S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   6958
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                                May 9, 2023
                                ___________
 
 Introduced  by M. of A. REYES -- 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:

   Section 1. The education law is amended by adding a new article  139-A
 to read as follows:
                               ARTICLE 139-A
                  CERTIFIED REGISTERED NURSE ANESTHETIST
 SECTION 6912. INTRODUCTION.
         6913. DEFINITIONS.
         6914.  DEFINITION  OF  PRACTICE  OF  CERTIFIED  REGISTERED NURSE
                 ANESTHETIST.
         6915. PRACTICE OF CERTIFIED REGISTERED NURSE ANESTHETIST AND USE
                 OF THE TITLE "CERTIFIED REGISTERED NURSE ANESTHETIST" OR
                 "NURSE ANESTHETIST".
         6916. STATE BOARD FOR NURSING.
         6917. REQUIREMENTS FOR A LICENSE AS A CERTIFIED REGISTERED NURSE
                 ANESTHETIST.
         6918. LIMITED PERMITS.
         6919. EXEMPT PERSONS.
         6920. SPECIAL PROVISIONS.
   § 6912. INTRODUCTION. THIS ARTICLE APPLIES TO THE PROFESSION OF CERTI-
 FIED REGISTERED  NURSE  ANESTHETIST.  THE  GENERAL  PROVISIONS  FOR  ALL
 PROFESSIONS  CONTAINED IN ARTICLE ONE HUNDRED THIRTY OF THIS TITLE APPLY
 TO THIS ARTICLE.
   § 6913. DEFINITIONS. AS USED IN THIS ARTICLE:
   1. "HEALTHCARE FACILITY" MEANS:
   A. A HOSPITAL OR AMBULATORY SURGERY CENTER  AUTHORIZED  UNDER  ARTICLE
 TWENTY-EIGHT OF THE PUBLIC HEALTH LAW;
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD02498-01-3
              

 A. 6958                             2
 
   B.  A  FACILITY AUTHORIZED TO PERFORM OFFICE-BASED SURGERY PURSUANT TO
 ARTICLE TWO OF SECTION TWO HUNDRED THIRTY-D OF THE PUBLIC HEALTH LAW; OR
   C.  THE  OFFICE  OF  A  PROFESSIONAL LICENSED TO PRACTICE IN THE STATE
 PURSUANT TO ARTICLE ONE HUNDRED THIRTY-THREE OF THE EDUCATION LAW.
   2. "PERI-ANESTHETIC PERIOD" MEANS THE PERIOD OF TIME  COMMENCING  UPON
 THE  PRE-OPERATIVE  EVALUATION  OF THE PATIENT BEFORE SURGERY AND ENDING
 UPON THE PATIENT'S POST-OPERATIVE DISCHARGE.
   3. "PERI-OBSTETRIC PERIOD" MEANS THE PERIOD OF  TIME  COMMENCING  UPON
 THE PREANESTHETIC PREPARATION OR EVALUATION, ANESTHESIA INDUCTION, MAIN-
 TENANCE  OR  EMERGENCE,  OR POSTANESTHESIA CARE OF THE OBSTETRIC PATIENT
 AND ENDING UPON THE PATIENT'S POST-OBSTETRIC DISCHARGE.
   4. "PERI-PROCEDURAL PERIOD" MEANS THE PERIOD OF TIME  COMMENCING  UPON
 THE  PRE-PROCEDURE  EVALUATION  OF  THE  PATIENT  BEFORE A PROCEDURE AND
 ENDING UPON THE PATIENT'S POST-PROCEDURE DISCHARGE.
   5.  "COLLABORATING  PHYSICIAN"  MEANS  AN  ANESTHESIOLOGIST  OR  OTHER
 LICENSED  PHYSICIAN  QUALIFIED  TO  DETERMINE  THE  NEED  FOR ANESTHESIA
 SERVICES.
   § 6914. DEFINITION OF PRACTICE OF CERTIFIED REGISTERED NURSE  ANESTHE-
 TIST.  1.  IN  ADDITION  TO  THE  PROVISIONS  OF PRACTICE FOR REGISTERED
 PROFESSIONAL NURSING OUTLINED IN SECTION SIXTY-NINE HUNDRED TWO OF  THIS
 TITLE,  THE PRACTICE OF A CERTIFIED REGISTERED NURSE ANESTHETIST FURTHER
 INCLUDES, BUT IS NOT LIMITED  TO,  ADMINISTRATION  OF  ANESTHESIA  TO  A
 PATIENT  DURING  THE PERI-ANESTHETIC, PERI-OBSTETRIC, OR PERI-PROCEDURAL
 PERIOD AT A HEALTHCARE FACILITY; PERFORMING AND DOCUMENTING  A  PREANES-
 THETIC  ASSESSMENT  AND  EVALUATION OF THE PATIENT, INCLUDING REQUESTING
 CONSULTATIONS AND DIAGNOSTIC STUDIES;  SELECTING,  OBTAINING,  ORDERING,
 AND   ADMINISTERING  PREANESTHETIC  MEDICATIONS  AND  FLUIDS;  OBTAINING
 INFORMED CONSENT FOR ANESTHESIA, DEVELOPING AND  IMPLEMENTING  AN  ANES-
 THETIC PLAN; INITIATING THE ANESTHETIC TECHNIQUE; MONITORING THE PATIENT
 INCLUDING SELECTING, APPLYING, AND INSERTING APPROPRIATE NONINVASIVE AND
 INVASIVE   MONITORING   MODALITIES  FOR  CONTINUOUS  EVALUATION  OF  THE
 PATIENT'S PHYSICAL STATUS; SELECTING, OBTAINING, AND  ADMINISTERING  THE
 ANESTHETICS,  ADJUVANT  AND  ACCESSORY  DRUGS,  AND  FLUIDS NECESSARY TO
 MANAGE THE ANESTHETIC; ORDERING AND EVALUATING LABORATORY AND DIAGNOSTIC
 TESTS AND PERFORMING  POINT-OF-CARE  TESTING;  ORDERING  AND  EVALUATING
 RADIOGRAPHIC  IMAGING STUDIES; MANAGING A PATIENT'S AIRWAY AND PULMONARY
 STATUS USING CURRENT PRACTICE  MODALITIES;  FACILITATING  EMERGENCE  AND
 RECOVERY  FROM ANESTHESIA BY SELECTING, OBTAINING, ORDERING AND ADMINIS-
 TERING MEDICATIONS, FLUIDS, AND  VENTILATORY  SUPPORT;  DISCHARGING  THE
 PATIENT  FROM  A  POSTANESTHESIA  CARE AREA AND PROVIDING POSTANESTHESIA
 FOLLOW-UP EVALUATION AND  CARE;  IMPLEMENTING  ACUTE  AND  CHRONIC  PAIN
 MANAGEMENT MODALITIES; AND RESPONDING TO EMERGENCY SITUATIONS BY PROVID-
 ING AIRWAY MANAGEMENT, ADMINISTRATION OF EMERGENCY FLUIDS AND DRUGS, AND
 USING BASIC OR ADVANCED CARDIAC LIFE SUPPORT TECHNIQUES.
   2.  NURSE  ANESTHESIA MUST BE PROVIDED IN COLLABORATION WITH A COLLAB-
 ORATING PHYSICIAN, PROVIDED SUCH SERVICES ARE  PERFORMED  IN  ACCORDANCE
 WITH  A WRITTEN PRACTICE AGREEMENT AND WRITTEN PRACTICE PROTOCOLS AS SET
 FORTH IN SUBDIVISION FOUR OF THIS SECTION OR PURSUANT  TO  COLLABORATIVE
 RELATIONSHIPS AS SET FORTH IN SUBDIVISION FIVE OF THIS SECTION, WHICHEV-
 ER IS APPLICABLE.
   3. PRESCRIPTIONS FOR DRUGS, DEVICES, AND ANESTHETIC AGENTS, ANESTHESIA
 RELATED  AGENTS,  AND ANALGESICS MAY BE ISSUED BY A CERTIFIED REGISTERED
 NURSE ANESTHETIST DURING THE PERI-ANESTHETIC, PERI-OBSTETRIC,  OR  PERI-
 OPERATIVE  PERIOD, IN ACCORDANCE WITH THE WRITTEN PRACTICE AGREEMENT AND
 WRITTEN PRACTICE PROTOCOLS DESCRIBED IN SUBDIVISION FOUR OF THIS SECTION
 IF APPLICABLE.  THE CERTIFIED REGISTERED NURSE ANESTHETIST SHALL  OBTAIN
 A. 6958                             3
 
