S T A T E   O F   N E W   Y O R K
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                                  2945

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                            January 25, 2013
                               ___________

Introduced  by  Sen.  HANNON -- 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  providing  for  the
  licensing  of  anesthesiologist assistants and regulating the practice
  of such professionals

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1.  Section  6523 of the education law, as amended by chapter
364 of the laws of 1991, is amended to read as follows:
  S 6523. State board for medicine.  A state board for medicine shall be
appointed by the board of regents on recommendation of the  commissioner
for  the purpose of assisting the board of regents and the department on
matters of professional licensing in accordance with section  sixty-five
hundred  eight  of  this  title. The board shall be composed of not less
than twenty physicians licensed in this state for at least  five  years,
two of whom shall be doctors of osteopathy. The board shall also consist
of not less than two physician's assistants licensed to practice in this
state.  The  participation  of  physician's  assistant  members shall be
limited to matters relating to article one hundred thirty-one-B of  this
[chapter]  TITLE.   THE BOARD OF MEDICINE SHALL ALSO CONSIST OF NOT LESS
THAN TWO ANESTHESIOLOGIST ASSISTANTS LICENSED TO PRACTICE IN THIS STATE.
THE PARTICIPATION OF ANESTHESIOLOGIST ASSISTANTS  SHALL  BE  LIMITED  TO
MATTERS  RELATING  TO  SECTION  SIXTY-FIVE HUNDRED TWENTY-NINE-A OF THIS
ARTICLE. An executive secretary to the board shall be appointed  by  the
board  of  regents  on  recommendation  of the commissioner and shall be
either a physician licensed in this state  or  a  non-physician,  deemed
qualified by the commissioner and board of regents.
  S  2.  The  education law is amended by adding a new section 6529-a to
read as follows:

