S 357: 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 ________________________________________________________________________ 357 2025-2026 Regular Sessions  IN SENATE (Prefiled) January 8, 2025 ___________ Introduced by Sens. COONEY, ADDABBO, BAILEY, FERNANDEZ, GALLIVAN, GONZA- LEZ, HARCKHAM, HELMING, HINCHEY, PALUMBO, PARKER, RAMOS, RHOADS, RIVERA, SALAZAR, SANDERS, SKOUFIS, WEBB -- 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 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. EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD00477-01-5 
 S. 357 2 1 § 6921. Definition of practice of certified registered nurse anesthe- 2 tist. 1. In addition to the provisions of practice for registered 3 professional nursing outlined in section sixty-nine hundred two of this 4 title, the practice of a certified registered nurse anesthetist further 5 includes, but is not limited to, administration of anesthesia and 6 sedation to a patient; performing and documenting a preanesthetic 7 assessment and evaluation of the patient, including requesting consulta- 8 tions and diagnostic studies; selecting, obtaining, ordering, and admin- 9 istering preanesthetic medications and fluids; obtaining informed 10 consent for anesthesia, developing and implementing an anesthetic plan; 11 initiating the anesthetic technique; monitoring the patient including 12 selecting, applying, and inserting appropriate noninvasive and invasive 13 monitoring modalities for continuous evaluation of the patient's phys- 14 ical status; selecting, obtaining, and administering the anesthetics, 15 adjuvant and accessory drugs, and fluids necessary to manage anesthetics 16 and acute and chronic pain; ordering and evaluating laboratory and diag- 17 nostic tests and performing point-of-care testing; ordering and evaluat- 18 ing radiographic imaging studies; managing a patient's airway and 19 cardiopulmonary status using current practice modalities; facilitating 20 emergence and recovery from anesthesia by selecting, obtaining, ordering 21 and administering medications, fluids, and ventilatory support; 22 discharging the patient from a postanesthesia care area and providing 23 postanesthesia follow-up evaluation and care; implementing acute and 24 chronic pain management modalities; responding to emergency situations 25 by providing airway management, administration of emergency fluids and 26 drugs, and using basic or advanced cardiac life support techniques; and 27 prescribe tests, drugs and other treatments necessary to anesthesia care 28 provided by a nurse anesthetist. 29 2. (a) A certified registered nurse anesthetist licensed under this 30 article and practicing for thirty-six hundred hours or less shall do so 31 either under the direction of: (i) a physician who has completed a 32 residency program in anesthesiology that is accredited by an accrediting 33 organization acceptable to the department; (ii) a physician who is board 34 certified in anesthesiology by a certifying organization acceptable to 35 the department; (iii) a physician who has medical staff privileges to 36 provide anesthesia services (deep sedation, general and regional anes- 37 thesia assessments/administration) in a general hospital or ambulatory 38 surgery center authorized by article twenty-eight of the public health 39 law; or (iv) a dentist or podiatrist qualified to provide anesthesia 40 services as determined by the department on their cases. For purposes of 41 this section, direction shall mean patient care guidance and advice, 42 coordination and communication from the physician, dentist or podiatrist 43 to the certified registered nurse anesthetist practicing for less than 44 thirty-six hundred hours, as needed for the care of the patient. 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 a patient-centered care team. 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 necessary to anesthesia care provided by a nurse 51 anesthetist. The certified registered nurse anesthetist shall obtain a 52 certificate from the department upon successfully completing a program 53 including an appropriate pharmacology component, or its equivalent, as 54 established by the commissioner's regulations, prior to prescribing 55 under this subdivision. The license issued under this article shall 56 state whether the certified registered nurse anesthetist has successful- 
 S. 357 3 1 ly completed such a program or equivalent and is authorized to prescribe 2 under this subdivision. 3 4. Nothing in this section shall be deemed to limit or diminish the 4 practice of the profession of nursing as a registered professional nurse 5 under article one hundred thirty-nine of this title or any other law, 6 rule, regulation or certification, nor to deny any registered profes- 7 sional nurse the right to do any act or engage in any practice author- 8 ized by article one hundred thirty-nine of this title or any other law, 9 rule, regulation or certification. 10 § 6922. Practice of certified registered nurse anesthetist and use of 11 the title "certified registered nurse anesthetist" or "nurse anesthe- 12 tist". Only a person licensed or otherwise authorized under this article 13 shall practice as a certified registered nurse anesthetist or nurse 14 anesthetist, provided that any person who was practicing as a certified 15 registered nurse anesthetist in the state before the effective date of 16 this article shall have the right to continue using the title. Contin- 17 ued use of such title after that shall be dependent upon such person 18 applying for and obtaining a license from the department as a certified 19 registered nurse anesthetist pursuant to section sixty-nine hundred 20 twenty-seven of this article within three years from the effective date 21 of this article. 22 § 6923. State board for nursing. The state board for nursing as estab- 23 lished in section sixty-nine hundred four of this title shall be the 24 governing state board for certified registered nurse anesthetists. 