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Virtual House of Delegates Meeting Recap


In 2017, CSA began hosting a second House of Delegates meeting in November, after we changed the society’s budget year from a July-June fiscal year to a January-December calendar year. This change was made to align with ASA’s membership cycle after CSA adopted the unified dues billing agreement with the ASA, whereby members receive one invoice to pay for both their CSA and ASA dues. The new fiscal year naturally altered CSA’s budget cycle, and since the House is the ultimate authority over CSA finances, it made sense to have the House approve the budget in the fourth quarter.

While the virtual House of Delegates meeting’s primary purpose of to review and approve CSA’s annual budget, CSA leaders have taken this opportunity to inform delegates and alternates on issues of importance to the society and our specialty.

At the November 2021 Virtual House meeting, attendees witnessed an informative session on the Future of Medicare Reimbursement for Anesthesiologists. The session was moderated by Johnathan Pregler, MD, FASA, Chair of ASA’s 33% Problem Workgroup and ASA Alternate Director from California, Michael Champeau, MD, FASA, former CSA President and currently ASA President Elect, and Randy Clark, MD, FASA, 2021-22 ASA President.

The education session highlighted the work that California leaders are doing on three fronts within the ASA to ensure anesthesiologists are fairly reimbursed for their work. They are

  • Addressing the current inadequate reimbursement anesthesiologists receive from Medicare,
  • Engaging with the administration and members of Congress to appropriately implement the recent “No Surprises Act” concerning out of network billing,
  • and Reviewing ASA’s Payment Progress Initiative, intended to develop measures and models that capture and express the value of what anesthesiologists do.

A recording of the complete session will be made available to CSA members in the coming days.

Antonio Hernandez Conte, MD, MBA, FASA, and CSA lobbyist Bryce Docherty, updated the delegates on CSA’s advocacy efforts at the state level, including engaging on legislation concerning the administration of anesthesia in dental offices, monitoring legislation to establish a single payer health system in California, and co-sponsoring legislation (AB 562, Low/Flora) to establish wellness support for front line health workers including physicians, nurses and first responders.

Dr. Conte and Mr. Docherty also informed delegates of the work CSA is doing to address the issue of medical title misappropriation, to ensure health care providers clearly and honestly state their level of training, education, and licensing. Christopher Tirce, MD, FASA, CSA’s Chair of the Committee on Practice Management, reviewed the progress his committee has made to develop a “toolkit” for CSA members and practice groups to help ensure hospitals and health systems are adequately applying current state truth in advertising laws.

Dr. Conte reminded the delegates that 2022 would likely be dominated by efforts of CSA, CMA and members of the California House of Medicine to oppose a November ballot measure to scale back the provisions of MICRA and significantly increase medical malpractice awards, which will increase healthcare costs, reduce patient access.

Rita Agarwal, MD, FAAP, FASA, Chair of CSA’s Committee on Public and Professional Communications introduced Alison McLeod, a partner with KP Public Affairs, CSA’s communications consulting firm, in presenting initial outcomes from a public communications strategy approved by the CSA Board of Directors at its September meeting. The three-month initiative utilizes social media platforms to target three primary groups – hospital and healthcare administrators, public policy leaders, and the general public to better position anesthesiologists as “part of the solution” in reducing overall health care costs and improving patient outcomes.  Results of the campaign will be reviewed by the Board of Directors at its January planning meeting at which time the board will determine if the campaign should be renewed and if so, how it might be adjusted.

Phillip Richardson, MD, MBA, FASA, announced the formation of the inaugural class of CSA’s Leadership Development program, managed in partnership with the Paul Merage School of Business at UC Irvine. The nine-month program is intended to equip graduates with the knowledge, skills, and relationships they need to gain leadership positions within their groups, hospitals and/or health systems to position anesthesiologists as “part of the solution” in addressing broader system concerns of reduced costs and improved patient outcomes. The blended virtual/in-person program will conclude with team presentations of capstone projects at the June House of Delegates meeting in Irvine.

During his report, CSA Treasurer, John Hsieh, MD, FASA, presented year to date financials for 2021 which project a modest surplus for the year due to relatively steady membership revenue, reduced meeting and travel costs due to COVID restrictions and better than budgeted investment income. Dr. Hsieh presented a conservative 2022 budget which assumes flat membership revenue, a resumption of in person CSA education meetings operating at a modest deficit and very modest returns on investment due to the projected state of the economy. The approved 2022 budget assumes a 7% deficit, which, if necessary, can be offset by CSA’s financial reserves. Dr. Hsieh pledged to work with CSA staff and the Committee on Finance and Administration to monitor expenses and to work with staff and volunteers to increase membership, sponsorship, and advertising revenue.

As you can see, the November Virtual House of Delegates meeting was more than just a check-off to approve the annual budget, as the meeting was filled with information and actions relevant to expressed member priorities in the areas of advocacy, practice management and leadership development.

As your President for the next seven months, I am extremely proud of the work that our physician leaders and our team of staff and professional consultants are doing to advance your interests and priorities as members. If you have any questions, suggestions, or concerns about the work of CSA, I encourage you to please contact me at

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