 A CERTIFICATE FROM THE DEPARTMENT UPON SUCCESSFULLY COMPLETING A PROGRAM
 INCLUDING  AN  APPROPRIATE PHARMACOLOGY COMPONENT, OR ITS EQUIVALENT, AS
 ESTABLISHED BY THE  COMMISSIONER'S  REGULATIONS,  PRIOR  TO  PRESCRIBING
 UNDER  THIS  SUBDIVISION.  THE  LICENSE  ISSUED UNDER THIS ARTICLE SHALL
 STATE WHETHER THE CERTIFIED REGISTERED NURSE ANESTHETIST HAS SUCCESSFUL-
 LY COMPLETED SUCH A PROGRAM OR EQUIVALENT AND IS AUTHORIZED TO PRESCRIBE
 UNDER THIS SUBDIVISION.
   4. A CERTIFIED REGISTERED NURSE ANESTHETIST LICENSED UNDER THIS  ARTI-
 CLE  AND  PRACTICING FOR THIRTY-SIX HUNDRED HOURS OR LESS SHALL DO SO IN
 ACCORDANCE WITH A WRITTEN PRACTICE AGREEMENT AND WRITTEN PRACTICE PROTO-
 COLS AGREED UPON BY A COLLABORATING PHYSICIAN, WHO SHALL  BE  REASONABLY
 AVAILABLE FOR CONSULTATION AS NEEDED.
   (A)  THE  WRITTEN PRACTICE AGREEMENT SHALL INCLUDE EXPLICIT PROVISIONS
 FOR THE RESOLUTION OF ANY DISAGREEMENT BETWEEN THE COLLABORATING  PHYSI-
 CIAN  AND  THE CERTIFIED REGISTERED NURSE ANESTHETIST REGARDING A MATTER
 OF ANESTHESIA OR PAIN MANAGEMENT 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) 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 AVAILABLE IN
 THE PRACTICE SETTING OF THE CERTIFIED REGISTERED NURSE ANESTHETIST.
   (C) THE PRACTICE PROTOCOL SHALL REFLECT CURRENT ACCEPTED  MEDICAL  AND
 NURSING  PRACTICE.  THE COMMISSIONER SHALL MAKE REGULATIONS ESTABLISHING
 THE PROCEDURE FOR THE REVIEW OF PROTOCOLS AND  THE  DISPOSITION  OF  ANY
 ISSUES ARISING FROM SUCH REVIEW.
   5.  A CERTIFIED REGISTERED NURSE ANESTHETIST LICENSED UNDER THIS ARTI-
 CLE AND PRACTICING FOR MORE THAN THIRTY-SIX  HUNDRED  HOURS  SHALL  HAVE
 COLLABORATIVE  RELATIONSHIPS  WITH ONE OR MORE COLLABORATING PHYSICIANS,
 WHO SHALL BE REASONABLY AVAILABLE  FOR  CONSULTATION  AS  NEEDED,  OR  A
 HOSPITAL,  LICENSED UNDER ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW,
 THAT PROVIDES SERVICES THROUGH COLLABORATING  PHYSICIANS  HAVING  PRIVI-
 LEGES AT SUCH INSTITUTION.
   (A)  FOR  PURPOSES  OF THIS SUBDIVISION, "COLLABORATIVE RELATIONSHIPS"
 SHALL MEAN THAT THE CERTIFIED REGISTERED NURSE ANESTHETIST SHALL  COMMU-
 NICATE,  WHETHER  IN  PERSON, BY TELEPHONE OR THROUGH WRITTEN (INCLUDING
 ELECTRONIC) MEANS, WITH A COLLABORATING PHYSICIAN, OR, IN THE CASE OF  A
 HOSPITAL,  COMMUNICATE  WITH A COLLABORATING PHYSICIAN HAVING PRIVILEGES
 AT SUCH HOSPITAL, FOR THE PURPOSES OF EXCHANGING INFORMATION, AS NEEDED,
 IN ORDER TO PROVIDE COMPREHENSIVE PATIENT CARE AND TO MAKE REFERRALS  AS
 NECESSARY.
   (B)  AS EVIDENCE THAT THE CERTIFIED REGISTERED NURSE ANESTHETIST MAIN-
 TAINS  COLLABORATIVE  RELATIONSHIPS,  THE  CERTIFIED  REGISTERED   NURSE
 ANESTHETIST  SHALL  COMPLETE AND MAINTAIN A FORM, CREATED BY THE DEPART-
 MENT, TO WHICH THE CERTIFIED REGISTERED NURSE ANESTHETIST SHALL  ATTEST,
 THAT  DESCRIBES  SUCH  COLLABORATIVE RELATIONSHIPS. SUCH FORM SHALL ALSO
 REFLECT THE CERTIFIED  REGISTERED  NURSE  ANESTHETIST'S  ACKNOWLEDGEMENT
 THAT  IF  REASONABLE  EFFORTS TO RESOLVE ANY DISPUTE THAT MAY ARISE WITH
 THE COLLABORATING PHYSICIAN OR, IN THE CASE OF A  COLLABORATION  WITH  A
 HOSPITAL,  WITH  A  COLLABORATING  PHYSICIAN  HAVING  PRIVILEGES AT SUCH
 HOSPITAL, ABOUT A PATIENT'S CARE ARE NOT SUCCESSFUL, THE  RECOMMENDATION
 OF THE PHYSICIAN SHALL PREVAIL. SUCH FORM SHALL BE UPDATED AS NEEDED AND
 MAY  BE  SUBJECT  TO  REVIEW BY THE DEPARTMENT. THE CERTIFIED REGISTERED
 NURSE ANESTHETIST SHALL MAINTAIN DOCUMENTATION THAT SUPPORTS SUCH COLLA-
 BORATIVE RELATIONSHIPS.
 A. 6958                             4
 
