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S00357 Summary:

BILL NOS00357B
 
SAME ASNo Same As
 
SPONSORCOONEY
 
COSPNSRADDABBO, BAILEY, BORRELLO, FERNANDEZ, GALLIVAN, GONZALEZ, HARCKHAM, HELMING, HINCHEY, JACKSON, MURRAY, OBERACKER, PALUMBO, PARKER, RAMOS, RHOADS, RIVERA, SALAZAR, SANDERS, SKOUFIS, WEBB, WEIK
 
MLTSPNSR
 
Add Art 139-A §§6920 - 6927, amd §§6903 & 6904, Ed L
 
Defines the practice of certified registered nurse anesthetist; requires collaboration with a licensed physician qualified to determine the need for anesthesia services; requires licensing; defines qualifications.
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S00357 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         357--B
 
                               2025-2026 Regular Sessions
 
                    IN SENATE
 
                                       (Prefiled)
 
                                     January 8, 2025
                                       ___________
 
        Introduced by Sens. COONEY, ADDABBO, BAILEY, BORRELLO, FERNANDEZ, GALLI-
          VAN, GONZALEZ, HARCKHAM, HELMING, HINCHEY, JACKSON, MURRAY, OBERACKER,
          PALUMBO,  PARKER,  RAMOS,  RHOADS,  RIVERA, SALAZAR, SANDERS, SKOUFIS,
          WEBB, WEIK -- read twice and ordered printed, and when printed  to  be
          committed   to   the   Committee  on  Higher  Education  --  committee
          discharged, bill amended, ordered reprinted as amended and recommitted
          to said committee  --  committee  discharged,  bill  amended,  ordered
          reprinted as amended and recommitted to said committee
 
        AN  ACT  to amend the education law, in relation to creating the profes-
          sion of nurse anesthetist
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section  1. The education law is amended by adding a new article 139-A
     2  to read as follows:
     3                                ARTICLE 139-A
     4                   CERTIFIED REGISTERED NURSE ANESTHETIST
     5  Section 6920. Introduction.
     6          6921. Definition  of  practice  of  certified  registered  nurse
     7                  anesthetist.
     8          6922. Practice of certified registered nurse anesthetist and use
     9                  of the title "certified registered nurse anesthetist" or
    10                  "nurse anesthetist".
    11          6923. State board for nursing.
    12          6924. Requirements for a license as a certified registered nurse
    13                  anesthetist.
    14          6925. Limited permits.
    15          6926. Exempt persons.
    16          6927. Special provisions.
    17    § 6920. Introduction. This article applies to the profession of certi-
    18  fied  registered  nurse  anesthetist.  The  general  provisions  for all
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD00477-04-5

        S. 357--B                           2
 
     1  professions contained in article one hundred thirty of this title  apply
     2  to this article.
     3    §  6921. Definition of practice of certified registered nurse anesthe-
     4  tist. 1. In addition  to  the  provisions  of  practice  for  registered
     5  professional  nursing outlined in section sixty-nine hundred two of this
     6  title, the practice of a certified registered nurse anesthetist  further
     7  includes,  but  is  not  limited  to,  administration  of anesthesia and
     8  sedation to  a  patient;  performing  and  documenting  a  preanesthetic
     9  assessment and evaluation of the patient, including requesting consulta-
    10  tions and diagnostic studies; selecting, obtaining, ordering, and admin-
    11  istering   preanesthetic  medications  and  fluids;  obtaining  informed
    12  consent for anesthesia, developing and implementing an anesthetic  plan;
    13  initiating  the  anesthetic  technique; monitoring the patient including
    14  selecting, applying, and inserting appropriate noninvasive and  invasive
    15  monitoring  modalities  for continuous evaluation of the patient's phys-
    16  ical status; selecting, obtaining, and  administering  the  anesthetics,
    17  adjuvant and accessory drugs, and fluids necessary to manage anesthetics
    18  and acute and chronic pain; ordering and evaluating laboratory and diag-
    19  nostic tests and performing point-of-care testing; ordering and evaluat-
    20  ing  radiographic  imaging  studies;  managing  a  patient's  airway and
    21  cardiopulmonary status using current practice  modalities;  facilitating
    22  emergence and recovery from anesthesia by selecting, obtaining, ordering
    23  and   administering   medications,   fluids,  and  ventilatory  support;
    24  discharging the patient from a postanesthesia care  area  and  providing
    25  postanesthesia  follow-up  evaluation  and  care; implementing acute and
    26  chronic pain management modalities; responding to  emergency  situations
    27  by  providing  airway management, administration of emergency fluids and
    28  drugs, and using basic or advanced cardiac life support techniques;  and
    29  prescribe tests, drugs and other treatments necessary to anesthesia care
    30  provided by a nurse anesthetist.
    31    2.  (a)  A  certified registered nurse anesthetist licensed under this
    32  article and practicing for thirty-six hundred hours or less shall do  so
    33  either  under  the supervision of:   (i) a physician who has completed a
    34  residency program in anesthesiology that is accredited by an accrediting
    35  organization acceptable to the department; (ii) a physician who is board
    36  certified in anesthesiology by a certifying organization  acceptable  to
    37  the  department; (iii) the operating physician who the governing body of
    38  the general hospital or ambulatory surgery center, that  is  subject  to
    39  section  twenty-eight hundred one-b of the public health law, has deter-
    40  mined is qualified to  supervise  anesthesia  services  in  the  general
    41  hospital  or  ambulatory surgery center; or (iv) a dentist or podiatrist
    42  qualified to provide anesthesia services pursuant to sections  sixty-six
    43  hundred  five-a  and seven thousand one of this title, respectively, who
    44  are immediately available as needed.
    45    (b) After practicing for more than thirty-six hundred hours, a  certi-
    46  fied  registered  nurse  anesthetist shall function in an interdependent
    47  role as a member of the patient-centered care team  that  is  performing
    48  the patient's procedure, which shall include a physician, podiatrist, or
    49  dentist.
    50    3. Prescriptions for drugs, devices, and anesthetic agents, anesthesia
    51  related  agents,  and analgesics may be issued by a certified registered
    52  nurse anesthetist under this paragraph and  section  sixty-nine  hundred
    53  twenty-four  of this article, necessary to anesthesia care provided by a
    54  nurse anesthetist.   The certified registered  nurse  anesthetist  shall
    55  obtain  a certificate from the department upon successfully completing a
    56  program including an appropriate pharmacology component, or  its  equiv-