25 § 6924. Requirements for a license as a certified registered nurse 26 anesthetist. To qualify for a license as a certified registered nurse 27 anesthetist, an applicant shall fulfill the following requirements: 28 1. Application: file an application with the department; 29 2. License: be New York state licensed and currently registered as a 30 registered professional nurse; 31 3. Education: have received a master's degree or higher in a program 32 of nurse anesthesia from a program registered by the department or 33 determined by the department to be substantially equivalent or meet the 34 requirements of section sixty-nine hundred twenty-seven of this article; 35 4. Examination: pass an examination satisfactory to the board and in 36 accordance with the commissioner's regulations; 37 5. Character: be of good moral character as determined by the depart- 38 ment; 39 6. Fees: pay a fee of one hundred fifty dollars to the department for 40 an initial license and a fee of fifty dollars for each triennial regis- 41 tration period; and 42 7. Information and documentation: in conjunction with and as a condi- 43 tion of each triennial registration a certified registered nurse anesth- 44 etist shall provide to the department, and the department shall collect, 45 such information and documentation required by the department, in 46 consultation with the department of health, as is necessary to enable 47 the department of health to evaluate access to needed services in this 48 state, including, but not limited to, the location and type of setting 49 wherein the certified registered nurse anesthetist practices and other 50 information the department, in consultation with the department of 51 health, deems relevant. The department of health, in consultation with 52 the department, shall make such data available in aggregate, de-identi- 53 fied form on a publicly accessible website. Additionally, in conjunc- 54 tion with each triennial registration, the department, in consultation 55 with the department of health, shall provide information on registering 
 S. 357 4 1 in the donate life registry for organ and tissue donation, including the 2 website address for such registry. 3 § 6925. Limited permits. 1. The department may issue a limited permit 4 to an applicant who is New York state licensed and registered as a 5 registered nurse and meets all qualifications for licensure, except the 6 examination and/or experience requirements, or to an applicant who is 7 gaining experience for the diagnostic privilege, in accordance with 8 regulations promulgated therefor. 9 2. Limited permits shall be for two years. 10 3. A limited anesthetist permit shall entitle the holder to practice 11 as a nurse anesthetist only in a health care facility under the 12 personal, on-premise supervision of a certified registered nurse anesth- 13 etist with more than thirty-six hundred hours of practice experience or 14 physician who: (a) has completed a residency program in anesthesiology 15 that is accredited by an accrediting organization acceptable to the 16 department; or (b) is board certified in anesthesiology by a certifying 17 organization acceptable to the department; or (c) has medical staff 18 privileges to provide anesthesia services at the health care facility 19 and with the endorsement of the health care facility. 20 4. Fees. The fee for each limited permit shall be thirty-five dollars. 21 § 6926. Exempt persons. This article shall not be construed: 22 1. as applying to any activity authorized, pursuant to statute, rule 23 or regulation, to be performed by a registered professional nurse in a 24 hospital as defined in article twenty-eight of the public health law; 25 2. as prohibiting the furnishing of nurse anesthesia assistance in 26 case of an emergency; 27 3. as prohibiting such performance of nurse anesthesia service by 28 students enrolled in department registered nurse anesthesia programs or 29 students enrolled in other nurse anesthesia programs that are authorized 30 pursuant to section two hundred twenty-four of this chapter to place 31 such students in clinical rotations in this state under appropriate 32 supervision; or 33 4. as prohibiting or preventing the practice of nurse anesthesia in 34 this state, in obedience to the requirements of the laws of the United 35 States, by any commissioned nurse anesthetist officer in the armed forc- 36 es of the United States or by any nurse anesthetist employed in the 37 United States veterans administration or United States public health 38 service while engaged in the performance of the actual duties prescribed 39 for such nurse anesthetist under the United States statutes, provided 40 such person does not represent or hold themselves out as a certified 41 registered nurse anesthetist registered to practice in this state. 42 § 6927. Special provisions. It shall be lawful for an individual 43 practicing as a certified registered nurse anesthetist in this state as 44 of the effective date of this section that does not meet the educational 45 requirements, but meets the other requirements of section sixty-nine 46 hundred twenty-four of this article, to continue such practice provided 47 that such certified registered nurse anesthetist: 48 1. submits evidence of certification as a certified registered nurse 49 anesthetist by an appropriate national certifying body to the depart- 50 ment; 51 2. has continually maintained active, up-to-date recertification 52 status as a certified registered nurse anesthetist by an appropriate 53 national recertifying body; and 54 3. has submitted an application for licensure. 55 § 2. Section 6903 of the education law, as amended by chapter 323 of 56 the laws of 2006, is amended to read as follows: 
 S. 357 5 1 § 6903. Practice of nursing and use of title "registered professional 2 nurse" or "licensed practical nurse". Only a person licensed or other- 3 wise authorized under this article shall practice nursing and only a 4 person licensed under section sixty-nine hundred five of this article 5 shall use the title "registered professional nurse" and only a person 6 licensed under section sixty-nine hundred six of this article shall use 7 the title "licensed practical nurse". No person shall use the title 8 "nurse" or any other title or abbreviation that would represent to the 9 public that the person is authorized to practice nursing unless the 10 person is licensed or otherwise authorized under this article or article 11 one hundred thirty-nine-A of this title. 12 § 3. Section 6904 of the education law, as amended by chapter 994 of 13 the laws of 1971 and as renumbered by chapter 50 of the laws of 1972, is 14 amended to read as follows: 15 § 6904. State board for nursing. A state board for nursing shall be 16 appointed by the board of regents on recommendation of the commissioner 17 for the purpose of assisting the board of regents and the department on 18 matters of professional licensing and professional conduct in accordance 19 with section sixty-five hundred eight of this title. The board shall be 20 composed of not less than [fifteen] seventeen members, eleven of whom 21 shall be registered professional nurses and four of whom shall be 22 licensed practical nurses and two of whom shall be certified registered 23 nurse anesthetists all licensed and practicing in this state for at 24 least five years. An executive secretary to the board shall be 25 appointed by the board of regents on recommendation of the commissioner 26 and shall be a registered professional nurse registered in this state. 27 § 4. This act shall take effect eighteen months after it shall have 28 become a law.