As AACVPR members prepare to take issues that are important to our profession to Congress in 2020, Pat Comoss provides a look back at how this organization began its presence in the political arena in Washington DC. It should be recognized that Pat, as AACVPR President, was instrumental in obtaining a federal grant for AACVPR to develop the first clinical practice guidelines for cardiac rehabilitation. AACVPR is grateful to Pat for her continued leadership in advocacy, over 14 years of DOTH, and for mentoring of so many of us today who strive to provide quality cardiac and pulmonary rehabilitation services.

Pat Comoss RN, BS, MAACVPR | February 21, 2020

Each year at this time, staff and volunteers at AACVPR begin planning for what has become a dynamic event affecting the future healthcare delivery and practice of cardiac and pulmonary rehabilitation (CR/PR). That event is the Association’s annual Day on the Hill (DOTH) in Washington DC.

The purpose of that advocacy visit to the nation’s capital is to inform and educate elected members of Congress about legislative and regulatory issues that impact rehab patients and CR/PR programs. And so it is in 2020 where the issue at hand is win support for U.S. House bill # 4838 - SOS (Sustaining Outpatient Services).

Approval of U.S. House bill # 4838, would enable rehab programs to expand or relocate offsite without suffering the currently imposed cut in Medicare reimbursement when such a move occurs away from hospital campus. Congressional support is essential to getting the bill passed this year. The proposed relief from the so-called “Section 603 rule” is the key to future growth of CR and PR rehab programs. But no movement on a bill happens unless/until our US Congressional members are made aware of the need for and importance of why they should vote in favor. Signatures of support only come when legislators understand what needs to be done and why. And that is our job – to explain the what and the why of the pending legislation, to advocate for change that benefits our patients and our CR/PR programs.

Such advocacy efforts through DOTH appear to be a recent development to some involved with AACVPR activities. But in fact, the seeds for such association – government education and collaboration efforts were planted 25 years ago. In 1995, the Agency for Health Care Policy and Research (AHCPR-now the Agency for Healthcare Research and Quality) published a landmark document in its growing collection of national healthcare guidelines – Clinical Practice Guideline #17, Cardiac Rehabilitation. That 200 page book was the product of 3 years of work done under a government contract awarded to AACVPR.

The work to collect, review, and synthesize available research on cardiac rehab involved several prestigious content experts in the field who were led by Nanette Wenger MD, Erika Froelicher RN, PhD, and L. Kent Smith MD, PhD. Support and guidance were offered by the Nationals Heart, Lung, and Blood Institute (NHLBI) throughout the project.

When completed, not only did the Guideline justify the use of cardiac rehabilitation as a standard component of contemporary cardiac care, it also established an enduring connection between professional interests and government activities. The collaboration of AACVPR, AHCPR and NHLBI produced advances and advantages that propelled the field forward. That connection, now deeply rooted as DOTH activities, remains an integral part of promoting and protecting cardiac and pulmonary rehab interests in the 21st century.

Now, in the current and often confusing political environment, each of us needs to be part of ongoing efforts to nurture our still young and evolving specialty. Involvement in advocacy efforts at the national (DOTH) level or locally via visits to your Congress member’s office makes a difference to your program and your practice. Collaborative efforts that began over 25 years ago continue to be essential to sustaining cardiac and pulmonary rehab for the next 25 years and beyond. Be part of that history starting in 2020!