        S. 357--B                           3
 
     1  alent,  as  established  by  the  commissioner's  regulations,  prior to
     2  prescribing under this subdivision. The  license  issued  under  section
     3  sixty-nine  hundred  twenty-four of this article shall state whether the
     4  certified registered nurse anesthetist has successfully completed such a
     5  program or equivalent and is authorized to prescribe under this subdivi-
     6  sion.
     7    §  6922. Practice of certified registered nurse anesthetist and use of
     8  the title "certified registered nurse anesthetist"  or  "nurse  anesthe-
     9  tist". Only a person licensed or otherwise authorized under this article
    10  shall  practice  as  a  certified  registered nurse anesthetist or nurse
    11  anesthetist.
    12    § 6923. State board for nursing. The state board for nursing as estab-
    13  lished in section sixty-nine hundred four of this  title  shall  be  the
    14  governing state board for certified registered nurse anesthetists.
    15    §  6924.  Requirements  for  a license as a certified registered nurse
    16  anesthetist. To qualify for a license as a  certified  registered  nurse
    17  anesthetist, an applicant shall fulfill the following requirements:
    18    1. Application: file an application with the department;
    19    2.  License:  be New York state licensed and currently registered as a
    20  registered professional nurse;
    21    3. Education: have received a degree in a program of nurse  anesthesia
    22  from a program registered by the department or determined by the depart-
    23  ment  to be substantially equivalent or meet the requirements of section
    24  sixty-nine hundred twenty-seven of this article;
    25    4. Examination:  pass an examination satisfactory  to  the  department
    26  after  consultation  with  the state board for nursing and in accordance
    27  with the commissioner's regulations;
    28    5. Character: be of good moral character as determined by the  depart-
    29  ment; and
    30    6.  Fees: pay a fee of one hundred fifty dollars to the department for
    31  an initial license and a fee of fifty dollars for each triennial  regis-
    32  tration period.
    33    § 6925. Limited permits. 1.  The department may issue a limited permit
    34  to  an  applicant  who  is  New  York state licensed and registered as a
    35  registered nurse and meets all qualifications for licensure, except  the
    36  examination.
    37    2. Limited permits shall be for two years.
    38    3.  A  limited anesthetist permit shall entitle the holder to practice
    39  as a nurse  anesthetist  only  in  a  health  care  facility  under  the
    40  personal, on-premise supervision of a certified registered nurse anesth-
    41  etist  with more than thirty-six hundred hours of practice experience or
    42  physician who: (a) has completed a residency program  in  anesthesiology
    43  that  is  accredited  by  an  accrediting organization acceptable to the
    44  department; or (b) is board certified in anesthesiology by a  certifying
    45  organization  acceptable  to  the  department;  or (c) has medical staff
    46  privileges to provide anesthesia services at the  health  care  facility
    47  and with the endorsement of the health care facility.
    48    4. Fees. The fee for each limited permit shall be thirty-five dollars.
    49    § 6926. Exempt persons. This article shall not be construed:
    50    1. to limit or diminish the practice of the profession of nursing as a
    51  nurse  practitioner or registered professional nurse pursuant to article
    52  one hundred thirty-nine of this title or any other law, rule, regulation
    53  or certification;
    54    2. as prohibiting the furnishing of  nurse  anesthesia  assistance  in
    55  case of an emergency;