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD05775-01-3

S. 2945                             2
              

  S  6529-A.  ANESTHESIOLOGIST  ASSISTANTS.  1.  DEFINITIONS.  FOR   THE
PURPOSES  OF  THIS SECTION, THE FOLLOWING TERMS SHALL HAVE THE FOLLOWING
MEANINGS:
  (A)  "ANESTHESIOLOGIST ASSISTANT" MEANS A PERSON WHO IS LICENSED AS AN
ANESTHESIOLOGIST ASSISTANT PURSUANT TO THIS SECTION.
  (B)  "ANESTHESIOLOGIST"  MEANS  A  PHYSICIAN  WHO   HAS   SUCCESSFULLY
COMPLETED  A  RESIDENCY IN ANESTHESIOLOGY APPROVED BY THE AMERICAN BOARD
OF MEDICINE OF ANESTHESIOLOGY  OR  THE  AMERICAN  OSTEOPATHIC  BOARD  OF
ANESTHESIOLOGY  AND WHO IS ACTIVELY AND DIRECTLY ENGAGED IN THE CLINICAL
PRACTICE OF MEDICINE AS AN ANESTHESIOLOGIST.
  (C) "ADMINISTRATION OF ANESTHESIA IN THE HOSPITAL OR AMBULATORY SURGI-
CAL CENTER" MEANS ANESTHESIA SERVICES SHALL BE DIRECTED BY  AN  ANESTHE-
SIOLOGIST  WHO  HAS RESPONSIBILITY FOR THE CLINICAL ASPECTS OR ORGANIZA-
TION AND DELIVERY OF ALL ANESTHESIA SERVICES PROVIDED BY THE HOSPITAL OR
AMBULATORY SURGICAL  CENTER.  THAT  ANESTHESIOLOGIST  SHALL  DIRECT  THE
ADMINISTRATION  ASPECTS  OF  THE  SERVICE,  AND SHALL BE RESPONSIBLE, IN
CONJUNCTION WITH THE MEDICAL STAFF, FOR RECOMMENDING  TO  THE  GOVERNING
BODY  PRIVILEGES  TO  THOSE PERSONS QUALIFIED TO ADMINISTER ANESTHETICS,
INCLUDING THE PROCEDURES EACH PERSON IS QUALIFIED  TO  PERFORM  AND  THE
LEVELS  OF REQUIRED SUPERVISION AS APPROPRIATE. FOR THE PURPOSES OF THIS
SECTION, "ADMINISTRATION OF ANESTHESIA IN OFFICE-BASED  SURGERY  VENUES"
MEANS  THE ANESTHESIA COMPONENT OF THE MEDICAL OR DENTAL PROCEDURE SHALL
BE SUPERVISED BY AN  ANESTHESIOLOGIST  WHO  IS  PHYSICALLY  PRESENT  AND
AVAILABLE  TO  IMMEDIATELY DIAGNOSE AND TREAT THE PATIENT FOR ANESTHESIA
COMPLICATIONS OR EMERGENCIES.
  (D) "DEEP SEDATION" MEANS THE  ADMINISTRATION  OF  MEDICATION  BY  THE
ORAL,  PARENTERAL  OR  INHALATION  ROUTES  WHICH RESULTS IN A CONTROLLED
STATE OF DEPRESSED CONSCIOUSNESS ACCOMPANIED BY PARTIAL LOSS OF  PROTEC-
TIVE  REFLEXES.  THERE  MAY BE AN INABILITY TO INDEPENDENTLY AND CONTIN-
UOUSLY MAINTAIN AN OPEN AIRWAY AND/OR  REGULAR  BREATHING  PATTERN  WITH
DEEP  SEDATION,  AND THE ABILITY TO APPROPRIATELY AND RATIONALLY RESPOND
TO PHYSICAL STIMULI AND VERBAL COMMANDS IS LOST.
  (E) "GENERAL ANESTHESIA" MEANS THE ADMINISTRATION OF A  MEDICATION  BY
THE  PARENTERAL OR INHALATION ROUTES WHICH RESULTS IN A CONTROLLED STATE
OF UNCONSCIOUSNESS ACCOMPANIED BY A COMPLETE LOSS OF PROTECTIVE REFLEXES
INCLUDING LOSS OF THE ABILITY TO INDEPENDENTLY AND CONTINUOUSLY MAINTAIN
PATIENT AIRWAY AND A REGULAR  BREATHING  PATTERN.    THERE  IS  ALSO  AN
INABILITY  TO  RESPOND  PURPOSEFULLY  TO  VERBAL COMMANDS AND/OR TACTILE
STIMULATION.
  (F) "HOSPITAL" MEANS AN INSTITUTION OR  FACILITY  POSSESSING  A  VALID
OPERATING  CERTIFICATE  ISSUED  PURSUANT  TO ARTICLE TWENTY-EIGHT OF THE
PUBLIC HEALTH LAW.
  (G) "AMBULATORY SURGICAL CENTER"  MEANS  AN  INSTITUTION  OR  FACILITY
POSSESSING  A  VALID  OPERATING  CERTIFICATE  ISSUED PURSUANT TO ARTICLE
TWENTY-EIGHT OF THE PUBLIC HEALTH LAW.
  (H) "IMMEDIATELY AVAILABLE" MEANS REMAINING PHYSICALLY PRESENT FOR THE
IMMEDIATE TREATMENT OF EMERGENCIES AND PROVIDING  INDICATED  POST-OPERA-
TIVE CARE.
  (I)  "MODERATE SEDATION" MEANS A DRUG-INDUCED DEPRESSION OF CONSCIOUS-
NESS DURING WHICH  (I)  THE  PATIENT  RESPONDS  PURPOSEFULLY  TO  VERBAL
COMMANDS, EITHER ALONE OR ACCOMPANIED BY LIGHT TACTILE STIMULATION; (II)
NO  INTERVENTIONS ARE REQUIRED TO MAINTAIN A PATIENT AIRWAY; (III) SPON-
TANEOUS VENTILATION IS ADEQUATE; AND (IV)  THE  PATENT'S  CARDIOVASCULAR
FUNCTION IS USUALLY MAINTAINED WITHOUT ASSISTANCE.
  (J) "MONITORING" MEANS THE CONTINUAL CLINICAL OBSERVATION OF A PATIENT
AND THE USE OF INSTRUMENTS TO MEASURE, DISPLAY, AND RECORD THE VALUES OF

