S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   2563
 
                        2019-2020 Regular Sessions
 
                             I N  S E N A T E
 
                             January 28, 2019
                                ___________
 
 Introduced  by  Sen.  BAILEY -- 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  the  profession  of
   nurse anesthesia
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section 1. Legislative  intent.  The  legislature  hereby  finds  that
 certified  registered nurse anesthetists are highly educated and trained
 advanced practice nurses who hold a national professional certification,
 and whose competency in the professional practice of nurse anesthesia in
 hospitals, free-standing ambulatory surgery  centers,  clinics,  profes-
 sional  offices  and  other facilities is well known. Nurse anesthetists
 are integral to the continued professional delivery of services in  such
 health care facilities throughout the state.
   The  legislature  further  finds  that  statutory recognition of nurse
 anesthetists will further enhance  patient  safety  by  codifying  their
 professional  scope of practice that is currently governed in this state
 by regulations promulgated pursuant to the public health law in the case
 of hospitals and ambulatory surgery centers.
   The legislature also finds that while nurse anesthetists are  advanced
 practice  nurses, licensed as registered professional nurses under arti-
 cle 139 of the education law, no provision  of  this  act  is  meant  to
 limit,  diminish  or in any way impinge upon the practice of the profes-
 sion of nursing as a registered professional nurse under such article.
   Therefore, the legislature hereby declares that, due to the  intrinsic
 nature  of  the administration of anesthesia services, the integral part
 that certified registered nurse anesthetists play in the  safe  delivery
 of  such  services and the need to protect and enhance patient safety in
 all health care facilities, it is in the interest of the people of  this
 state to recognize the national professional certification of registered
 nurse  anesthetists  and  that  the  existing scope of practice of nurse

