A 6771: 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.

  
  STATE OF NEW YORK ________________________________________________________________________ 6771 2025-2026 Regular Sessions  IN ASSEMBLY March 13, 2025 ___________ Introduced by M. of A. REYES, PAULIN, MAMDANI, R. CARROLL, BENDETT, RAGA, ZINERMAN, SEPTIMO, SANTABARBARA, JACOBSON, CLARK, DINOWITZ, LEVENBERG, SHIMSKY, TAPIA, KELLES, HEVESI, SAYEGH, McDONOUGH, LUNSFORD -- read once and referred to the Committee on Higher Education 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 19 professions contained in article one hundred thirty of this title apply 20 to this article. 21 § 6921. Definition of practice of certified registered nurse anesthe- 22 tist. 1. In addition to the provisions of practice for registered 23 professional nursing outlined in section sixty-nine hundred two of this EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD00477-03-5 
 A. 6771 2 1 title, the practice of a certified registered nurse anesthetist further 2 includes, but is not limited to, administration of anesthesia and 3 sedation to a patient; performing and documenting a preanesthetic 4 assessment and evaluation of the patient, including requesting consulta- 5 tions and diagnostic studies; selecting, obtaining, ordering, and admin- 6 istering preanesthetic medications and fluids; obtaining informed 7 consent for anesthesia, developing and implementing an anesthetic plan; 8 initiating the anesthetic technique; monitoring the patient including 9 selecting, applying, and inserting appropriate noninvasive and invasive 10 monitoring modalities for continuous evaluation of the patient's phys- 11 ical status; selecting, obtaining, and administering the anesthetics, 12 adjuvant and accessory drugs, and fluids necessary to manage anesthetics 13 and acute and chronic pain; ordering and evaluating laboratory and diag- 14 nostic tests and performing point-of-care testing; ordering and evaluat- 15 ing radiographic imaging studies; managing a patient's airway and 16 cardiopulmonary status using current practice modalities; facilitating 17 emergence and recovery from anesthesia by selecting, obtaining, ordering 18 and administering medications, fluids, and ventilatory support; 19 discharging the patient from a postanesthesia care area and providing 20 postanesthesia follow-up evaluation and care; implementing acute and 21 chronic pain management modalities; responding to emergency situations 22 by providing airway management, administration of emergency fluids and 23 drugs, and using basic or advanced cardiac life support techniques; and 24 prescribe tests, drugs and other treatments necessary to anesthesia care 25 provided by a nurse anesthetist. 26 2. (a) A certified registered nurse anesthetist licensed under this 27 article and practicing for thirty-six hundred hours or less shall do so 28 either under the direction of: (i) a physician who has completed a 29 residency program in anesthesiology that is accredited by an accrediting 30 organization acceptable to the department; (ii) a physician who is board 31 certified in anesthesiology by a certifying organization acceptable to 32 the department; (iii) the operating physician who the governing body of 33 the general hospital or ambulatory surgery center, that is subject to 34 section twenty-eight hundred one-b of the public health law, has deter- 35 mined is qualified to supervise anesthesia services in the general 36 hospital or ambulatory surgery center; or (iv) a dentist or podiatrist 37 qualified to provide anesthesia services pursuant to sections sixty-six 38 hundred five-a and seven thousand one of this title, respectively. For 39 purposes of this section, direction shall mean patient care guidance and 40 advice, coordination and communication from the physician, dentist or 41 podiatrist to the certified registered nurse anesthetist practicing for 42 less than thirty-six hundred hours, as needed for the care of the 43 patient. 44 (b) After practicing for more than thirty-six hundred hours, a certi- 45 fied registered nurse anesthetist shall function in an interdependent 46 role as a member of a patient-centered care team, which shall include a 47 physician, podiatrist, or dentist. 48 3. Prescriptions for drugs, devices, and anesthetic agents, anesthesia 49 related agents, and analgesics may be issued by a certified registered 50 nurse anesthetist under this paragraph and section sixty-nine hundred 51 twenty-four of this article, necessary to anesthesia care provided by a 52 nurse anesthetist. The certified registered nurse anesthetist shall 53 obtain a certificate from the department upon successfully completing a 54 program including an appropriate pharmacology component, or its equiv- 55 alent, as established by the commissioner's regulations, prior to 56 prescribing under this subdivision. The license issued under section 
 A. 6771 3 1 sixty-nine hundred twenty-four of this article shall state whether the 2 certified registered nurse anesthetist has successfully completed such a 3 program or equivalent and is authorized to prescribe under this subdivi- 4 sion. 5 § 6922. Practice of certified registered nurse anesthetist and use of 6 the title "certified registered nurse anesthetist" or "nurse anesthe- 7 tist". Only a person licensed or otherwise authorized under this article 8 shall practice as a certified registered nurse anesthetist or nurse 9 anesthetist. 10 § 6923. State board for nursing. The state board for nursing as estab- 11 lished in section sixty-nine hundred four of this title shall be the 12 governing state board for certified registered nurse anesthetists. 13 § 6924. Requirements for a license as a certified registered nurse 14 anesthetist. To qualify for a license as a certified registered nurse 15 anesthetist, an applicant shall fulfill the following requirements: 16 1. Application: file an application with the department; 17 2. License: be New York state licensed and currently registered as a 18 registered professional nurse; 19 3. Education: have received a degree in a program of nurse anesthesia 20 from a program registered by the department or determined by the depart- 21 ment to be substantially equivalent or meet the requirements of section 22 sixty-nine hundred twenty-seven of this article; 23 4. Examination: pass an examination satisfactory to the department 24 after consultation with the state board for nursing and in accordance 25 with the commissioner's regulations; 26 5. Character: be of good moral character as determined by the depart- 27 ment; and 28 6. Fees: pay a fee of one hundred fifty dollars to the department for 29 an initial license and a fee of fifty dollars for each triennial regis- 30 tration period. 