   6. NOTHING IN THIS SECTION SHALL BE DEEMED TO LIMIT  OR  DIMINISH  THE
 PRACTICE OF THE PROFESSION OF NURSING AS A REGISTERED PROFESSIONAL NURSE
 UNDER  ARTICLE  ONE  HUNDRED THIRTY-NINE OF THIS TITLE OR ANY OTHER LAW,
 RULE, REGULATION OR CERTIFICATION, NOR TO DENY  ANY  REGISTERED  PROFES-
 SIONAL  NURSE  THE RIGHT TO DO ANY ACT OR ENGAGE IN ANY PRACTICE AUTHOR-
 IZED BY ARTICLE ONE HUNDRED THIRTY-NINE OF THIS TITLE OR ANY OTHER  LAW,
 RULE, REGULATION OR CERTIFICATION.
   §  6915. PRACTICE OF CERTIFIED REGISTERED NURSE ANESTHETIST AND USE OF
 THE TITLE "CERTIFIED REGISTERED NURSE ANESTHETIST"  OR  "NURSE  ANESTHE-
 TIST." ONLY A PERSON LICENSED OR OTHERWISE AUTHORIZED UNDER THIS ARTICLE
 SHALL  PRACTICE  AS  A  CERTIFIED  REGISTERED NURSE ANESTHETIST OR NURSE
 ANESTHETIST, PROVIDED THAT ANY PERSON WHO WAS PRACTICING AS A  CERTIFIED
 REGISTERED  NURSE  ANESTHETIST IN THE STATE BEFORE THE EFFECTIVE DATE OF
 THIS ARTICLE SHALL HAVE THE RIGHT TO CONTINUE USING THE TITLE.
   § 6916. STATE BOARD FOR NURSING. THE STATE BOARD FOR NURSING AS ESTAB-
 LISHED IN SECTION SIXTY-NINE HUNDRED FOUR OF THIS  TITLE  SHALL  BE  THE
 GOVERNING STATE BOARD FOR CERTIFIED REGISTERED NURSE ANESTHETISTS.
   §  6917.  REQUIREMENTS  FOR  A LICENSE AS A CERTIFIED REGISTERED NURSE
 ANESTHETIST. TO QUALIFY FOR A LICENSE AS A  CERTIFIED  REGISTERED  NURSE
 ANESTHETIST, AN APPLICANT SHALL FULFILL THE FOLLOWING REQUIREMENTS:
   1. APPLICATION: FILE AN APPLICATION WITH THE DEPARTMENT;
   2. LICENSE: BE LICENSED AS A REGISTERED PROFESSIONAL NURSE;
   3.  EDUCATION:  HAVE RECEIVED A MASTER'S DEGREE OR HIGHER IN A PROGRAM
 OF NURSE ANESTHESIA IN ACCORDANCE WITH THE COMMISSIONER'S REGULATIONS;
   4. EXAMINATION: MEET THE STANDARDS TO  SIT  FOR  THE  CERTIFYING  EXAM
 PROVIDED BY THE NATIONAL BOARD FOR CERTIFICATION OF NURSE ANESTHETISTS;
   5.  CHARACTER: BE OF GOOD MORAL CHARACTER AS DETERMINED BY THE DEPART-
 MENT;
   6. FEES: PAY A FEE OF FIFTY DOLLARS TO THE DEPARTMENT FOR  AN  INITIAL
 LICENSE  AND  A  FEE  OF  THIRTY DOLLARS FOR EACH TRIENNIAL REGISTRATION
 PERIOD; AND
   7. INFORMATION AND DOCUMENTATION: IN CONJUNCTION WITH AND AS A  CONDI-
 TION  OF EACH TRIENNIAL REGISTRATION, PROVIDE TO THE DEPARTMENT, AND THE
 DEPARTMENT SHALL COLLECT, SUCH INFORMATION AND DOCUMENTATION REQUIRED BY
 THE DEPARTMENT, IN CONSULTATION WITH THE DEPARTMENT  OF  HEALTH,  AS  IS
 NECESSARY TO ENABLE THE DEPARTMENT OF HEALTH TO EVALUATE ACCESS TO NEED-
 ED  SERVICES  IN THIS STATE, INCLUDING, BUT NOT LIMITED TO, THE LOCATION
 AND TYPE OF SETTING WHEREIN THE CERTIFIED REGISTERED  NURSE  ANESTHETIST
 PRACTICES AND OTHER INFORMATION THE DEPARTMENT, IN CONSULTATION WITH THE
 DEPARTMENT  OF  HEALTH,  DEEMS  RELEVANT.  THE  DEPARTMENT OF HEALTH, IN
 CONSULTATION WITH THE DEPARTMENT, SHALL  MAKE  SUCH  DATA  AVAILABLE  IN
 AGGREGATE,  DE-IDENTIFIED  FORM ON A PUBLICLY ACCESSIBLE WEBSITE.  ADDI-
 TIONALLY, IN CONJUNCTION WITH EACH TRIENNIAL REGISTRATION,  THE  DEPART-
 MENT,  IN  CONSULTATION  WITH  THE  DEPARTMENT  OF HEALTH, SHALL PROVIDE
 INFORMATION ON REGISTERING IN THE DONATE LIFE  REGISTRY  FOR  ORGAN  AND
 TISSUE DONATION, INCLUDING THE WEBSITE ADDRESS FOR SUCH REGISTRY.
   § 6918. LIMITED PERMITS. 1. A PERMIT TO PRACTICE AS A CERTIFIED REGIS-
 TERED  NURSE ANESTHETIST MAY BE ISSUED BY THE DEPARTMENT UPON THE FILING
 OF AN APPLICATION FOR A LICENSE AS A CERTIFIED REGISTERED NURSE ANESTHE-
 TIST AND SUBMISSION OF SUCH OTHER  INFORMATION  AS  THE  DEPARTMENT  MAY
 REQUIRE  TO  (A)  GRADUATES OF SCHOOLS OF NURSE ANESTHESIA REGISTERED BY
 THE DEPARTMENT OR (B) GRADUATES OF SCHOOLS OF NURSE ANESTHESIA  APPROVED
 IN ANOTHER STATE, PROVINCE, OR COUNTRY.
   2. SUCH LIMITED PERMIT SHALL EXPIRE ONE YEAR FROM THE DATE OF ISSUANCE
 OR  UPON  NOTICE TO THE APPLICANT BY THE DEPARTMENT THAT THE APPLICATION
 A. 6958                             5
 
