7 Facts about Record-Breaking Response to VA Proposal to Improve Veterans' Access to Care

Newswise — Striking a nerve with the American public unlike any previous Veterans Administration (VA) policy change, the VA’s proposed rule to improve veterans’ access to timely, quality healthcare through increased use of advanced practice registered nurses (APRNs) spurred an overwhelming response during the public comment period on the rule, said Juan Quintana, DNP, MHS, CRNA, president of the 49,000-member American Association of Nurse Anesthetists (AANA).

Weighing in on the VA’s proposal to allow APRNs, including Certified Registered Nurse Anesthetists (CRNAs), to practice to the full scope of their education, training and abilities in the VA health system, veterans and other interested Americans submitted an unprecedented 167,000+ letters to the VA during the 60-day comment period that concluded on July 25. In addition, veterans’ organizations, public interest groups, healthcare associations, government agencies, and other stakeholders have expressed their support for the rule through other forums, including a congressional hearing.

“Making full use of highly qualified, highly educated CRNAs and other APRNs who already work in the VA would reduce the long wait times for care experienced by many military vets, a problem that has plagued the administration for years,” said Quintana, who is a veteran himself. “We urge the VA to promptly finalize and implement the rule so that veterans no longer have to wait for the high quality care that they deserve and have earned.”

While it is likely to take the VA months to sift through the record-shattering volume of letters it received, a preliminary analysis of the comments is possible by searching phrases such as “veteran support” or “veteran oppose” on the regulations.gov website. Adding to the discussion, numerous veterans service organizations have also weighed in on the issue on behalf of their members.

1. The 167,000+ comments were more than 25 times the total number of comments received by the agency on all other regulatory proposals since 2006, when electronic submission of comments was first implemented.

2. Leading veterans’ service organizations collectively representing more than 1 million veterans have supported the proposed rule, including: Military Officers Association of America (390,000 members), AMVETS (250,000 members), Iraq and Afghanistan Veterans of America (200,000 members), Air Force Sergeants Association (100,000 members), Vietnam Veterans of America (75,000 members), and Paralyzed Veterans of America (60,000 members). On its website, the Iraq and Afghanistan Veterans of American bills itself as “The voice for 2.5 million post-9/11 veterans.” AMVETS, which opposed the rule early in the comment period, quickly changed direction and became a supporter of the VA’s proposal to grant full practice authority for APRNs. 3. AARP, whose membership includes more than 3.7 million veteran households, supports the rule.

4. The American Hospital Association (AHA), which lists more than 130 VA hospitals among its members, supports the rule.

5. The professional staff of the Federal Trade Commission (FTC) came out in support of the rule.

6. A search of the regulations.gov database of letters to the VA after the comment period closed revealed the following numbers: 86,381 letters used the phrase “veteran support,” nearly three times more than the 31,802 letters that used the phrase “veteran oppose.”

7. The idea of using APRNs to the full scope of their practice reflects the way the Department of Defense (DoD) already ensures top-notch care for active-duty personnel in all military service branches. APRNs, including CRNAs, nurse practitioners, nurse-midwives, and clinical nurse specialists, are granted full practice authority under the DoD system.

“The outpouring of support for the VA’s proposal to grant full practice authority to CRNAs and other APRNs has been staggering,” said Quintana. “Much like the preponderance of research data that confirm the quality and safety of care provided by CRNAs, the preponderance of facts shows that veterans’ organizations, AARP, the AHA and FTC, and thousands of veterans and citizens are in favor of the VA’s proposed solution to dangerously long wait times for healthcare endured by our military heroes.

“It is unfortunate that some physician groups were so desperate at the end of the comment period that they sent waves of form letters opposing the rule in a vain attempt to pad the final tally to their advantage. These efforts still came up short,” Quintana said. “It’s well known that in the final count these types of impersonal letters get lumped together and viewed as a singular response from a special interest group, rather than as a unique or sincere comment about the issue at hand.”

About the American Association of Nurse AnesthetistsFounded in 1931 and located in Park Ridge, Ill., the AANA is the professional organization for more than 49,000 nurse anesthetists across the United States. As anesthesia specialists, Certified Registered Nurse Anesthetists (CRNAs) safely provide approximately 40 million anesthetics to patients each year for surgical, obstetrical, pain management, and trauma stabilization services. CRNAs deliver essential healthcare in thousands of communities and are able to prevent gaps in access to anesthesia services, especially in rural, inner-city, and other medically underserved areas of the country. They are highly valued in today’s healthcare environment because they deliver the same safe, high-quality anesthesia care as other anesthesia professionals but at a lower cost, helping to control rising healthcare costs. Additional information about the AANA and CRNAs is available at www.aana.com and www.aana.com/future-today.