31 § 6925. Limited permits. 1. The department may issue a limited permit 32 to an applicant who is New York state licensed and registered as a 33 registered nurse and meets all qualifications for licensure, except the 34 examination. 35 2. Limited permits shall be for two years. 36 3. A limited anesthetist permit shall entitle the holder to practice 37 as a nurse anesthetist only in a health care facility under the 38 personal, on-premise supervision of a certified registered nurse anesth- 39 etist with more than thirty-six hundred hours of practice experience or 40 physician who: (a) has completed a residency program in anesthesiology 41 that is accredited by an accrediting organization acceptable to the 42 department; or (b) is board certified in anesthesiology by a certifying 43 organization acceptable to the department; or (c) has medical staff 44 privileges to provide anesthesia services at the health care facility 45 and with the endorsement of the health care facility. 46 4. Fees. The fee for each limited permit shall be thirty-five dollars. 47 § 6926. Exempt persons. This article shall not be construed: 48 1. to limit or diminish the practice of the profession of nursing as a 49 nurse practitioner or registered professional nurse pursuant to article 50 one hundred thirty-nine of this title or any other law, rule, regulation 51 or certification; 52 2. as prohibiting the furnishing of nurse anesthesia assistance in 53 case of an emergency; 54 3. as prohibiting such performance of nurse anesthesia service by 55 students enrolled in department registered nurse anesthesia programs or 56 students enrolled in other nurse anesthesia programs that are authorized 
 A. 6771 4 1 pursuant to section two hundred twenty-four of this chapter to place 2 such students in clinical rotations in this state under appropriate 3 supervision; or 4 4. as prohibiting or preventing the practice of nurse anesthesia in 5 this state, in obedience to the requirements of the laws of the United 6 States, by any commissioned nurse anesthetist officer in the armed forc- 7 es of the United States or by any nurse anesthetist employed in the 8 United States veterans administration or United States public health 9 service while engaged in the performance of the actual duties prescribed 10 for such nurse anesthetist under the United States statutes, provided 11 such person does not represent or hold themselves out as a certified 12 registered nurse anesthetist registered to practice in this state. 13 § 6927. Special provisions. It shall be lawful for an individual 14 practicing as a certified registered nurse anesthetist in this state as 15 of the effective date of this section that does not meet the educational 16 requirements, but meets the other requirements of section sixty-nine 17 hundred twenty-four of this article, to continue such practice provided 18 that such certified registered nurse anesthetist: 19 1. submits evidence of certification as a certified registered nurse 20 anesthetist by an appropriate national certifying body to the depart- 21 ment; 22 2. has continually maintained active, up-to-date recertification 23 status as a certified registered nurse anesthetist by an appropriate 24 national recertifying body; 25 3. has submitted an application for and obtained licensure as a New 26 York state certified registered nurse anesthetist within three years of 27 the effective date of this article; and 28 4. nothing in this article shall be construed to authorize an individ- 29 ual to continue to practice as or use the title "certified registered 30 nurse anesthetist" or "CRNA" beyond the three-year time frame unless 31 such individual obtains a New York state license under this article. 32 § 2. Section 6903 of the education law, as amended by chapter 323 of 33 the laws of 2006, is amended to read as follows: 34 § 6903. Practice of nursing and use of title "registered professional 35 nurse" or "licensed practical nurse". Only a person licensed or other- 36 wise authorized under this article shall practice nursing and only a 37 person licensed under section sixty-nine hundred five of this article 38 shall use the title "registered professional nurse" and only a person 39 licensed under section sixty-nine hundred six of this article shall use 40 the title "licensed practical nurse". No person shall use the title 41 "nurse" or any other title or abbreviation that would represent to the 42 public that the person is authorized to practice nursing unless the 43 person is licensed or otherwise authorized under this article or article 44 one hundred thirty-nine-A of this title. 45 § 3. Section 6904 of the education law, as amended by chapter 994 of 46 the laws of 1971 and as renumbered by chapter 50 of the laws of 1972, is 47 amended to read as follows: 48 § 6904. State board for nursing. A state board for nursing shall be 49 appointed by the board of regents on recommendation of the commissioner 50 for the purpose of assisting the board of regents and the department on 51 matters of professional licensing and professional conduct in accordance 52 with section sixty-five hundred eight of this title. The board shall be 53 composed of not less than [fifteen] seventeen members, eleven of whom 54 shall be registered professional nurses and four of whom shall be 55 licensed practical nurses and two of whom shall be certified registered 56 nurse anesthetists all licensed and practicing in this state for at 
 A. 6771 5 1 least five years. An executive secretary to the board shall be 2 appointed by the board of regents on recommendation of the commissioner 3 and shall be a registered professional nurse registered in this state. 4 § 4. This act shall take effect eighteen months after it shall have 5 become a law. Effective immediately, the addition, amendment and/or 6 repeal of any rule or regulation necessary for the implementation of 7 this act on its effective date are authorized to be made and completed 8 on or before such effective date.