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

                                                            LBD03584-02-9

 S. 2563                             2
 
 anesthesia, as currently practiced in this state, be codified  in  stat-
 ute.
   §  2.    Section  6902 of the education law is amended by adding a new
 subdivision 4 to read as follows:
   4. (A) THE PRACTICE OF REGISTERED PROFESSIONAL NURSING BY A  CERTIFIED
 REGISTERED NURSE ANESTHETIST, CERTIFIED UNDER SECTION SIXTY-NINE HUNDRED
 TWELVE  OF  THIS  ARTICLE  MAY INCLUDE THE PRACTICE OF NURSE ANESTHESIA.
 NURSE ANESTHESIA INCLUDES: THE ADMINISTRATION OF  ANESTHESIA  AND  ANES-
 THESIA  RELATED CARE TO PATIENTS; PREANESTHETICS EVALUATION AND PREPARA-
 TION; ANESTHETIC INDUCTION, MAINTENANCE AND EMERGENCE;  POST  ANESTHESIA
 CARE;  PERIANESTHETICS  AND CLINICAL SUPPORT FUNCTIONS; AND PAIN MANAGE-
 MENT, IN COLLABORATION WITH A LICENSED PHYSICIAN  QUALIFIED  BY  LAW  TO
 DETERMINE  THE  NEED FOR ANESTHESIA SERVICES, PROVIDED SUCH SERVICES ARE
 PERFORMED IN ACCORDANCE WITH A WRITTEN PRACTICE  AGREEMENT  AND  WRITTEN
 PRACTICE PROTOCOLS. THE WRITTEN PRACTICE AGREEMENT SHALL INCLUDE EXPLIC-
 IT PROVISIONS FOR THE RESOLUTION OF ANY DISAGREEMENT BETWEEN THE COLLAB-
 ORATING PHYSICIAN AND THE CERTIFIED REGISTERED NURSE ANESTHETIST REGARD-
 ING  A  MATTER  OF  ANESTHESIA  TREATMENT  THAT  IS  WITHIN THE SCOPE OF
 PRACTICE OF BOTH. TO THE EXTENT  THE  PRACTICE  AGREEMENT  DOES  NOT  SO
 PROVIDE, THEN THE COLLABORATING PHYSICIAN'S TREATMENT SHALL PREVAIL.
   (B)  PRESCRIPTIONS  FOR  DRUGS,  DEVICES  AND ANESTHETIC AGENTS MAY BE
 ISSUED BY A CERTIFIED REGISTERED NURSE ANESTHETIST, UNDER THIS  SUBDIVI-
 SION  AND  SECTION SIXTY-NINE HUNDRED TWELVE OF THIS ARTICLE, IN ACCORD-
 ANCE WITH THE PRACTICE AGREEMENT AND PRACTICE PROTOCOLS.  THE  CERTIFIED
 REGISTERED NURSE ANESTHETIST SHALL OBTAIN A CERTIFICATE FROM THE DEPART-
 MENT  UPON  SUCCESSFULLY  COMPLETING  A PROGRAM INCLUDING AN APPROPRIATE
 PHARMACOLOGY COMPONENT, OR ITS EQUIVALENT, AS ESTABLISHED BY THE COMMIS-
 SIONER'S REGULATIONS, PRIOR TO PRESCRIBING UNDER THIS  SUBDIVISION.  THE
 CERTIFICATE ISSUED UNDER SECTION SIXTY-NINE HUNDRED TWELVE OF THIS ARTI-
 CLE  SHALL  STATE WHETHER THE CERTIFIED REGISTERED NURSE ANESTHETIST HAS
 SUCCESSFULLY COMPLETED SUCH A PROGRAM OR EQUIVALENT AND IS AUTHORIZED TO
 PRESCRIBE UNDER THIS SUBDIVISION.
   (C) EACH PRACTICE AGREEMENT SHALL PROVIDE FOR PATIENT  RECORDS  REVIEW
 BY  THE COLLABORATING PHYSICIAN IN A TIMELY FASHION BUT IN NO EVENT LESS
 OFTEN THAN EVERY THREE MONTHS. THE NAMES  OF  THE  CERTIFIED  REGISTERED
 NURSE ANESTHETIST AND THE COLLABORATING PHYSICIAN SHALL BE CLEARLY POST-
 ED  IN  THE  PRACTICE SETTING OF THE CERTIFIED REGISTERED NURSE ANESTHE-
 TIST.
   (D) THE PRACTICE PROTOCOL SHALL REFLECT CURRENT ACCEPTED  MEDICAL  AND
 NURSING PRACTICE. THE PROTOCOLS SHALL BE FILED WITH THE DEPARTMENT WITH-
 IN  NINETY  DAYS  OF THE COMMENCEMENT OF THE PRACTICE AND MAY BE UPDATED
 PERIODICALLY. THE COMMISSIONER SHALL MAKE REGULATIONS  ESTABLISHING  THE
 PROCEDURE  FOR THE REVIEW OF PROTOCOLS AND THE DISPOSITION OF ANY ISSUES
 ARISING FROM SUCH REVIEW.
   (E) NO PHYSICIAN SHALL ENTER INTO PRACTICE AGREEMENTS WITH  MORE  THAN
 FOUR  CERTIFIED REGISTERED NURSE ANESTHETISTS WHO ARE NOT LOCATED ON THE
 SAME PHYSICAL PREMISES AS THE COLLABORATING PHYSICIAN.
   (F) NOTHING IN THIS SUBDIVISION SHALL BE DEEMED TO LIMIT  OR  DIMINISH
 THE  PRACTICE  OF THE PROFESSION OF NURSING AS A REGISTERED PROFESSIONAL
 NURSE UNDER THIS ARTICLE OR ANY OTHER LAW, RULE, REGULATION  OR  CERTIF-
 ICATION,  NOR  TO DENY ANY REGISTERED PROFESSIONAL NURSE THE RIGHT TO DO
 ANY ACT OR ENGAGE IN ANY PRACTICE AUTHORIZED  BY  THIS  ARTICLE  OR  ANY
 OTHER LAW, RULE, REGULATION OR CERTIFICATION.
   (G) THE PROVISIONS OF THIS SUBDIVISION SHALL NOT APPLY TO ANY ACTIVITY
 AUTHORIZED,  PURSUANT TO STATUTE, RULE OR REGULATION, TO BE PERFORMED BY

