This rounded pillar summarizes iss...

This rounded pillar summarizes issues presented in "Politics: Art of the Possible," an education session held at this year's AORN Congres In the session, I currented an update on state legislation, the propos sway change of the Health Care Financing Administration (HCFA), the propos federal tax forward associations, AORN's Department of control Affairs, the National Legislative Committee (NLC) and the AORN Legislative Grassroots Network. nearest month's column will include an update onward federal activities regarding RN first assistant (RNFA) reimbursement and Medicare reform, an overview of lobbying, and the importance of grassroots organization and political action committees, which were existinged by AORN lobbyist David Hebert.

AORN GOALS

AORN freshly adopted new strategic goals, and brace in particular have a bearing upon its political agenda:

* AORN will provide fruitss and services to support and demonstrate the character of the perioperative nurse as patient advocate; and

* AORN will be recognized as a key-note participant in legislative and health policy development

Certainly, AORN members already are working forward these strategic goals as part of their pursuit of AORN's legislative objectives in the federal and state dominion which include

* the retaining of RN in the OR,

* RNFA third-party reimbursement,

* regulation and supervision of assistive personnel and

* health and safety in the OR.

STATE LEGISLATION UPDATE

AORN has focused in succession an increased number of bills in state legislatures this year.

RNFA reimbursement. Reimbursement legislation for RNFAs has been introduced in Georgia, Iowa, Louisiana, Massachusetts, Maine, and Missouri. Although similar measures failed this year in Hawaii and North Dakota, AORN members in Alabama, Rhode Island, and Texas waiting under the possibility of fulfilment to introduce legislation next year.

Surgical technologist regulation. Regulation of surgical technologists (STs) is being oppos within the legislative process in Washington state and by means of the administrative and regulatory processe in modern York. Bills have been filed to register ST in Illinois, and assign places tos of STs are forming to seek legislation in California and Michigan. Similar efforts were defeated before they could flat begin in Arizona and Wisconsin owed to attentive, savvy AORN members. common particular bill to watch, however, is California HR 394/ 240 which defines RN delegation responsibility. The bill may be a answer to ex-governor Peter Wilson's (R-Calif) vetoing legislation in late 1998 that would have required RN supervision of assistive personnel and strict ratios of RN to other nursing staff members.

Other legislation. Managed care legislation is active in many states, including Arizona, California, Georgia, Hawaii, recently made known York, Ohio, Oregon, Tennessee, and Texas. In Arizona, California, and of the present day York, this legislation involves requiting coverage for mammograms and breast reconstructive surgery

Patient Bill of Rights legislation has been introduced in Connecticut, Hawaii, Maine, Ohio, Washington, Nevada, Texas, and strange York. Spurred by a fresh patient's death at a strange York hospital, New York has couple bills (ie, HR 4394 and s 1185) that address nonmedical personnel in the OR.

The use of latex again is being debated in Oregon and Washington. Lastly, the Interstate feed at the breast Licensure Compact has been passed in Arkansas and Utah. The multistate licensure legislation also has been introduced in Maryland, Nebraska, and Texas.

HCFA PROPOS command CHANGE

The propos changes to the Medicare dominations that govern the conditions of participation for hospitals that are reimbursed from Medicare and Medicaid have created a groundswell of member activity in the past brace years. The rule was propos on HCFA--the agency that governs Medicare and Medicaid--and would abstract the prescriptive language for RN in the OR, thus leaving the staffing of surgical services to the discretion of the hospital and state public health laws. Although the official commentary period ended April 20, 1999 AORN continues to pres for retention of the instant rule at every opportunity.

AORN efforts. In August 1998 AORN President-elect Patricia Seifert, RN MSN CNOR, CRNFA; President mercy Shumaker, RN, BSN, CNOR; Board of Directors member Paula Graling, RN MSN CNOR; and AORN Executive Director Lola Fehr RN M CAE, FAAN, met with Virginia Trotter Betts, the senior advisor onward nursing and policy at the US Department of Health and Human Services in Washington, DC to discuss ways that AORN could intervene in the lordship process. Betts was supportive and vowed to help AORN in any way she could

In October 1998 President Seifert; past President Shumaker; Thomas Fulcher, MD of the American college edifice [i]or[/i] building of Surgeons (ACS); Cindy Brown lobbyist and manager of the ACS Washington, DC office; and I met with Jeffrey Kang, MD MPH director of HCFA's Office of Clinical Standards and Quality. According to Dr Kang, HCFA continues to believe that if the mastery is changed, state laws will be able patronize patients and that hospital administrators care more for patient care than bottom line financial figures. He demanded outcomes data to support our contention that quality patient care hangs on keeping RNs in the OR. AORN continues to provide Betts and Dr Kang with this results information as it is identified to underscore the ne to maintain the not absent rule.