 FOR LICENSE HAS BEEN DENIED. THE LIMITED PERMIT MAY BE RENEWED,  AT  THE
 DISCRETION OF THE DEPARTMENT, FOR ONE ADDITIONAL YEAR.
   3.  A  LIMITED PERMIT SHALL ENTITLE THE HOLDER TO PRACTICE NURSE ANES-
 THESIA ONLY UNDER  THE  SUPERVISION  OF  A  CERTIFIED  REGISTERED  NURSE
 ANESTHETIST  OR  COLLABORATING  PHYSICIAN  CURRENTLY  REGISTERED IN THIS
 STATE AND WITH THE ENDORSEMENT OF THE EMPLOYING AGENCY.
   4. FEES. THE FEE FOR EACH LIMITED PERMIT SHALL BE THIRTY-FIVE DOLLARS.
   § 6919. EXEMPT PERSONS. THIS ARTICLE SHALL NOT BE CONSTRUED:
   1. AS APPLYING 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;
   2. AS PROHIBITING THE FURNISHING OF  NURSE  ANESTHESIA  ASSISTANCE  IN
 CASE OF AN EMERGENCY;
   3.  AS  PROHIBITING  SUCH  PERFORMANCE  OF NURSE ANESTHESIA SERVICE BY
 STUDENTS ENROLLED IN REGISTERED SCHOOLS OR PROGRAMS AS MAY BE INCIDENTAL
 TO THEIR COURSE OF STUDY;
   4. AS PROHIBITING OR PREVENTING THE PRACTICE OF  NURSE  ANESTHESIA  IN
 THIS  STATE BY ANY LEGALLY QUALIFIED NURSE OR PRACTICAL NURSE OF ANOTHER
 STATE, PROVINCE, OR COUNTRY WHOSE ENGAGEMENT  REQUIRES  HIM  OR  HER  TO
 ACCOMPANY  AND  CARE  FOR  A  PATIENT TEMPORARILY RESIDING IN THIS STATE
 DURING THE PERIOD OF SUCH  ENGAGEMENT  PROVIDED  SUCH  PERSON  DOES  NOT
 REPRESENT OR HOLD HIMSELF OR HERSELF OUT AS A CERTIFIED REGISTERED NURSE
 ANESTHETIST REGISTERED TO PRACTICE IN THIS STATE;
   5.  AS  PROHIBITING  OR PREVENTING THE PRACTICE OF NURSE ANESTHESIA IN
 THIS STATE DURING AN EMERGENCY OR  DISASTER  BY  ANY  LEGALLY  QUALIFIED
 NURSE  ANESTHETIST  OF  ANOTHER  STATE,  PROVINCE, OR COUNTRY WHO MAY BE
 RECRUITED BY THE AMERICAN NATIONAL RED CROSS OR  PURSUANT  TO  AUTHORITY
 VESTED  IN  THE  STATE  CIVIL  DEFENSE  COMMISSION FOR SUCH EMERGENCY OR
 DISASTER SERVICE, PROVIDED  SUCH  PERSON  DOES  NOT  REPRESENT  OR  HOLD
 HIMSELF  OR  HERSELF  OUT  AS  A  CERTIFIED REGISTERED NURSE ANESTHETIST
 REGISTERED TO PRACTICE IN THIS STATE;
   6. AS PROHIBITING OR PREVENTING THE PRACTICE OF  NURSE  ANESTHESIA  IN
 THIS  STATE,  IN OBEDIENCE TO THE REQUIREMENTS OF THE LAWS OF THE UNITED
 STATES, BY ANY COMMISSIONED NURSE ANESTHETIST OFFICER IN THE ARMED FORC-
 ES OF THE UNITED STATES OR BY ANY  NURSE  ANESTHETIST  EMPLOYED  IN  THE
 UNITED  STATES  VETERANS  ADMINISTRATION  OR UNITED STATES PUBLIC HEALTH
 SERVICE WHILE ENGAGED IN THE PERFORMANCE OF THE ACTUAL DUTIES PRESCRIBED
 FOR HIM OR HER UNDER THE UNITED STATES STATUTES,  PROVIDED  SUCH  PERSON
 DOES  NOT REPRESENT OR HOLD HIMSELF OR HERSELF OUT AS A CERTIFIED REGIS-
 TERED NURSE ANESTHETIST REGISTERED TO PRACTICE IN THIS STATE; OR
   7. AS PROHIBITING THE CARE OF THE SICK WHEN DONE  IN  CONNECTION  WITH
 THE PRACTICE OF THE RELIGIOUS TENETS OF ANY CHURCH.
   §  6920.  SPECIAL PROVISIONS. A CERTIFIED REGISTERED NURSE ANESTHETIST
 LICENSED UNDER THIS ARTICLE IS REQUIRED TO  PURCHASE  AND  MAINTAIN,  OR
 OTHERWISE  BE  COVERED BY, PROFESSIONAL LIABILITY INSURANCE IN AN AMOUNT
 NOT LESS ONE MILLION DOLLARS PER CLAIM WITH AN AGGREGATE  LIABILITY  FOR
 ALL  CLAIMS  DURING  THE  YEAR  OF  THREE  MILLION DOLLARS. PROFESSIONAL
 LIABILITY INSURANCE REQUIRED BY THIS SECTION SHALL COVER ALL ACTS WITHIN
 THE SCOPE OF PRACTICE OF REGISTERED NURSE ANESTHETIST.
   § 2. Section 6903 of the education law, as amended by chapter  323  of
 the laws of 2006, is amended to read  as follows:
   § 6903. Practice  of nursing and use of title "registered professional
 nurse" or "licensed practical nurse". Only a person licensed  or  other-
 wise  authorized  under  this  article shall practice nursing and only a
 person licensed under section sixty-nine hundred five  of  this  article
 shall  use  the  title "registered professional nurse" and only a person
 A. 6958                             6
 
