Establishes certification procedures for the profession of nurse anesthesia; provides for the issuance of a certification to practice as a certified registered nurse anesthetist upon the filing of an application, having a license as a registered professional nurse, having the appropriate educational requirements and paying the fifty dollar initial certification fee and the triennial thirty dollar registration fee.
BILL NUMBER: S3288
TITLE OF BILL : An act to amend the education law, in relation to the profession of nurse anesthesia
PURPOSE OR GENERAL IDEA OF BILL : This act codifies the profession of nurse anesthesia as a specialty of the profession of nursing.
SUMMARY OF SPECIFIC PROVISIONS : Amends section 6902 of the education law by adding a new subdivision 4 which sets ,out the definition of certified registered nurse anesthetists, and adds section 6911 regarding the education and training of nurse anesthetists.
JUSTIFICATION : Currently, New York State law does not codify the practice of nurse anesthesia. Instead, the scope of this practice has been defined through educational requirements and Health Department regulations.
Existing requirements for training, education, and certification of certified register nurse anesthetists (CRNAs) have resulted in high quality, professional care by CRNAs. Statutory codification would resolve problems relating to liability, supervision, and authority to administer anesthesia.
This legislation was developed with the support of the New York state Association of Nurse Anesthetists.
PRIOR LEGISLATIVE HISTORY : 2003-04: A.5021-A - referred to higher education committee 2005-06: A.4015-A - referred to higher education committee 2007-08: A.5201 - referred to higher education committee
FISCAL IMPLICATIONS : None.
EFFECTIVE DATE : Immediately.
STATE OF NEW YORK ________________________________________________________________________ 3288 2009-2010 Regular Sessions IN SENATE March 13, 2009 ___________Introduced by Sens. HASSELL-THOMPSON, DIAZ, HUNTLEY, MONSERRATE, OPPEN- HEIMER, PERKINS -- read twice and ordered printed, and when printed to be committed to the Committee on Higher Education AN ACT to amend the education law, in relation to the profession of nurse anesthesia THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Legislative intent. The legislature hereby finds that certified registered nurse anesthetists are highly educated and trained advanced practice nurses who hold a national professional certification, and whose competency in the professional practice of nurse anesthesia in hospitals, free-standing ambulatory surgery centers, clinics, profes- sional offices and other facilities is well known. Nurse anesthetists are integral to the continued professional delivery of services in such health care facilities throughout the state. The legislature further finds that statutory recognition of nurse anesthetists will further enhance patient safety by codifying their professional scope of practice that is currently governed in this state by regulations promulgated pursuant to the public health law in the case of hospitals and ambulatory surgery centers. The legislature also finds that while nurse anesthetists are advanced practice nurses, licensed as registered professional nurses under arti- cle 139 of the education law, no provision of this act is meant to limit, diminish or in any way impinge upon the practice of the profes- sion of nursing as a registered professional nurse under such article. Therefore, the legislature hereby declares that, due to the intrinsic nature of the administration of anesthesia services, the integral part that certified registered nurse anesthetists play in the safe delivery of such services and the need to protect and enhance patient safety in all health care facilities, it is in the interest of the people of this state to recognize the national professional certification of registeredEXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD00777-01-9 S. 3288 2
