S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   5780
 
                        2017-2018 Regular Sessions
 
                             I N  S E N A T E
 
                              April 28, 2017
                                ___________
 
 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.    The  education  law  is amended by adding a new section
 6529-a to read as follows:
   §  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
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD10280-01-7

 S. 5780                             2
 
 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 IN PHYSICAL PROXIMITY SO
 AS TO ALLOW  THE  ANESTHESIOLOGIST  TO  RETURN  TO  RE-ESTABLISH  DIRECT
 CONTACT  WITH  THE  PATIENT IN ORDER TO MEET THE PATIENT'S MEDICAL NEEDS
 AND ADDRESS ANY URGENT OR EMERGENT CLINICAL PROBLEMS.
   (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
 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-

 S. 5780                             3

 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:
   (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. AN INDIVIDUAL WHO IS DULY ENROLLED  IN  A  PROGRAM  OF  EDUCATIONAL
 PREPAREDNESS  TO  BECOME  AN  ANESTHESIOLOGIST  ASSISTANT MAY ADMINISTER
 ANESTHESIA TO A PATIENT BUT ONLY UNDER THE DIRECT  PERSONAL  SUPERVISION
 OF AN ANESTHESIOLOGIST.

 S. 5780                             4

   6.  THE  COMMISSIONER  IS  AUTHORIZED AND DIRECTED TO PROMULGATE REGU-
 LATIONS TO IMPLEMENT THE PROVISIONS OF THIS SECTION.
   §  2. This act shall take effect on the first day 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 are authorized and directed to be made and completed
 on or before such effective date.