 S. 2563                             3
 
 A REGISTERED PROFESSIONAL NURSE IN A  HOSPITAL  AS  DEFINED  IN  ARTICLE
 TWENTY-EIGHT OF THE PUBLIC HEALTH LAW.
   § 3. The education law is amended by adding a new section 6912 to read
 as follows:
   § 6912. CERTIFICATES FOR NURSE ANESTHESIA PRACTICE. 1. FOR ISSUANCE OF
 A  CERTIFICATE  TO  PRACTICE AS A CERTIFIED REGISTERED NURSE ANESTHETIST
 UNDER SUBDIVISION FOUR OF SECTION SIXTY-NINE HUNDRED TWO OF  THIS  ARTI-
 CLE, THE APPLICANT SHALL FULFILL THE FOLLOWING REQUIREMENTS:
   (A) APPLICATION: FILE AN APPLICATION WITH THE DEPARTMENT;
   (B)  LICENSE:  BE  LICENSED  AS A REGISTERED PROFESSIONAL NURSE IN THE
 STATE;
   (C) EDUCATION: (I) HAVE SATISFACTORILY COMPLETED EDUCATIONAL  PREPARA-
 TION  FOR  PROVISION  OF  THESE  SERVICES IN A PROGRAM REGISTERED BY THE
 DEPARTMENT OR IN A PROGRAM ACCREDITED BY A NATIONAL BODY  RECOGNIZED  BY
 THE DEPARTMENT OR DETERMINED BY THE DEPARTMENT TO BE THE EQUIVALENT; AND
 (II)  SUBMIT  EVIDENCE  OF CURRENT CERTIFICATION OR RECERTIFICATION BY A
 NATIONAL CERTIFYING BODY, RECOGNIZED BY THE DEPARTMENT;
   (D) FEES: PAY A FEE TO THE DEPARTMENT OF FIFTY DOLLARS FOR AN  INITIAL
 CERTIFICATE AUTHORIZING NURSE ANESTHESIA PRACTICE AND A TRIENNIAL REGIS-
 TRATION FEE OF THIRTY DOLLARS.
   AFTER A CERTIFIED REGISTERED NURSE ANESTHETIST'S INITIAL REGISTRATION,
 REGISTRATION  UNDER THIS SECTION SHALL BE COTERMINOUS WITH THE CERTIFIED
 REGISTERED NURSE ANESTHETIST'S REGISTRATION AS A PROFESSIONAL NURSE.
   2. ONLY A PERSON CERTIFIED UNDER THIS  SECTION  SHALL  USE  THE  TITLE
 "CERTIFIED REGISTERED NURSE ANESTHETIST".
   3.  THE PROVISIONS OF THIS SECTION SHALL NOT APPLY TO ANY ACT OR PRAC-
 TICE AUTHORIZED BY ANY OTHER LAW, RULE, REGULATION OR CERTIFICATION.
   4. THE PROVISIONS OF THIS SECTION SHALL  NOT  APPLY  TO  ANY  ACTIVITY
 AUTHORIZED,  PURSUANT TO STATUTE, RULE OR REGULATION, TO BE PERFORMED BY
 A REGISTERED PROFESSIONAL NURSE IN A  HOSPITAL  AS  DEFINED  IN  ARTICLE
 TWENTY-EIGHT OF THE PUBLIC HEALTH LAW.
   5.  AN  INDIVIDUAL WHO IS AUTHORIZED TO PRACTICE AS A CERTIFIED REGIS-
 TERED NURSE ANESTHETIST IN A HOSPITAL UNDER REGULATIONS OF  THE  DEPART-
 MENT  OF  HEALTH  MAY USE THE TITLE "CERTIFIED REGISTERED NURSE ANESTHE-
 TIST" IN CONNECTION WITH THAT PRACTICE.  IF SUCH AN  INDIVIDUAL  APPLIES
 FOR  A  CERTIFICATE UNDER THIS SECTION, HE OR SHE MAY SATISFY THE EDUCA-
 TION REQUIREMENT OF SUBDIVISION ONE OF THIS SECTION BY PRESENTING SATIS-
 FACTORY EVIDENCE OF SUCH AUTHORITY.
   6. (A) A REGISTERED PROFESSIONAL NURSE LICENSED UNDER  SECTION  SIXTY-
 NINE  HUNDRED  FIVE  OF  THIS ARTICLE WHO HAS SATISFACTORILY COMPLETED A
 PROGRAM OF EDUCATIONAL PREPARATION AS PROVIDED  IN  SUBDIVISION  ONE  OF
 THIS  SECTION  MAY,  FOR A PERIOD NOT TO EXCEED TWENTY-FOUR MONTHS IMME-
 DIATELY FOLLOWING THE COMPLETION OF SUCH EDUCATIONAL  PROGRAM,  PRACTICE
 NURSE  ANESTHESIA  UNDER  SUBDIVISION FOUR OF SECTION SIXTY-NINE HUNDRED
 TWO OF THIS ARTICLE AS A GRADUATE NURSE ANESTHETIST IN THE  SAME  MANNER
 AS A CERTIFIED REGISTERED NURSE ANESTHETIST UNDER THAT SUBDIVISION.
   (B)  A REGISTERED PROFESSIONAL NURSE LICENSED UNDER SECTION SIXTY-NINE
 HUNDRED FIVE OF THIS ARTICLE WHO IS DULY ENROLLED IN A PROGRAM OF EDUCA-
 TIONAL PREPARATION, MAY PRACTICE NURSE ANESTHESIA  AS  A  STUDENT  NURSE
 ANESTHETIST  UNDER THE SUPERVISION OF AN ANESTHESIOLOGIST OR A CERTIFIED
 REGISTERED NURSE ANESTHETIST, WHO IS IMMEDIATELY AVAILABLE AS NEEDED.
   7. THE COMMISSIONER IS AUTHORIZED TO PROMULGATE REGULATIONS TO  IMPLE-
 MENT THE PROVISIONS OF THIS SECTION.
   § 4. This act shall take effect immediately.