Meetings
Workforce Shortage Center Stage as ASCP Addresses Group of State Health Officials
Last month, the American Society for Clinical Pathology was invited to address the Reforming States Group (RSG) of the Milbank Memorial Fund about the laboratory workforce shortage. The Milbank Memorial Fund is an endowed operating foundation that works to improve health by assisting decision makers in the public and private sectors acquire and use the best available evidence to inform policy for health care and population health. The Reforming States Group (RSG), a committee sponsored by the Milbank Memorial Fund, is composed of state health officials and legislators responsible for overseeing state health services.
ASCP President-Elect Barbara McKenna, MD, FASCP began the discussion by sharing some of the challenges and difficulties she has faced in staffing her own hospital laboratory in recent years. Her laboratory, like thousands across the nation, is filled with laboratory professionals that plan to retire in the next few years. She stressed that the need to fill those vacancies as well as new positions created by the increased demand for services by aging baby boomers, hasten our mandate to find solutions to this issue.
John Ball, MD, JD, FASCP, ASCP Executive Vice President, outlined the ASCP’s mission and gave an overview of the organization’s activities for the Committee. Senior Program Manager for Public Policy, Andrea Bennett, MPH, MT(ASCP), presented an overview of the field by explaining the training requirements and roles of the various professionals in the laboratory. Bennett also offered a “window” on the laboratory for the RSG by sharing some examples of how laboratory professionals directly impact patient care.
Blair Holladay, PhD, SCT(ASCP)CM, ASCP Vice President for Scientific Affairs and Executive Director of the Board of Registry, continued the discussion with an overview of the shortage from a national perspective. Holladay outlined the shortage’s complex etiology, including CLIA regulations that relaxed the educational requirements for those permitted to perform laboratory tests, the subsequent closure of NAACLS accredited training programs, salaries that fail to be commensurate with education and competency requirements, lack of visibility of the profession and advancement in the profession, and heavy competition for clinical laboratory scientists from pharmaceutical companies and industry. Jeff Jacobs, ASCP Vice President for Public Policy followed with an overview of organizational initiatives (e.g., communication strategies, coalition and collaborative approaches, data gathering needs, etc) and possible legislative approaches to enhance recruitment and retention efforts.
The RSG members were appreciative to ASCP for the presentation. Although many of the members were aware that a workforce shortage did exist in the allied health fields, they were not aware that there was currently such a serious shortage of laboratory personnel. There was much concern in the room over the effect that the shortage might have on the quality of laboratory services. In addition, the RSG offered a number of recommendations to ASCP to garner more attention to this matter and make it a priority at the state level. To accomplish this goal, the RSG stressed the need for solid data. As this newsletter goes to press, the ASCP 2007 Wage and Vacancy Survey data is under analysis. In the coming months, ASCP will be using that data as well as data from other sources to formulate an accurate snapshot of the laboratory workforce shortage and determine the most effective strategies to deal with it.
The laboratory workforce shortage continues to be a high priority issue for ASCP and collaboration, on both local and national levels, will be the key to solving such a complex problem. ASCP looks forward to continued dialogue with the Reforming States Group as we develop strategies to address this nationwide dilemma.
Society News
ASCP Announces Public Policy Fellowship/Internship Program
The American Society for Clinical Pathology’s (ASCP) is announcing the establishment of its public policy fellowship & internship program. ASCP policy fellows and interns will work on laboratory and health policy at ASCP’s Washington, D.C. Office. The program is a great opportunity for individuals interested in health policy, public health, and politics to learn more about these issues.
The ASCP fellowship program is suitable for undergraduate graduate and post-graduate individuals, as well as individuals who are not currently matriculating in an academic or clinical program. Participants will receive a stipend dependent on their availability. Fellowships and internships typically last between 8-12 weeks, however, this schedule may vary depending upon ASCP need and student availability. Individuals interested in applying for the program may contact Matthew Schulze at 202.347.4450 or by e-mail at matthew.schulze@ascp.org for details.
Federal
ASCP Submits Comments on CMS MUE Phase VIII Edits
ASCP recently provided comments on Phase VIII of the Centers for Medicare and Medicaid Services Medically Unlikely Edits (MUEs) initiative. The Phase VIII edits proposed a series of units of service limitations that Medicare would reimburse per patient per day. There were approximately 100 edits that would affect pathology and laboratory medicine. In developing its comments on the proposed units of service limits, ASCP coordinated with the College of American Pathologists, the American Clinical Laboratory Association and the Association of Pathology Chairs.
ASCP urged caution on setting the proposed units of service limits too low and that CMS should establish a pathology and laboratory medicine working group, including representatives from representatives from pathology and laboratory medicine societies, to provide technical input on the establishment of MUEs. “With new technological advances rapidly changing the field of pathology and laboratory medicine, especially in molecular pathology, we are concerned these edits may inappropriately constrain the ability of these advances to diagnose patient health,” ASCP wrote.
ASCP is not allowed to share its units of service recommendations as CMS does not allow entities reviewing the proposed edits to publicly disseminate the specific proposed unit of service limitations or respondent comments on the specific proposals.
CLIAC Convenes, Considers Genetic Testing Among Topics
The Clinical Laboratory Improvement Advisory Committee (CLIAC) met last month in Atlanta, GA. A primary area of focus was genetic testing. Under consideration was the report pulled together by the Genetic Testing Workgroup for the purposes of providing CLIAC recommendations for good laboratory practices to be included in Morbidity and Mortality Weekly Report: Recommendations and Reports. Topics surrounding the discussion of genetic testing were divided into three categories: the preanalytic, analytic and post-analytic phases of testing. In the preanalytic phase the workgroup addressed the role of laboratories in providing user information about services offered, informed consent, test requests, specimen submission, handling and referral, authorization for ordering genetic tests as well as systems assessments. During the analytic phase, areas of discussion included performance establishment and verification, control procedures unidirectional workflow and monitoring molecular amplification procedures as well as proficiency testing and alternatives. Finally, the discussion of post-analytic testing topics included the contents of the test report, retention of records and reports and specimen retention. Other issues focused on confidentiality, personnel, considerations before offering new genetic tests and quality management systems.
Other items on the CLIAC agenda included a discussion of laboratory quality control through risk management; a Centers for Medicare & Medicaid Services (CMS) update on the status of waived testing and a report on the Federal Drug Administration (FDA) Waiver Panel Meeting.
The meeting was convened by new CLIAC Chair, Elissa Passiment, EdM, CLS(NCA).