nurse anesthetists and that the existing scope of practice of nurse anesthesia, as currently practiced in this state, be codified in stat- ute. S 2. Section 6902 of the education law is amended by adding a new subdivision 4 to read as follows: 4. (A) THE PRACTICE OF REGISTERED PROFESSIONAL NURSING BY A CERTIFIED REGISTERED NURSE ANESTHETIST, CERTIFIED UNDER SECTION SIXTY-NINE HUNDRED ELEVEN OF THIS ARTICLE MAY INCLUDE THE PRACTICE OF NURSE ANESTHESIA. NURSE ANESTHESIA INCLUDES: THE ADMINISTRATION OF ANESTHESIA AND ANES- THESIA RELATED CARE TO PATIENTS; PREANESTHETICS EVALUATION AND PREPARA- TION; ANESTHETIC INDUCTION, MAINTENANCE AND EMERGENCE; POST ANESTHESIA CARE; PERIANESTHETICS AND CLINICAL SUPPORT FUNCTIONS; AND PAIN MANAGE- MENT, IN COLLABORATION WITH A LICENSED PHYSICIAN QUALIFIED BY LAW TO DETERMINE THE NEED FOR ANESTHESIA SERVICES, PROVIDED SUCH SERVICES ARE PERFORMED IN ACCORDANCE WITH A WRITTEN PRACTICE AGREEMENT AND WRITTEN PRACTICE PROTOCOLS. THE WRITTEN PRACTICE AGREEMENT SHALL INCLUDE EXPLIC- IT PROVISIONS FOR THE RESOLUTION OF ANY DISAGREEMENT BETWEEN THE COLLAB- ORATING PHYSICIAN AND THE CERTIFIED REGISTERED NURSE ANESTHETIST REGARD- ING A MATTER OF ANESTHESIA TREATMENT THAT IS WITHIN THE SCOPE OF PRACTICE OF BOTH. TO THE EXTENT THE PRACTICE AGREEMENT DOES NOT SO PROVIDE, THEN THE COLLABORATING PHYSICIAN'S TREATMENT SHALL PREVAIL. (B) PRESCRIPTIONS FOR DRUGS, DEVICES AND ANESTHETIC AGENTS MAY BE ISSUED BY A CERTIFIED REGISTERED NURSE ANESTHETIST, UNDER THIS SUBDIVI- SION AND SECTION SIXTY-NINE HUNDRED ELEVEN OF THIS ARTICLE, IN ACCORD- ANCE WITH THE PRACTICE AGREEMENT AND PRACTICE PROTOCOLS. THE CERTIFIED REGISTERED NURSE ANESTHETIST SHALL OBTAIN A CERTIFICATE FROM THE DEPART- MENT UPON SUCCESSFULLY COMPLETING A PROGRAM INCLUDING AN APPROPRIATE PHARMACOLOGY COMPONENT, OR ITS EQUIVALENT, AS ESTABLISHED BY THE COMMIS- SIONER'S REGULATIONS, PRIOR TO PRESCRIBING UNDER THIS SUBDIVISION. THE CERTIFICATE ISSUED UNDER SECTION SIXTY-NINE HUNDRED ELEVEN OF THIS ARTI- CLE SHALL STATE WHETHER THE CERTIFIED REGISTERED NURSE ANESTHETIST HAS SUCCESSFULLY COMPLETED SUCH A PROGRAM OR EQUIVALENT AND IS AUTHORIZED TO PRESCRIBE UNDER THIS SUBDIVISION. (C) EACH PRACTICE AGREEMENT SHALL PROVIDE FOR PATIENT RECORDS REVIEW BY THE COLLABORATING PHYSICIAN IN A TIMELY FASHION BUT IN NO EVENT LESS OFTEN THAN EVERY THREE MONTHS. THE NAMES OF THE CERTIFIED REGISTERED NURSE ANESTHETIST AND THE COLLABORATING PHYSICIAN SHALL BE CLEARLY POST- ED IN THE PRACTICE SETTING OF THE CERTIFIED REGISTERED NURSE ANESTHE- TIST. (D) THE PRACTICE PROTOCOL SHALL REFLECT CURRENT ACCEPTED MEDICAL AND NURSING PRACTICE. THE PROTOCOLS SHALL BE FILED WITH THE DEPARTMENT WITH- IN NINETY DAYS OF THE COMMENCEMENT OF THE PRACTICE AND MAY BE UPDATED PERIODICALLY. THE COMMISSIONER SHALL MAKE REGULATIONS ESTABLISHING THE PROCEDURE FOR THE REVIEW OF PROTOCOLS AND THE DISPOSITION OF ANY ISSUES ARISING FROM SUCH REVIEW. (E) NO PHYSICIAN SHALL ENTER INTO PRACTICE AGREEMENTS WITH MORE THAN FOUR CERTIFIED REGISTERED NURSE ANESTHETISTS WHO ARE NOT LOCATED ON THE SAME PHYSICAL PREMISES AS THE COLLABORATING PHYSICIAN. (F) NOTHING IN THIS SUBDIVISION SHALL BE DEEMED TO LIMIT OR DIMINISH THE PRACTICE OF THE PROFESSION OF NURSING AS A REGISTERED PROFESSIONAL NURSE UNDER THIS ARTICLE OR ANY OTHER LAW, RULE, REGULATION OR CERTIF- ICATION, NOR TO DENY ANY REGISTERED PROFESSIONAL NURSE THE RIGHT TO DO ANY ACT OR ENGAGE IN ANY PRACTICE AUTHORIZED BY THIS ARTICLE OR ANY OTHER LAW, RULE, REGULATION OR CERTIFICATION. (G) THE PROVISIONS OF THIS SUBDIVISION SHALL NOT APPLY TO ANY ACTIVITY AUTHORIZED, PURSUANT TO STATUTE, RULE OR REGULATION, TO BE PERFORMED BYS. 3288 3