 licensed under section sixty-nine hundred six of this article shall  use
 the  title  "licensed  practical  nurse".  No person shall use the title
 "nurse" or any other title or abbreviation that would represent  to  the
 public  that  the  person  is  authorized to practice nursing unless the
 person is licensed or otherwise authorized under this article OR ARTICLE
 ONE HUNDRED THIRTY-NINE-A OF THIS TITLE.
   § 3. Section 6904 of the education law, as amended by chapter  994  of
 the laws of 1971 and as renumbered by chapter 50 of the laws of 1972, is
 amended to read as follows:
   § 6904. State  board  for nursing.  A state board for nursing 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 and professional conduct in accordance
 with section sixty-five hundred eight of this title.  The board shall be
 composed of not less than [fifteen] SEVENTEEN members,  eleven  of  whom
 shall  be  registered  professional  nurses  and  four  of whom shall be
 licensed practical nurses AND TWO OF WHOM SHALL BE CERTIFIED  REGISTERED
 NURSE  ANESTHETISTS  all  licensed  and  practicing in this state for at
 least five years.    An  executive  secretary  to  the  board  shall  be
 appointed  by the board of regents on recommendation of the commissioner
 and shall be a registered professional nurse registered in this state.
   § 4. This act shall take effect immediately.

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  6958--A
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                                May 9, 2023
                                ___________
 
 Introduced  by  M.  of  A.  REYES,  PAULIN, MAMDANI, CARROLL, O'DONNELL,
   JOYNER, BENDETT -- read once and referred to the Committee  on  Higher
   Education  -- committee discharged, bill amended, ordered reprinted as
   amended and recommitted to said committee
 
 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:
 
   Section 1. The education law is amended by adding a new article  139-A
 to read as follows:
                               ARTICLE 139-A
                  CERTIFIED REGISTERED NURSE ANESTHETIST
 SECTION 6912. INTRODUCTION.
         6913. DEFINITION  OF  PRACTICE  OF  CERTIFIED  REGISTERED  NURSE
                 ANESTHETIST.
         6914. PRACTICE OF CERTIFIED REGISTERED NURSE ANESTHETIST AND USE
                 OF THE TITLE "CERTIFIED REGISTERED NURSE ANESTHETIST" OR
                 "NURSE ANESTHETIST".
         6915. STATE BOARD FOR NURSING.
         6916. REQUIREMENTS FOR A LICENSE AS A CERTIFIED REGISTERED NURSE
                 ANESTHETIST.
         6917. LIMITED PERMITS.
         6918. EXEMPT PERSONS.
         6919. SPECIAL PROVISIONS.
   § 6912. INTRODUCTION. THIS ARTICLE APPLIES TO THE PROFESSION OF CERTI-
 FIED REGISTERED  NURSE  ANESTHETIST.  THE  GENERAL  PROVISIONS  FOR  ALL
 PROFESSIONS  CONTAINED IN ARTICLE ONE HUNDRED THIRTY OF THIS TITLE APPLY
 TO THIS ARTICLE.
   § 6913. DEFINITION OF PRACTICE OF CERTIFIED REGISTERED NURSE  ANESTHE-
 TIST.  1.  IN  ADDITION  TO  THE  PROVISIONS  OF PRACTICE FOR REGISTERED
 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.
                                                            LBD02498-03-3
              

