in the greatest degree of AORN's le...

in the greatest degree of AORN's legislative activity in 2002 was related to the priorities in place before the AORN Board of Directors approved a of the present day legislative agenda in August 2002 The 2001-2002 priorities included the following.

* render certain the supervisory presence of the professional RN in the perioperative arena and further AORN's position that every surgical patient be entitled tos a perioperative nurse. AORN will make secure that all state laws and regulations require barely RNs in the circulator role

* Medicare reimbursement for certified RN first assistants (CRNFAs) and third-party reimbursement for RN first assistants (RNFAs) in the states.

* Supervision to and regulation of assistive personnel AORN supports the establishment of basic educational standards for surgical technologists (STs) In addition, AORN suspends opposition to the registration or certification of ST as lengthy as it is under the state nursing board or equivalent.

* Patient and personnel health and safety in the perioperative arena.

AORN's updated and expanded legislative priorities for 2002-2003 are listed in this article following the recap of the 2002 legislative session.

KEEPING THE RN IN THE OR

At the federal even AORN continues to oppose any change to the prescriptive language requiring RN in the OR in the Center for Medicare and Medicaid Services (CMS) hospital conditions of participation. The Center for Medicare and Medicaid Services first announced the propos elimination of the prescriptive language in December 1997 AORN followed this announcement with an aggressive campaign to retain the prescriptive language. (1) There has been no indication from Tom Scully CM administrator, or anyone at CM that this issue will be considered further at any time in the near that will be AORN will continue to monitor this issue. AORN's Department of conduct Affairs followed some activity at the state flat on the issue of the RN in the OR during the 2002 legislative session.

California. In 1999 California became the first state in the nation to require broad nurse-to-patient ratios with the signing of AB 394 Before AB 394 California already had regulations in place requiring an RN in the circulating character Although the wording has changed slightly in the propos regulations implementing AB 394 it still requires undivided RN assigned as circulating foster for each patient-occupied OR. (2) The commentary period for the regulations propos to implement the law finiss Dec 6, 2002.

Florida. pair sets of companion bills were introduced in Florida during the 2002 legislative session. All four bills (ie, HB 1827/SB 2230 HB 1799/SB 2326) would have locate standards for staffing health care facilities. Specifically, they would have required a ratio of single in kind RN to one patient in the OR. All four bills died in committee.

Rhode Island. House Bill 7219 would have required health care facilities' staffing plans to incorporate a 1:1 direct care nurse-to-patient ratio (ie, the same perioperative circulating nurse to individual patient). The bill did not make it not at home of the House Committee upon Health, Education, and Welfare when the session ended

Virginia. A member-initiated bill that would require a ratio of common perioperative nurse to one patient in the OR was introduced in Virginia. Although the bill did not pass in 2002 it has been carried through to the 2003 session.

in succession July 27, 2001, the Virginia Board of Nursing issued a guidance document (ie, 90-42) stating that the RN may not delegate circulating duties to unlicensed personnel (3) AORN and its members also are following closely the work of the Virginia Board of Nursing concerning a propos amendment to the regulations governing the practice of nursing. The propos amendment, which has not to this time been approved for public make comments [i]or[/i] remarks adds "circulating duties in an operating room" to the tasks that shall not be delegated to any unlicensed human frame (4)

Washington. [i]or[/i] part of to the other the hard work of AORN offers in Washington, in May 2002 the Washington State Nursing Care Quality Assurance Commission adopted a draft position statement upon the RN as circulating encourage in the OR. The statement affirms that it is the RN's part to function as the circulating foment in the OR. It further states that it is not within the room of practice of the licensed practical foster or ST to function as the circulating foment (5)

REIMBURSEMENT FOR CRNFAS AND RNFAS

Rep Mac Collins (R-Ga) continues to champion CRNFAs within his ongoing support for CRNFA reimbursement. Rep Collins introduced the Medicare Certified Registered nourish at the breast First Assistant Direct Reimbursement Act of 2001 (ie, HR 822) in March 2001 If passed, HR 822 would mandate reimbursement of CRNFAs at the same rate as other nonphysician providers of first assistant services, who generally are reimbursed at 13.6% of the surgeon's recompense As of Oct 29, 2002 HR 822 had 105 cosponsors. (6) The bill has broad bipartisan support and significant support from sum of two units committees with jurisdiction over Medicare.

upon Dec 21, 2000, President Bill Clinton signed into law HR 4577 (ie, Public Law 106-554) which includes a provision that directed the General Accounting Office (GAO) to guard a study on the coverage of surgical first assisting services of CRNFAs. The cogitation is to focus on the impact of quality of care, appropriate education and training requirements, and appropriate rates of payment. yet the legislation requires the GAO to submit the report to Congres no later than united year after the bill's passage, as of pres time, the report had not been submitted. Should HR 822 fail to pass during the 107th Congres the CRNFA Medicare reimbursement legislation would have to be reintroduced during the nearest Congressional session.