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THE ROLE OF PROFESSIONAL REGISTERED NURSES IN

PROFESSIONAL STANDARDS REVIEW ORGANIZATIONS

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- MAR 1

HEARING

BEFORE THE

SUBCOMMITTEE ON HEALTH

OF THE

1973

COMMITTEE ON WAYS AND MEANS

HOUSE OF REPRESENTATIVES

NINETY-FIFTH CONGRESS

FIRST SESSION

97-566

SEPTEMBER 30, 1977

Serial 95-45

Printed for the use of the Committee on Ways and Means

U.S. GOVERNMENT PRINTING OFFICE

WASHINGTON: 1977

143

BARBER B. CONABLE, JR., New York
JOHN J. DUNCAN, Tennessee
BILL ARCHER, Texas

GUY VANDER JAGT, Michigan
WILLIAM A. STEIGER, Wisconsin
PHILIP M. CRANE, Illinois
BILL FRENZEL, Minnesota
JAMES G. MARTIN, North Carolina

L. A. (SKIP) BAFALIS, Florida
WILLIAM M. KETCHUM, California
RICHARD T. SCHULZE, Pennsylvania
BILL GRADISON, Ohio

JOHN J. DUNCAN, Tennessee
PHILIP M. CRANE, Illinois
JAMES G. MARTIN, North Carolina
BILL GRADISON, Ohio

78-601258

COMMITTEE ON WAYS AND MEANS

AL ULLMAN, Oregon, Chairman

JAMES A. BURKE, Massachusetts
DAN ROSTENKOWSKI, Illinois
CHARLES A. VANIK, Ohio
OMAR BURLESON, Texas
JAMES C. CORMAN, California
SAM M. GIBBONS, Florida

JOE D. WAGGONNER, JR., Louisiana
OTIS G. PIKE, New York

J. J. PICKLE, Texas

CHARLES B. RANGEL, New York
WILLIAM R. COTTER, Connecticut
FORTNEY H. (PETE) STARK, California
JAMES R. JONES, Oklahoma

ANDY JACOBS, JR., Indiana

ABNER J. MIKVA, Illinois

MARTHA KEYS, Kansas

JOSEPH L. FISHER, Virginia

HAROLD FORD, Tennessee

KEN HOLLAND, South Carolina

WILLIAM M. BRODHEAD, Michigan
ED JENKINS, Georgia

RICHARD A. GEPHARDT, Missouri
JIM GUY TUCKER, Arkansas

RAYMOND F. LEDERER, Pennsylvania

JOHN M. MARTIN, Jr., Chief Counsel
J. P. BAKER, Assistant Chief Counsel
JOHN K. MEAGHER, Minority Counsel

SUBCOMMITTEE ON HEALTH

DAN ROSTENKOWSKI, Illinois, Chairman

JAMES C. CORMAN, California

OTIS G. PIKE, New York
CHARLES A: VANIK, Ohio
OMAR BURLESON, Texas

WILLIAM R. COTTER, Connecticut
MARTHA KEYS, Kansas

HAROLD FORD, Tennessee

WILLIAM M. BRODHEAD, Michigan

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American Association of Nurse Anesthetists, Goldie Brangman...

American Nurses Association:

Joan Guy, Marie Zimmer, and Connie Holleran.

Charles White, California Nurses' Association..

Judy Zoellner, Illinois State Nurses' Association..

Patsy McClure, Tennessee State Nurses' Association..

Ruth Stewart, Texas State Nurses' Association..

Roberta Thiry, Kansas State Nurses' Association.

Sandra Byers, Ohio Nurses' Association..

Russell Tranbarger, North Carolina State Nurses' Association.-

Dr. Virginia Barker, New York State Nurses' Association..

Claire O'Neil, Connecticut Nurses' Association.-

American Medical Association, John Glasson, M.D. and Harry Peterson.-

American Speech and Hearing Association, Kathleen M. Griffin-

Barker, Dr. Virginia, American Nurses' Association and the New York

State Nurses' Association.com

Brangman, Goldie, American Association of Nurse Anesthetists

Byers, Sandra, American Nurses' Association and the Ohio Nurses'

Association.

California Nurses' Association, Charles White-

Connecticut Nurses' Association, Claire O'Neil...

Glasson, John, M.D., American Medical Association.

Griffin, Kathleen M., American Speech and Hearing Association.

Guy, Joan, American Nurses' Association ----

Holleran, Connie, American Nurses' Association...

Hull, Charles, Jr., National Federation of Licensed Practical Nurses.

Illinois State Nurses' Association, Judy Zoellner.

Kansas State Nurses' Association, Roberta Thiry-

McClure, Patsy, American Nurses' Association and the Tennessee State

Nurses' Association.

National Federation of Licensed Practical Nurses, Charles Hull, Jr..

