensure, you are supporting safe and quality care for your consituents. It is for these reasons that I ask you to support this bill for CAA liscensure in Virginia. Thank you.

CAAs will provide effective and safe anesthesia care in Virginia as they do in other states.

I am a DC resident interested in seeing a neighboring state of Virginia to open so I can expand my practice outside of the DC area. I support the VSA's proposal for CAA licensure in VA and I request that the Medical Society of Virginia continue to support the proposal for CAA licensure.

I work at a number of ambulatory surgery centers in Virginia as Chief Medical Officer for our ambulatory anesthesia group where we use the team model with CRNAs.  In the ASC, we have a fast pace and need experienced providers to provide the kind of care that we expect.  I have recently had the experience of starting a new ASC in Washingon, DC where I have employed a number of CAAs along with CRNAs.  I can say that my experience directing CAAs and been a pleasure.  The individual CAAs have been competent, motivated and have taken direction well.  Because we have the ability to hire CAAs in DC, we have been able to ramp up operations quickly and efficiently.  Although my experience working with CAAs is limited to a few months, I believe that having the ability to hire CAAs in Virginia will greatly aid in staffing, especially in areas that are traditionally more difficult to staff in my experience due to geographic and other considerations.

I would like to leave a very brief comment. Our group has made offers to 5 physicians to join our anesthesia group with a 1-year to partner offer. Four declines and one still deciding. Therefore, we have had to increase the number of CRNAs. It is expected this trend will continue with retirements exceeding new graduates.

Hiring additional CRNAs itself has been difficult. Their shortage is resulting in a bidding war. We had one CRNA who resigned a few days before he arrived. He did work out his month required notice but he was to return to his prior job after a substantial increase in salary. My guess is that the other anesthesia groups are also having trouble recruiting physicians and are also attempting to increase the number of CRNAs.

One more resignation and we will have to go to working the day after call – which in anesthesia is clearly associated with an increase in Critical Events. In simulator studies, the performance hit is worse than 0.08 ETOH level after 24 hours continuous duty. Therefore, this is less a financial issue and more a safety issue. People just make more errors when pushed too hard. We need the CAAs to simply maintaining the numbers of Anesthetizing Locations and to be able to keep a sane and safe work schedule, much less accede to the hospital’s request for additional staffing.

I am a retired Virginia physician who practiced 47 years in Manassas.  I strongly recommend the MSV, of which I am  member, advocate Prosposal 20 CAA licensure.  My son, John Gower CAA lived in Front Royal VA for 3 years while working at Providence Hospital in Washington, DC. but had to move to Toledo, Ohio.  Using CAA 's gives better patient care and cost effectiveness.

I am a VA resident and I support VSA's proposal for CAA licensure in VA. Please so continue to support this proposal.

I am a VA resident and I support VSA's proposal for CAA licensure in VA. Please so continue to support this proposal.

I am commenting in support of the Virginia Society of Anesthesiologist’s proposal for licensure of Certified Anesthesiologist Assistants in Virginia.  I ask that the Medical Society of Virginia support this effort. I reside in Alexandria Virginia and I am forced to leave the state to practice. Please support our efforts to increase the availibility of qualified anesthesia providers in Virginia.

Please support the licensure of Certified Anesthesiologist Assistants.  I am a Virginia resident and I should have the right to choose from all anesthesia providers. 

1.  I am an Virginia resident who has to go out of state to work.  I aspire to work in the state that I live in.

2. I support the VSA proposal for CAA licensure in Virginia 100%.

3. Request that the MSV continues to support the proposal for CAA licensure

I live in Reston VA and I strongly support the licensure for CAAs in VA.  I believe this will provide better medical care for patients as well as provide solutions to address some of the issues anesthesiologists are currently faced with in VA.

I am a Virginia resident and have been for most of my life.  However I am currently doing locum tenens work as an anesthesiologist assistant in other states because I cannot work in Virginia.  If the legislation was changed I would be very eager to work near my family in southwest Virginia.  I support the VSA's proposal for CAA licensure in Virginia. I hope that the MSV will continue to support the proposal for CAA licensure.

I am a Virginia resident (Reston, VA) and I support licensure of Certified Anesthesiology Assistants (CAAs) to enable them to practice in the state of Virginia. Among other benefits of doing this, I believe the most important benefit to the public would be addressing the provider shortage, thereby increasing access to care.

My name is Christopher Leung and I have been a certified anesthesiologist assistant for 3 years and a former resident of Alexandria, VA. Because I am unable to provide anesthetic care for patients in the state of Virginia without licensure, the only local opportunity to practice is in the District of Columbia.  While patiently enduring the VA/DC highway traffic daily, I often contemplated whether to relocate within the District. This decision was not easy and currently, I am a resident of DC. Please provide continued support proposal #20 for the licensure of anesthesiologist assistants so we can expand our practice into Virginia. Thank you.

I support the VSA request that the Medical Society of Virginia advocate for a bill permitting licensure for CAAs in the Commonwealth of Virginia.

Allowing Anesthisiolgist Assistances (AA's) to practice in Virginia is a common sense approach to expanding safe, affordable and effective health to all Virginians.  As a government affairs professional who has represented a number of healthcare providers the oppostion to this common sense inititive is nothing more than typical scare tactics to protect the bottom line of those currently licensed in this manner.  AA's are extensively educated and qualfiied to provide the services they are trained to do and are already safely and efficiently providing those services to residents of Virginia in areas such as Washington DC.  We must stop giving time and consideration to silly oppostion positions but instead think of patients and common sense inititives like licensing AA's in the state of Virginia

Please support Proposal 20

I am a recent graduate from Case Western University's Washington DC Anesthesiologist Assistant Program and I fully support the VSA's proposal for CAA licensure in the state of Virginia. I am currently working full-time in Washington DC and living in Maryland, but I am extremely interested in seeing a neighboring state open licensure for CAAs. My fiance and I are looking to buy a house soon and have been very interested in living in Virginia. Unfortunately, the areas in Virginia we would like to live are too far of a commute to Washington DC, and since CAAs are currently not licensed to practice in Virginia, we have been forced to look elsewhere.  I request that the Medical Society of Virginia continue to support the proposal for CAA licensure.

Pages

Add new comment

CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.