State and Regional Advocacy Leads in Priority Among Numerous Advancing New CSNS Initiatives

Mark E. Linskey, MD

In Congress Quarterly last fall, we outlined and discussed six major goals for the current two-year 2013-2015 leadership term. Among those six, the first was “To develop the CSNS, working with our parent organizations (CNS and AANS) as well as the AANS/CNS Washington Office and our state neurosurgery societies, into a truly integrated state and regional advocacy platform, with enhanced communication to and from our state neurosurgery societies, direct executive support to our state neurosurgery societies and expansion of our current national and federal advocacy and health policy efforts into the state and regional arena.” To effect that goal, a very robust and active CSNS team of individuals was brought together in a new Ad Hoc Committee led by Shelly Timmons from Pennsylvania and with Katie Orrico of our Washington Office serving in an ex-officio role. I am very happy to report that significant progress has been made towards realizing this goal.

The first component of this charge was to use the data from the three state and regional advocacy surveys completed over the last 18 months to create a formal proposal and business plan for implementing a state and regional advocacy pilot program in conjunction with one or two state neurosurgical societies, the CSNS and the AANS/CNS Washington Office, that can be presented to both parent organizations for budget approval, and subsequent implementation July 1, 2014. In fact, for this component of the committee charge, not one, but two pilot projects began in July 2014. The first involves, for the first time, proactive monitoring of state-level legislative issues by our own Washington Office staff with bi-directional communications with the relevant state neurosurgical society (New Jersey – CSNS Northeast Quadrant). The second pilot project involves, also for the first time, proactive monitoring of state-level third-party payer policies by our own Washington Office staff with bi-directional communications with the relevant state neurosurgical society (Washington – CSNS Northwest Quadrant).

In order to perform these two CSNS pilot projects, in April 2013, the CNS and the AANS approved the purchase of two new software programs for use by our Washington Office. The first is called State Track (CQ Roll Call,, Figure 1), and the second is called Policy Reporter (Policy Reporter,, Figure 2). Data on the effectiveness of these two pilot projects will be collected between 2014 and 2015, and reported on in the fall of 2015 for consideration of the desirability and advisability of continuing and/or expanding these two CSNS projects to other states with active state neurosurgical societies. The assistance of our Washington Office, led by Katie Orrico, with these two CSNS-generated and led pilot projects is greatly appreciated.

The CSNS neurosurgery-specific patient safety initiative continues to progress towards conclusion with Greg Smith from Texas leading another energetic ad hoc committee. We expect this committee to be able to make a final report complete with recommendations by either the fall of 2014 or the spring of 2015 CSNS meeting. The remaining four goals have either already been met (numbers two and five), or are currently progressing (numbers four and six).

This winter, the CSNS added five exciting new initiatives to our agenda. The first is the codifying and endorsement by the Neurosurgery Research and Education Foundation (NREF) of a new role for the CSNS standing committees, to provide NREF with an infrastructure for review of socio-economic grants submitted to NREF.

The second is the establishment of a Joint Task Force through the CSNS Young Neurosurgeons Representative Section (led by Chaim Colen from Michigan) and the Medical Practice Committee (led by Darlene Lobel from Ohio) to study and research the US Affordable Care Act to proactively monitor changes to the act and timeline implementation implications on an ongoing basis for neurosurgery, allowing for the development of resolutions that will promote appropriate education and discussion and allow for action by organized neurosurgery in sufficient time to make a difference. Maya Babu from Minnesota has already taken a lead position on this new project.

The third is a tasking of the CSNS Communications and Education Committee led by Karin Swartz from Kentucky to form a working group to explore potential mechanisms for developing a neurosurgery medical practice training simulator to provide neurosurgeons with an opportunity to practice and train in socioeconomic management of a standard neurosurgical practice. The overall goal will be to crystalize the image and operationalize the concept for future implementation.

The fourth is the formation of a new Patient Advocacy Ad Hoc Committee under the leadership of Gary Simonds from Virginia, tasked with examining existing CSNS policies and procedures with an eye towards recommending where we can strengthen and better intertwine patient advocacy within our existing organizational processes. We expect this report to be presented at the spring 2015 CSNS meeting.

Finally, we have formed a new Neurosurgery Medical Director’s Ad Hoc committee under the able leadership of Gary Bloomgarden from Texas to explore the potentially unique perspectives, experiences and needs of neurosurgeons who serve as medical directors for clinical programs, hospitals and/or thirdparty payers. They will explore whether or not this category of neurosurgeon might be unique enough to warrant forming a new CSNS representative section. We also expect this committee to report out at the spring 2015 CSNS meeting.

As outlined above, in addition to our existing biannual meeting, our effective grass roots resolution process, our large, ongoing socioeconomic educational scientific program contributions to both the CNS and AANS meetings and our robust neurosurgery resident fellowship and medical student fellowship programs, the CSNS continues to advance an ambitious and stand-alone agenda designed to benefit the field of neurosurgery in the U.S. We welcome any and all ideas and offers of support and assistance in our efforts. The CSNS is an inclusive, grass roots organization, and all input and participation is welcome. Please step up and participate. Neurosurgery is our profession, neurosurgeons are the best advocates for our patients, and we need everyone to get involved.