 A. 6958--A                          2
 
 TITLE,  THE PRACTICE OF A CERTIFIED REGISTERED NURSE ANESTHETIST FURTHER
 INCLUDES, BUT IS  NOT  LIMITED  TO,  ADMINISTRATION  OF  ANESTHESIA  AND
 SEDATION  TO  A  PATIENT;  PERFORMING  AND  DOCUMENTING  A PREANESTHETIC
 ASSESSMENT AND EVALUATION OF THE PATIENT, INCLUDING REQUESTING CONSULTA-
 TIONS AND DIAGNOSTIC STUDIES; SELECTING, OBTAINING, ORDERING, AND ADMIN-
 ISTERING   PREANESTHETIC  MEDICATIONS  AND  FLUIDS;  OBTAINING  INFORMED
 CONSENT FOR ANESTHESIA, DEVELOPING AND IMPLEMENTING AN ANESTHETIC  PLAN;
 INITIATING  THE  ANESTHETIC  TECHNIQUE; MONITORING THE PATIENT INCLUDING
 SELECTING, APPLYING, AND INSERTING APPROPRIATE NONINVASIVE AND  INVASIVE
 MONITORING  MODALITIES  FOR CONTINUOUS EVALUATION OF THE PATIENT'S PHYS-
 ICAL STATUS; SELECTING, OBTAINING, AND  ADMINISTERING  THE  ANESTHETICS,
 ADJUVANT AND ACCESSORY DRUGS, AND FLUIDS NECESSARY TO MANAGE ANESTHETICS
 AND ACUTE AND CHRONIC PAIN; ORDERING AND EVALUATING LABORATORY AND DIAG-
 NOSTIC TESTS AND PERFORMING POINT-OF-CARE TESTING; ORDERING AND EVALUAT-
 ING  RADIOGRAPHIC  IMAGING  STUDIES;  MANAGING  A  PATIENT'S  AIRWAY AND
 CARDIOPULMONARY STATUS USING CURRENT PRACTICE  MODALITIES;  FACILITATING
 EMERGENCE AND RECOVERY FROM ANESTHESIA BY SELECTING, OBTAINING, ORDERING
 AND   ADMINISTERING   MEDICATIONS,   FLUIDS,  AND  VENTILATORY  SUPPORT;
 DISCHARGING THE PATIENT FROM A POSTANESTHESIA CARE  AREA  AND  PROVIDING
 POSTANESTHESIA  FOLLOW-UP  EVALUATION  AND  CARE; IMPLEMENTING ACUTE AND
 CHRONIC PAIN MANAGEMENT MODALITIES; RESPONDING TO  EMERGENCY  SITUATIONS
 BY  PROVIDING  AIRWAY MANAGEMENT, ADMINISTRATION OF EMERGENCY FLUIDS AND
 DRUGS, AND USING BASIC OR ADVANCED CARDIAC LIFE SUPPORT TECHNIQUES;  AND
 PRESCRIBE TESTS, DRUGS AND OTHER TREATMENTS NECESSARY TO ANESTHESIA CARE
 PROVIDED BY A NURSE ANESTHETIST.
   2.  A CERTIFIED REGISTERED NURSE ANESTHETIST LICENSED UNDER THIS ARTI-
 CLE AND PRACTICING FOR THIRTY-SIX HUNDRED HOURS  OR  LESS  SHALL  DO  SO
 UNDER  THE DIRECTION OF A PHYSICIAN, DENTIST OR PODIATRIST. FOR PURPOSES
 OF THIS SECTION, DIRECTION SHALL MEAN THE COORDINATION AND COMMUNICATION
 BETWEEN THE PHYSICIAN, DENTIST OR PODIATRIST AND  THE  CERTIFIED  REGIS-
 TERED  NURSE  ANESTHETIST  FOR THE CARE OF THE PATIENT. AFTER PRACTICING
 FOR MORE THAN THIRTY-SIX HUNDRED HOURS,  A  CERTIFIED  REGISTERED  NURSE
 ANESTHETIST  SHALL  FUNCTION  IN AN INTERDEPENDENT ROLE AS A MEMBER OF A
 HEALTH CARE TEAM IN WHICH THE MEDICAL CARE OF A PATIENT IS OVERSEEN BY A
 PHYSICIAN, DENTIST OR PODIATRIST.
   3. PRESCRIPTIONS FOR DRUGS, DEVICES, AND ANESTHETIC AGENTS, ANESTHESIA
 RELATED AGENTS, AND ANALGESICS MAY BE ISSUED BY A  CERTIFIED  REGISTERED
 NURSE  ANESTHETIST  NECESSARY  TO  ANESTHESIA  CARE  PROVIDED BY A NURSE
 ANESTHETIST.  THE CERTIFIED REGISTERED NURSE ANESTHETIST SHALL OBTAIN  A
 CERTIFICATE  FROM  THE DEPARTMENT UPON SUCCESSFULLY COMPLETING A PROGRAM
 INCLUDING AN APPROPRIATE PHARMACOLOGY COMPONENT, OR ITS  EQUIVALENT,  AS
 ESTABLISHED  BY  THE  COMMISSIONER'S  REGULATIONS,  PRIOR TO PRESCRIBING
 UNDER THIS SUBDIVISION. THE LICENSE  ISSUED  UNDER  THIS  ARTICLE  SHALL
 STATE WHETHER THE CERTIFIED REGISTERED NURSE ANESTHETIST HAS SUCCESSFUL-
 LY COMPLETED SUCH A PROGRAM OR EQUIVALENT AND IS AUTHORIZED TO PRESCRIBE
 UNDER THIS SUBDIVISION.
   4.  NOTHING  IN  THIS SECTION SHALL BE DEEMED TO LIMIT OR DIMINISH THE
 PRACTICE OF THE PROFESSION OF NURSING AS A REGISTERED PROFESSIONAL NURSE
 UNDER ARTICLE ONE HUNDRED THIRTY-NINE OF THIS TITLE OR  ANY  OTHER  LAW,
 RULE,  REGULATION  OR  CERTIFICATION, NOR TO DENY ANY REGISTERED PROFES-
 SIONAL NURSE THE RIGHT TO DO ANY ACT OR ENGAGE IN ANY  PRACTICE  AUTHOR-
 IZED  BY ARTICLE ONE HUNDRED THIRTY-NINE OF THIS TITLE OR ANY OTHER LAW,
 RULE, REGULATION OR CERTIFICATION.
   § 6914. PRACTICE OF CERTIFIED REGISTERED NURSE ANESTHETIST AND USE  OF
 THE  TITLE  "CERTIFIED  REGISTERED NURSE ANESTHETIST" OR "NURSE ANESTHE-
 TIST". ONLY A PERSON LICENSED OR OTHERWISE AUTHORIZED UNDER THIS ARTICLE
 A. 6958--A                          3