A REGISTERED PROFESSIONAL NURSE IN A HOSPITAL AS DEFINED IN ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW. S 3. The education law is amended by adding a new section 6911 to read as follows: S 6911. CERTIFICATES FOR NURSE ANESTHESIA PRACTICE. 1. FOR ISSUANCE OF A CERTIFICATE TO PRACTICE AS A CERTIFIED REGISTERED NURSE ANESTHETIST UNDER SUBDIVISION FOUR OF SECTION SIXTY-NINE HUNDRED TWO OF THIS ARTI- CLE, THE APPLICANT SHALL FULFILL THE FOLLOWING REQUIREMENTS: (A) APPLICATION: FILE AN APPLICATION WITH THE DEPARTMENT; (B) LICENSE: BE LICENSED AS A REGISTERED PROFESSIONAL NURSE IN THE STATE; (C) EDUCATION: (I) HAVE SATISFACTORILY COMPLETED EDUCATIONAL PREPARA- TION FOR PROVISION OF THESE SERVICES IN A PROGRAM REGISTERED BY THE DEPARTMENT OR IN A PROGRAM ACCREDITED BY A NATIONAL BODY RECOGNIZED BY THE DEPARTMENT OR DETERMINED BY THE DEPARTMENT TO BE THE EQUIVALENT; AND (II) SUBMIT EVIDENCE OF CURRENT CERTIFICATION OR RECERTIFICATION BY A NATIONAL CERTIFYING BODY, RECOGNIZED BY THE DEPARTMENT; (D) FEES: PAY A FEE TO THE DEPARTMENT OF FIFTY DOLLARS FOR AN INITIAL CERTIFICATE AUTHORIZING NURSE ANESTHESIA PRACTICE AND A TRIENNIAL REGIS- TRATION FEE OF THIRTY DOLLARS. AFTER A CERTIFIED REGISTERED NURSE ANESTHETIST'S INITIAL REGISTRATION, REGISTRATION UNDER THIS SECTION SHALL BE COTERMINOUS WITH THE CERTIFIED REGISTERED NURSE ANESTHETIST'S REGISTRATION AS A PROFESSIONAL NURSE. 2. ONLY A PERSON CERTIFIED UNDER THIS SECTION SHALL USE THE TITLE "CERTIFIED REGISTERED NURSE ANESTHETIST". 3. THE PROVISIONS OF THIS SECTION SHALL NOT APPLY TO ANY ACT OR PRAC- TICE AUTHORIZED BY ANY OTHER LAW, RULE, REGULATION OR CERTIFICATION. 4. THE PROVISIONS OF THIS SECTION SHALL NOT APPLY TO ANY ACTIVITY AUTHORIZED, PURSUANT TO STATUTE, RULE OR REGULATION, TO BE PERFORMED BY A REGISTERED PROFESSIONAL NURSE IN A HOSPITAL AS DEFINED IN ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW. 5. AN INDIVIDUAL WHO IS AUTHORIZED TO PRACTICE AS A CERTIFIED REGIS- TERED NURSE ANESTHETIST IN A HOSPITAL UNDER REGULATIONS OF THE DEPART- MENT OF HEALTH MAY USE THE TITLE "CERTIFIED REGISTERED NURSE ANESTHE- TIST" IN CONNECTION WITH THAT PRACTICE. IF SUCH AN INDIVIDUAL APPLIES FOR A CERTIFICATE UNDER THIS SECTION, HE OR SHE MAY SATISFY THE EDUCA- TION REQUIREMENT OF SUBDIVISION ONE OF THIS SECTION BY PRESENTING SATIS- FACTORY EVIDENCE OF SUCH AUTHORITY. 6. (A) A REGISTERED PROFESSIONAL NURSE LICENSED UNDER SECTION SIXTY-NINE HUNDRED FIVE OF THIS ARTICLE WHO HAS SATISFACTORILY COMPLETED A PROGRAM OF EDUCATIONAL PREPARATION AS PROVIDED IN SUBDIVISION ONE OF THIS SECTION MAY, FOR A PERIOD NOT TO EXCEED TWENTY-FOUR MONTHS IMME- DIATELY FOLLOWING THE COMPLETION OF SUCH EDUCATIONAL PROGRAM, PRACTICE NURSE ANESTHESIA UNDER SUBDIVISION FOUR OF SECTION SIXTY-NINE HUNDRED TWO OF THIS ARTICLE AS A GRADUATE NURSE ANESTHETIST IN THE SAME MANNER AS A CERTIFIED REGISTERED NURSE ANESTHETIST UNDER THAT SUBDIVISION. (B) A REGISTERED PROFESSIONAL NURSE LICENSED UNDER SECTION SIXTY-NINE HUNDRED FIVE OF THIS ARTICLE WHO IS DULY ENROLLED IN A PROGRAM OF EDUCA- TIONAL PREPARATION, MAY PRACTICE NURSE ANESTHESIA AS A STUDENT NURSE ANESTHETIST UNDER THE SUPERVISION OF AN ANESTHESIOLOGIST OR A CERTIFIED REGISTERED NURSE ANESTHETIST, WHO IS IMMEDIATELY AVAILABLE AS NEEDED. 7. THE COMMISSIONER IS AUTHORIZED TO PROMULGATE REGULATIONS TO IMPLE- MENT THE PROVISIONS OF THIS SECTION. S 4. This act shall take effect immediately.