S. 2945                             3

CERTAIN PHYSIOLOGIC VARIABLES SUCH AS PULSE, OXYGEN SATURATION, LEVEL OF
CONSCIOUSNESS, BLOOD PRESSURE AND RESPIRATION.
  (K) "OFFICE-BASED SURGERY" MEANS ANY SURGICAL OR OTHER INVASIVE PROCE-
DURE,  REQUIRING GENERAL ANESTHESIA, MODERATE SEDATION OR DEEP SEDATION,
AND ANY LIPOSUCTION PROCEDURE, WHERE SUCH  SURGICAL  OR  OTHER  INVASIVE
PROCEDURE  OR LIPOSUCTION IS PERFORMED BY A LICENSEE IN A LOCATION OTHER
THAN A HOSPITAL, EXCLUDING MINOR  PROCEDURES  AND  PROCEDURES  REQUIRING
MINIMAL SEDATION.
  (L) "PATIENT" MEANS AN INDIVIDUAL WHO IS UNDER THE CARE OF A PHYSICIAN
IN  A  LICENSED FACILITY OR IN AN OFFICE, UNDER THE CARE OF A PHYSICIAN,
DENTIST, ORAL SURGEON OR PODIATRIST.
  (M) "PERI-OPERATIVE PERIOD" MEANS THE PERIOD OF TIME  COMMENCING  UPON
THE MEDICAL EVALUATION OF THE PATIENT BEFORE SURGERY AND ENDING UPON THE
PATIENT'S MEDICAL DISCHARGE FROM THE RECOVERY ROOM.
  (N)  "PHYSICALLY  PRESENT" BY AN ANESTHESIOLOGIST MEANS THE ABILITY TO
REACT AND RESPOND IN AN IMMEDIATE AND APPROPRIATE MANNER SO AS  TO  MAKE
POSSIBLE  THE  CONTINUOUS  EXERCISE  OF  MEDICAL JUDGMENT THROUGHOUT THE
ADMINISTRATION OF THE ANESTHESIA.
  (O) "SUPERVISION" MEANS THAT  AN  ANESTHESIOLOGIST  SHALL  DIRECT  THE
ANESTHESIA  SERVICES  THAT  THE ANESTHESIOLOGIST ASSISTANT IS PERFORMING
INCLUDING BUT NOT LIMITED TO A  PRE-ANESTHETIC  EXAMINATION  AND  EVALU-
ATION,  PRESCRIBING THE ANESTHESIA, INCLUDING POST-OPERATIVE MEDICATIONS
AS NEEDED FOR PAIN AND DISCOMFORT, INCLUDING NAUSEA  AND  VOMITING,  AND
SHALL  BE  IMMEDIATELY AVAILABLE DURING THE ENTIRE PERI-OPERATIVE PERIOD
FOR DIAGNOSIS, TREATMENT, AND MANAGEMENT OF  ANESTHESIA-RELATED  COMPLI-
CATIONS  OR  EMERGENCIES, AND ASSURE THE PROVISION OF INDICATED POST-AN-
ESTHESIA CARE.
  2. LICENSURE. FOR ISSUANCE OF A LICENSE  TO  PRACTICE  AS  A  LICENSED
ANESTHESIOLOGIST  ASSISTANT  THE  APPLICANT  SHALL FULFILL THE FOLLOWING
REQUIREMENTS:
  (A) APPLICATION: FILE AN APPLICATION WITH THE DEPARTMENT  WHICH  SHALL
BE IN SUCH FORM AS PROVIDED BY THE COMMISSIONER;
  (B) AGE: BE AT LEAST TWENTY-ONE YEARS OF AGE AND OF GOOD MORAL CHARAC-
TER;
  (C) EDUCATION:
  (I)  HAVE OBTAINED A BACHELOR'S OR HIGHER DEGREE APPROVED BY THE BOARD
OF MEDICINE;
  (II)  HAVE  SATISFACTORILY  COMPLETED  AN  ANESTHESIOLOGIST  ASSISTANT
PROGRAM  THAT IS ACCREDITED BY THE COMMISSION ON ACCREDITATION OF ALLIED
HEALTH EDUCATION PROGRAMS OR BY A PREDECESSOR OR SUCCESSOR ENTITY;
  (III) PASSED THE CERTIFYING EXAMINATION ADMINISTERED BY  AND  OBTAINED
ACTIVE  CERTIFICATION  FROM  THE NATIONAL COMMISSION ON CERTIFICATION OF
ANESTHESIOLOGIST ASSISTANTS OR A SUCCESSOR ENTITY; AND
  (IV) BIENNIALLY COMPLETE FORTY HOURS OF CONTINUING  MEDICAL  EDUCATION
OR  HOLD  A  CURRENT  CERTIFICATE  ISSUED  BY THE NATIONAL COMMISSION ON
CERTIFICATION OF ANESTHESIOLOGIST ASSISTANTS OR ITS SUCCESSOR; AND
  (D) FEES: PAY TO THE DEPARTMENT A  FEE  OF  ONE  HUNDRED  SEVENTY-FIVE
DOLLARS  FOR  INITIAL  LICENSURE AND A TRIENNIAL REGISTRATION FEE OF ONE
HUNDRED FIFTY-FIVE DOLLARS.
  3. USE OF TITLE. ONLY A PERSON LICENSED UNDER THIS SECTION  SHALL  USE
THE  TITLE  "ANESTHESIOLOGIST ASSISTANT" OR USE THE LETTERS "A.A." AFTER
HIS OR HER NAME.
  4. PERFORMANCE OF ANESTHESIOLOGIST ASSISTANTS. THE PRACTICE OF ANESTH-
ESIOLOGIST ASSISTANTS LICENSED UNDER THIS SECTION SHALL:

S. 2945                             4

  (A) INCLUDE THE ADMINISTRATION OF ANESTHESIA TO  A  PATIENT  BUT  ONLY
UNDER  THE SUPERVISION OF AN  ANESTHESIOLOGIST WHO IS IMMEDIATELY AVAIL-
ABLE;
  (B) EACH ANESTHESIOLOGIST WHO AGREES TO ACT AS THE SUPERVISING ANESTH-
ESIOLOGIST  OF AN ANESTHESIOLOGIST ASSISTANT SHALL ADOPT A WRITTEN PRAC-
TICE PROTOCOL WHICH DELINEATES THE SERVICES  THAT  THE  ANESTHESIOLOGIST
ASSISTANT  IS AUTHORIZED TO PROVIDE AND THE MANNER IN WHICH THE ANESTHE-
SIOLOGIST WILL SUPERVISE THE ANESTHESIOLOGIST  ASSISTANT.  THE  ANESTHE-
SIOLOGIST  SHALL BASE THE PROVISIONS OF THE PROTOCOL ON CONSIDERATION OF
RELEVANT QUALITY ASSURANCE STANDARDS, INCLUDING REGULAR  REVIEW  BY  THE
ANESTHESIOLOGIST  OF THE MEDICAL RECORDS OF THE PATIENTS OF THE ANESTHE-
SIOLOGIST ASSISTANT. THE SUPERVISING  ANESTHESIOLOGIST  SHALL  SUPERVISE
THE  ANESTHESIOLOGIST  ASSISTANT  IN  ACCORDANCE  WITH  THE TERMS OF THE
PROTOCOL UNDER WHICH THE ASSISTANT PRACTICES AND THE  RULES  FOR  SUPER-
VISION OF ANESTHESIOLOGIST ASSISTANTS; AND
  (C)  BE CONSISTENT WITH POLICIES AND PROCEDURE APPROVED BY THE MEDICAL
STAFF AND GOVERNING STAFF OF THE HEALTH CARE FACILITY OR  FREE  STANDING
AMBULATORY  SURGICAL  CENTER  DEFINED  UNDER ARTICLE TWENTY-EIGHT OF THE
PUBLIC HEALTH LAW WHERE APPLICABLE.
  5.  THE COMMISSIONER IS AUTHORIZED AND DIRECTED  TO  PROMULGATE  REGU-
LATIONS TO IMPLEMENT THE PROVISIONS OF THIS SECTION.
  S  3.  This  act  shall  take effect on the first of the twelfth month
which commences after this act shall have become a law; provided, howev-
er, that effective immediately, the addition, amendment and/or repeal of
any rule or regulation necessary for the implementation of this  act  on
its  effective  date is authorized and directed to be made and completed
on or before such effective date.