 SHALL PRACTICE AS A CERTIFIED  REGISTERED  NURSE  ANESTHETIST  OR  NURSE
 ANESTHETIST,  PROVIDED THAT ANY PERSON WHO WAS PRACTICING AS A CERTIFIED
 REGISTERED NURSE ANESTHETIST IN THE STATE BEFORE THE EFFECTIVE  DATE  OF
 THIS  ARTICLE SHALL HAVE THE RIGHT TO CONTINUE USING THE TITLE.  CONTIN-
 UED USE OF SUCH TITLE AFTER THAT SHALL BE  DEPENDENT  UPON  SUCH  PERSON
 APPLYING  FOR AND OBTAINING A LICENSE FROM THE DEPARTMENT AS A CERTIFIED
 REGISTERED NURSE ANESTHETIST PURSUANT TO THIS ARTICLE WITHIN THREE YEARS
 FROM THE EFFECTIVE DATE OF THIS ARTICLE.
   § 6915. STATE BOARD FOR NURSING. THE STATE BOARD FOR NURSING AS ESTAB-
 LISHED IN SECTION SIXTY-NINE HUNDRED FOUR OF THIS  TITLE  SHALL  BE  THE
 GOVERNING STATE BOARD FOR CERTIFIED REGISTERED NURSE ANESTHETISTS.
   §  6916.  REQUIREMENTS  FOR  A LICENSE AS A CERTIFIED REGISTERED NURSE
 ANESTHETIST. TO QUALIFY FOR A LICENSE AS A  CERTIFIED  REGISTERED  NURSE
 ANESTHETIST, AN APPLICANT SHALL FULFILL THE FOLLOWING REQUIREMENTS:
   1. APPLICATION: FILE AN APPLICATION WITH THE DEPARTMENT;
   2.  LICENSE:  BE NEW YORK STATE LICENSED AND CURRENTLY REGISTERED AS A
 REGISTERED PROFESSIONAL NURSE;
   3. EDUCATION: HAVE RECEIVED A MASTER'S DEGREE OR HIGHER IN  A  PROGRAM
 OF  NURSE  ANESTHESIA  FROM  A  PROGRAM  REGISTERED BY THE DEPARTMENT OR
 DETERMINED BY THE DEPARTMENT TO BE SUBSTANTIALLY EQUIVALENT OR MEET  THE
 REQUIREMENTS OF SECTION SIXTY-NINE HUNDRED NINETEEN OF THIS ARTICLE;
   4.  EXAMINATION:  PASS AN EXAMINATION SATISFACTORY TO THE BOARD AND IN
 ACCORDANCE WITH THE COMMISSIONER'S REGULATIONS;
   5. CHARACTER: BE OF GOOD MORAL CHARACTER AS DETERMINED BY THE  DEPART-
 MENT;
   6.  FEES: PAY A FEE OF ONE HUNDRED FIFTY DOLLARS TO THE DEPARTMENT FOR
 AN INITIAL LICENSE AND A FEE OF FIFTY DOLLARS FOR EACH TRIENNIAL  REGIS-
 TRATION PERIOD; AND
   7.  INFORMATION AND DOCUMENTATION: IN CONJUNCTION WITH AND AS A CONDI-
 TION OF EACH TRIENNIAL REGISTRATION A CERTIFIED REGISTERED NURSE ANESTH-
 ETIST SHALL PROVIDE TO THE DEPARTMENT, AND THE DEPARTMENT SHALL COLLECT,
 SUCH INFORMATION  AND  DOCUMENTATION  REQUIRED  BY  THE  DEPARTMENT,  IN
 CONSULTATION  WITH  THE  DEPARTMENT OF HEALTH, AS IS NECESSARY TO ENABLE
 THE DEPARTMENT OF HEALTH TO EVALUATE ACCESS TO NEEDED SERVICES  IN  THIS
 STATE,  INCLUDING,  BUT NOT LIMITED TO, THE LOCATION AND TYPE OF SETTING
 WHEREIN THE CERTIFIED REGISTERED NURSE ANESTHETIST PRACTICES  AND  OTHER
 INFORMATION  THE  DEPARTMENT,  IN  CONSULTATION  WITH  THE DEPARTMENT OF
 HEALTH, DEEMS RELEVANT. THE DEPARTMENT OF HEALTH, IN  CONSULTATION  WITH
 THE  DEPARTMENT, SHALL MAKE SUCH DATA AVAILABLE IN AGGREGATE, DE-IDENTI-
 FIED FORM ON A PUBLICLY ACCESSIBLE WEBSITE.   ADDITIONALLY, IN  CONJUNC-
 TION  WITH  EACH TRIENNIAL REGISTRATION, THE DEPARTMENT, IN CONSULTATION
 WITH THE DEPARTMENT OF HEALTH, SHALL PROVIDE INFORMATION ON  REGISTERING
 IN THE DONATE LIFE REGISTRY FOR ORGAN AND TISSUE DONATION, INCLUDING THE
 WEBSITE ADDRESS FOR SUCH REGISTRY.
   § 6917. LIMITED PERMITS. 1. A PERMIT TO PRACTICE AS A CERTIFIED REGIS-
 TERED  NURSE ANESTHETIST MAY BE ISSUED BY THE DEPARTMENT UPON THE FILING
 OF AN APPLICATION FOR A LICENSE AS A CERTIFIED REGISTERED NURSE ANESTHE-
 TIST AND SUBMISSION OF SUCH OTHER  INFORMATION  AS  THE  DEPARTMENT  MAY
 REQUIRE  TO  (A)  GRADUATES OF SCHOOLS OF NURSE ANESTHESIA REGISTERED BY
 THE DEPARTMENT OR (B) GRADUATES OF SCHOOLS OF NURSE ANESTHESIA  APPROVED
 IN ANOTHER STATE, PROVINCE, OR COUNTRY.
   2. SUCH LIMITED PERMIT SHALL EXPIRE ONE YEAR FROM THE DATE OF ISSUANCE
 OR  UPON  NOTICE TO THE APPLICANT BY THE DEPARTMENT THAT THE APPLICATION
 FOR LICENSE HAS BEEN DENIED. THE LIMITED PERMIT MAY BE RENEWED,  AT  THE
 DISCRETION OF THE DEPARTMENT, FOR ONE ADDITIONAL YEAR.
 A. 6958--A                          4
 