New York State Nurses' Association, Dr. Virginia Barker--

North Carolina State Nurses' Association, Russell Tranbarger.-

Nurses Association of the American College of Obstetricians and Gyne-

cologists, Dorothy Telega---

Ohio Nurses' Association, Sandra Byers---

O'Neil, Claire, American Nurses' Association and the Connecticut Nurses'

Association

Peterson, Harry, American Medical Association.

Pickle, Hon. J. I., a Representative in Congress from the State of Texas---

Stewart, Ruth, Texas State Nurses' Association and the American Nurses'

Association.

Telega, Dorothy, Nurses Association of the American College of Obstetri-

cians and Gynecologists--

Tennessee State Nurses' Association, Patsy McClure-

Texas State Nurses' Association, Ruth Stewart---

Thiry, Roberta, American Nurses' Association and the Kansas State

Nurses' Association..--

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51
23

27
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29

Tranbarger, Russell, American Nurses' Association and the North Carolina

Nurses' Association ----
White, Charles, American Nurses' Association and the California Nurses'

Association -
Zimmer, Marie, American Nurses' Association..
Zoellner, Judy, American Nurses' Association and the Illinois State Nurses'

Association -

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19

MATERIAL SUBMITTED FOR THE RECORD

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American Association of College Nursing, Linda Kay Amos, Ph. D., R.N.,

letter...
American Association of Professional Standards Review Organizations,

Harry Weeks, M.D., statement.-
American College of Nurse-Midwives, Helen V. Burst, letter----
American Dental Association, William E. Allen, D.D.S., statement..
American Hospital Association, statement.-
American Occupational Therapy Association, James J. Garibaldi, letter.
American Optometric Association, statement.-
American Psychological Association, statement-
American Public Health Association, Katherine S. McCarter, statement.-
American Public Welfare Association, National Council of State Public

Welfare Administrators of the, statement.
American Society for Medical Technology, L’Nora Wells, letter....
Coalition of American Public Employees, Patricia Ford-Roegner, letter--
Illinois Nurses Association, Chicago District, Jane Engle and Dorothy

Dosedlo, mailgram.
National Council of Community Hospitals, John F. Horty, statement.---
National League for Nursing, statement.-
Pepper, Hon. Claude, a Representative in Congress from the State of
Florida, and chairman, Select Committee on Aging and Subcommittee

on Health and Long-Term Care, statement.-
Physicians National Housestaff Association, Jay Dobkin, letter..

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THE ROLE OF PROFESSIONAL REGISTERED NURSES IN PROFESSIONAL STANDARDS REVIEW ORGANIZATIONS

FRIDAY, SEPTEMBER 30, 1977

HOUSE OF REPRESENTATIVES,

SUBCOMMITTEE ON HEALTH,
COMMITTEE ON WAYS AND MEANS,

Washington, D.C. The subcommittee met at 10:15 a.m., pursuant to notice, in room 1100, Longworth House Office Building, Hon. Martha Keys presiding.

Ms. KEYS. Good morning. Chairman Rostenkowski has asked me to convey his regrets that he is not here to open this hearing. He is at the White House this morning and is also sitting on a conference committee and intends to be here as much as possible.

However, there are a number of members of the committee here and we do plan to proceed with this hearing which is to examine the role of professional registered nurses in professional standards review organizations.

This issue is one that many Members of Congress are most concerned about. Legislation has been introduced which would increase the national PSRO council by the addition of three nurses, increase State councils by the addition of two nurses, and include nurses in local PSRO's. This hearing has been called to allow the members of this subcommittee to learn from you about the need for this kind of legislation. (The press release announcing the hearing follows:)

[Press release of Sept. 14, 1977] THE HONORABLE DAN ROSTENKOWSKI (D., ILL.), CHAIRMAN, SUBCOMMITTEE

ON HEALTH OF THE COMMITTEE ON WAYS AND MEANS, ANNOUNCES A ONE DAY HEARING ON THE ROLE OF PROFESSIONAL REGISTERED NURSES IN PROFESSIONAL STANDARDS REVIEW ORGANIZATIONS TO BE CONDUCTED FRIDAY, SEPTEMBER 30, 1977

The Honorable Dan Rostenkowski (D., Ill.), Chairman of the Subcommitte on Health of the Committee on Ways and Means, announced today that the Subcommittee will hold one day of hearings on the role of professional registered nurses in Professional Standards Review Organizations (PSRO's). This hearing will be conducted on Friday, September 30, 1977, in the main hearing room of the Committee on Ways and Means, Longworth House Office Building and will begin at 10 a.m. Background Information Regarding the Hearing Topic

During the subcommittee's markup this year of provisions of H.R. 3 (the Medicare-Medicaid Anti-Fraud and `Abuse Amendments) relating to Professional Standards Review Organizations, the issue of the appropriate role of registered professional nurses in PSRO's was raised by Congresswoman Martha Keys (D., Kan.). In the course of its discussion, the Subcommittee decided that this issue warranted thorough consideration and that it would be appropriate to schedule hearings specifically on this subject.

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