        S. 357--B                           4
 
     1    3.  as  prohibiting  such  performance  of nurse anesthesia service by
     2  students enrolled in department registered nurse anesthesia programs  or
     3  students enrolled in other nurse anesthesia programs that are authorized
     4  pursuant  to  section  two  hundred twenty-four of this chapter to place
     5  such  students  in  clinical  rotations  in this state under appropriate
     6  supervision; or
     7    4. as prohibiting or preventing the practice of  nurse  anesthesia  in
     8  this  state,  in obedience to the requirements of the laws of the United
     9  States, by any commissioned nurse anesthetist officer in the armed forc-
    10  es of the United States or by any  nurse  anesthetist  employed  in  the
    11  United  States  veterans  administration  or United States public health
    12  service while engaged in the performance of the actual duties prescribed
    13  for such nurse anesthetist under the United  States  statutes,  provided
    14  such  person  does  not  represent or hold themselves out as a certified
    15  registered nurse anesthetist registered to practice in this state.
    16    § 6927. Special provisions.   It shall be  lawful  for  an  individual
    17  practicing  as a certified registered nurse anesthetist in this state as
    18  of the effective date of this section that does not meet the educational
    19  requirements, but meets the other  requirements  of  section  sixty-nine
    20  hundred  twenty-four of this article, to continue such practice provided
    21  that such certified registered nurse anesthetist:
    22    1. submits evidence of certification as a certified  registered  nurse
    23  anesthetist  by  an  appropriate national certifying body to the depart-
    24  ment;
    25    2.  has  continually  maintained  active,  up-to-date  recertification
    26  status  as  a  certified  registered nurse anesthetist by an appropriate
    27  national recertifying body;
    28    3. has submitted an application for and obtained licensure  as  a  New
    29  York  state certified registered nurse anesthetist within three years of
    30  the effective date of this article; and
    31    4. nothing in this article shall be construed to authorize an individ-
    32  ual to continue to practice as or use the  title  "certified  registered
    33  nurse  anesthetist"  or  "CRNA"  beyond the three-year time frame unless
    34  such individual obtains a New York state license under this article.
    35    § 2. Section 6903 of the education law, as amended by chapter  323  of
    36  the laws of 2006, is amended to read  as follows:
    37    § 6903. Practice  of nursing and use of title "registered professional
    38  nurse" or "licensed practical nurse". Only a person licensed  or  other-
    39  wise  authorized  under  this  article shall practice nursing and only a
    40  person licensed under section sixty-nine hundred five  of  this  article
    41  shall  use  the  title "registered professional nurse" and only a person
    42  licensed under section sixty-nine hundred six of this article shall  use
    43  the  title  "licensed  practical  nurse".  No person shall use the title
    44  "nurse" or any other title or abbreviation that would represent  to  the
    45  public  that  the  person  is  authorized to practice nursing unless the
    46  person is licensed or otherwise authorized under this article or article
    47  one hundred thirty-nine-A of this title.
    48    § 3. Section 6904 of the education law, as amended by chapter  994  of
    49  the laws of 1971 and as renumbered by chapter 50 of the laws of 1972, is
    50  amended to read as follows:
    51    § 6904. State  board  for nursing.  A state board for nursing shall be
    52  appointed by the board of regents on recommendation of the  commissioner
    53  for  the purpose of assisting the board of regents and the department on
    54  matters of professional licensing and professional conduct in accordance
    55  with section sixty-five hundred eight of this title.  The board shall be
    56  composed of not less than [fifteen] seventeen members,  eleven  of  whom

        S. 357--B                           5
 
     1  shall  be  registered  professional  nurses  and  four  of whom shall be
     2  licensed practical nurses and two of whom shall be certified  registered
     3  nurse  anesthetists  all  licensed  and  practicing in this state for at
     4  least  five  years.    An  executive  secretary  to  the  board shall be
     5  appointed by the board of regents on recommendation of the  commissioner
     6  and shall be a registered professional nurse registered in this state.
     7    §  4.  This  act shall take effect eighteen months after it shall have
     8  become a law. Effective  immediately,  the  addition,  amendment  and/or
     9  repeal  of  any  rule  or regulation necessary for the implementation of
    10  this act on its effective date are authorized to be made  and  completed
    11  on or before such effective date.
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