   3.  A  LIMITED PERMIT SHALL ENTITLE THE HOLDER TO PRACTICE NURSE ANES-
 THESIA ONLY IN A HEALTH CARE FACILITY  UNDER  THE  PERSONAL,  ON-PREMISE
 SUPERVISION OF A CERTIFIED REGISTERED NURSE ANESTHETIST OR COLLABORATING
 PHYSICIAN CURRENTLY REGISTERED IN THIS STATE AND WITH THE ENDORSEMENT OF
 THE EMPLOYING AGENCY.
   4. FEES. THE FEE FOR EACH LIMITED PERMIT SHALL BE THIRTY-FIVE DOLLARS.
   § 6918. EXEMPT PERSONS. THIS ARTICLE SHALL NOT BE CONSTRUED:
   1.  AS  APPLYING 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;
   2.  AS  PROHIBITING  THE  FURNISHING OF NURSE ANESTHESIA ASSISTANCE IN
 CASE OF AN EMERGENCY;
   3. AS PROHIBITING SUCH PERFORMANCE  OF  NURSE  ANESTHESIA  SERVICE  BY
 STUDENTS  ENROLLED IN DEPARTMENT REGISTERED NURSE ANESTHESIA PROGRAMS OR
 STUDENTS ENROLLED IN OTHER NURSE ANESTHESIA PROGRAMS THAT ARE AUTHORIZED
 PURSUANT TO SECTION TWO HUNDRED TWENTY-FOUR OF  THIS  CHAPTER  TO  PLACE
 SUCH STUDENTS IN CLINICAL ROTATIONS IN NEW YORK STATE;
   4.  AS  PROHIBITING  OR PREVENTING THE PRACTICE OF NURSE ANESTHESIA IN
 THIS STATE BY ANY LEGALLY QUALIFIED NURSE OR PRACTICAL NURSE OF  ANOTHER
 STATE,  PROVINCE,  OR  COUNTRY  WHOSE  ENGAGEMENT REQUIRES HIM OR HER TO
 ACCOMPANY AND CARE FOR A PATIENT  TEMPORARILY  RESIDING  IN  THIS  STATE
 DURING  THE  PERIOD  OF  SUCH  ENGAGEMENT  PROVIDED SUCH PERSON DOES NOT
 REPRESENT OR HOLD HIMSELF OR HERSELF OUT AS A CERTIFIED REGISTERED NURSE
 ANESTHETIST REGISTERED TO PRACTICE IN THIS STATE;
   5. AS PROHIBITING OR PREVENTING THE PRACTICE OF  NURSE  ANESTHESIA  IN
 THIS  STATE  DURING  AN  EMERGENCY  OR DISASTER BY ANY LEGALLY QUALIFIED
 NURSE ANESTHETIST OF ANOTHER STATE, PROVINCE,  OR  COUNTRY  WHO  MAY  BE
 RECRUITED  BY  THE  AMERICAN NATIONAL RED CROSS OR PURSUANT TO AUTHORITY
 VESTED IN THE STATE CIVIL  DEFENSE  COMMISSION  FOR  SUCH  EMERGENCY  OR
 DISASTER  SERVICE,  PROVIDED  SUCH  PERSON  DOES  NOT  REPRESENT OR HOLD
 HIMSELF OR HERSELF OUT  AS  A  CERTIFIED  REGISTERED  NURSE  ANESTHETIST
 REGISTERED TO PRACTICE IN THIS STATE;
   6.  AS  PROHIBITING  OR PREVENTING THE PRACTICE OF NURSE ANESTHESIA IN
 THIS STATE, IN OBEDIENCE TO THE REQUIREMENTS OF THE LAWS OF  THE  UNITED
 STATES, BY ANY COMMISSIONED NURSE ANESTHETIST OFFICER IN THE ARMED FORC-
 ES  OF  THE  UNITED  STATES  OR BY ANY NURSE ANESTHETIST EMPLOYED IN THE
 UNITED STATES VETERANS ADMINISTRATION OR  UNITED  STATES  PUBLIC  HEALTH
 SERVICE WHILE ENGAGED IN THE PERFORMANCE OF THE ACTUAL DUTIES PRESCRIBED
 FOR  HIM  OR  HER UNDER THE UNITED STATES STATUTES, PROVIDED SUCH PERSON
 DOES NOT REPRESENT OR HOLD HIMSELF OR HERSELF OUT AS A CERTIFIED  REGIS-
 TERED NURSE ANESTHETIST REGISTERED TO PRACTICE IN THIS STATE; OR
   7.  AS  PROHIBITING  THE CARE OF THE SICK WHEN DONE IN CONNECTION WITH
 THE PRACTICE OF THE RELIGIOUS TENETS OF ANY CHURCH.
   § 6919. SPECIAL PROVISIONS. 1. A CERTIFIED REGISTERED  NURSE  ANESTHE-
 TIST  LICENSED  UNDER THIS ARTICLE, WHILE PROVIDING SERVICES TO PATIENTS
 IN NEW YORK STATE, IS REQUIRED TO PURCHASE AND MAINTAIN, OR OTHERWISE BE
 COVERED BY, PROFESSIONAL LIABILITY INSURANCE IN AN AMOUNT NOT LESS  THAN
 ONE MILLION DOLLARS PER CLAIM WITH AN AGGREGATE LIABILITY FOR ALL CLAIMS
 DURING  THE YEAR OF THREE MILLION DOLLARS. PROFESSIONAL LIABILITY INSUR-
 ANCE REQUIRED BY THIS SECTION SHALL COVER ALL ACTS WITHIN THE  SCOPE  OF
 PRACTICE OF REGISTERED NURSE ANESTHETIST.
   2.  IT  SHALL  BE  LAWFUL  FOR AN INDIVIDUAL PRACTICING AS A CERTIFIED
 REGISTERED NURSE ANESTHETIST IN THIS STATE AS OF THE EFFECTIVE  DATE  OF
 THIS SECTION THAT DOES NOT MEET THE EDUCATIONAL REQUIREMENTS TO CONTINUE
 SUCH PRACTICE PROVIDED THAT SUCH CERTIFIED REGISTERED NURSE ANESTHETIST:
 (A)  SUBMITS  EVIDENCE  OF CERTIFICATION AS A CERTIFIED REGISTERED NURSE
 A. 6958--A                          5
 
 ANESTHETIST BY AN APPROPRIATE NATIONAL  CERTIFYING  BODY;  AND  (B)  HAS
 CONTINUALLY  MAINTAINED  ACTIVE,  UP-TO-DATE RECERTIFICATION STATUS AS A
 CERTIFIED REGISTERED NURSE ANESTHETIST BY AN APPROPRIATE NATIONAL RECER-
 TIFYING BODY.
   §  2.  Section 6903 of the education law, as amended by chapter 323 of
 the laws of 2006, is amended to read  as follows:
   § 6903. Practice of nursing and use of title "registered  professional
 nurse"  or  "licensed practical nurse". Only a person licensed or other-
 wise authorized under this article shall practice  nursing  and  only  a
 person  licensed  under  section sixty-nine hundred five of this article
 shall use the title "registered professional nurse" and  only  a  person
 licensed  under section sixty-nine hundred six of this article shall use
 the title "licensed practical nurse". No  person  shall  use  the  title
 "nurse"  or  any other title or abbreviation that would represent to the
 public that the person is authorized  to  practice  nursing  unless  the
 person is licensed or otherwise authorized under this article OR ARTICLE
 ONE HUNDRED THIRTY-NINE-A OF THIS TITLE.
   §  3.  Section 6904 of the education law, as amended by chapter 994 of
 the laws of 1971 and as renumbered by chapter 50 of the laws of 1972, is
 amended to read as follows:
   § 6904. State board for nursing.  A state board for nursing  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 and professional conduct in accordance
 with section sixty-five hundred eight of this title.  The board shall be
 composed  of  not  less than [fifteen] SEVENTEEN members, eleven of whom
 shall be registered professional  nurses  and  four  of  whom  shall  be
 licensed  practical nurses AND TWO OF WHOM SHALL BE CERTIFIED REGISTERED
 NURSE ANESTHETISTS all licensed and practicing  in  this  state  for  at
 least  five  years.    An  executive  secretary  to  the  board shall be
 appointed by the board of regents on recommendation of the  commissioner
 and shall be a registered professional nurse registered in this state.
   §  4. This act shall take effect one year after it shall have become a
 law.