S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    357
 
                        2025-2026 Regular Sessions
 
                             I N  S E N A T E
 
                                (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:
 
   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 6920. INTRODUCTION.
         6921. DEFINITION  OF  PRACTICE  OF  CERTIFIED  REGISTERED  NURSE
                 ANESTHETIST.
         6922. PRACTICE OF CERTIFIED REGISTERED NURSE ANESTHETIST AND USE
                 OF THE TITLE "CERTIFIED REGISTERED NURSE ANESTHETIST" OR
                 "NURSE ANESTHETIST".
         6923. STATE BOARD FOR NURSING.
         6924. REQUIREMENTS FOR A LICENSE AS A CERTIFIED REGISTERED NURSE
                 ANESTHETIST.
         6925. LIMITED PERMITS.
         6926. EXEMPT PERSONS.
         6927. SPECIAL PROVISIONS.
   § 6920. 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.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD00477-01-5
              

 S. 357                              2
 
   § 6921. 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 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)  A  CERTIFIED REGISTERED NURSE ANESTHETIST LICENSED UNDER THIS
 ARTICLE AND PRACTICING FOR THIRTY-SIX HUNDRED HOURS OR LESS SHALL DO  SO
 EITHER  UNDER  THE  DIRECTION  OF:   (I) A PHYSICIAN WHO HAS COMPLETED A
 RESIDENCY PROGRAM IN ANESTHESIOLOGY THAT IS ACCREDITED BY AN ACCREDITING
 ORGANIZATION ACCEPTABLE TO THE DEPARTMENT; (II) A PHYSICIAN WHO IS BOARD
 CERTIFIED IN ANESTHESIOLOGY BY A CERTIFYING ORGANIZATION  ACCEPTABLE  TO
 THE  DEPARTMENT;  (III)  A PHYSICIAN WHO HAS MEDICAL STAFF PRIVILEGES TO
 PROVIDE ANESTHESIA SERVICES (DEEP SEDATION, GENERAL AND  REGIONAL  ANES-
 THESIA  ASSESSMENTS/ADMINISTRATION)  IN A GENERAL HOSPITAL OR AMBULATORY
 SURGERY CENTER AUTHORIZED BY ARTICLE TWENTY-EIGHT OF THE  PUBLIC  HEALTH
 LAW;  OR  (IV)  A  DENTIST OR PODIATRIST QUALIFIED TO PROVIDE ANESTHESIA
 SERVICES AS DETERMINED BY THE DEPARTMENT ON THEIR CASES. FOR PURPOSES OF
 THIS SECTION, DIRECTION SHALL MEAN PATIENT  CARE  GUIDANCE  AND  ADVICE,
 COORDINATION AND COMMUNICATION FROM THE PHYSICIAN, DENTIST OR PODIATRIST
 TO  THE  CERTIFIED REGISTERED NURSE ANESTHETIST PRACTICING FOR LESS THAN
 THIRTY-SIX HUNDRED HOURS, AS NEEDED FOR THE CARE OF THE PATIENT.
   (B) AFTER PRACTICING FOR MORE THAN THIRTY-SIX HUNDRED HOURS, A  CERTI-
 FIED  REGISTERED  NURSE  ANESTHETIST SHALL FUNCTION IN AN INTERDEPENDENT
 ROLE AS A MEMBER OF A PATIENT-CENTERED CARE TEAM.
   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-
 S. 357                              3
 
 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.
   § 6922. 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.  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  SECTION  SIXTY-NINE  HUNDRED
 TWENTY-SEVEN  OF THIS ARTICLE WITHIN THREE YEARS FROM THE EFFECTIVE DATE
 OF THIS ARTICLE.
   § 6923. 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.
   §  6924.  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 TWENTY-SEVEN 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
 S. 357                              4
 
 IN THE DONATE LIFE REGISTRY FOR ORGAN AND TISSUE DONATION, INCLUDING THE
 WEBSITE ADDRESS FOR SUCH REGISTRY.
   § 6925. LIMITED PERMITS. 1.  THE DEPARTMENT MAY ISSUE A LIMITED PERMIT
 TO  AN  APPLICANT  WHO  IS  NEW  YORK STATE LICENSED AND REGISTERED AS A
 REGISTERED NURSE AND MEETS ALL QUALIFICATIONS FOR LICENSURE, EXCEPT  THE
 EXAMINATION  AND/OR  EXPERIENCE  REQUIREMENTS, OR TO AN APPLICANT WHO IS
 GAINING EXPERIENCE FOR THE  DIAGNOSTIC  PRIVILEGE,  IN  ACCORDANCE  WITH
 REGULATIONS PROMULGATED THEREFOR.
   2. LIMITED PERMITS SHALL BE FOR TWO YEARS.
   3.  A  LIMITED ANESTHETIST PERMIT SHALL ENTITLE THE HOLDER TO PRACTICE
 AS A NURSE  ANESTHETIST  ONLY  IN  A  HEALTH  CARE  FACILITY  UNDER  THE
 PERSONAL, ON-PREMISE SUPERVISION OF A CERTIFIED REGISTERED NURSE ANESTH-
 ETIST  WITH MORE THAN THIRTY-SIX HUNDRED HOURS OF PRACTICE EXPERIENCE OR
 PHYSICIAN WHO: (A) HAS COMPLETED A RESIDENCY PROGRAM  IN  ANESTHESIOLOGY
 THAT  IS  ACCREDITED  BY  AN  ACCREDITING ORGANIZATION ACCEPTABLE TO THE
 DEPARTMENT; OR (B) IS BOARD CERTIFIED IN ANESTHESIOLOGY BY A  CERTIFYING
 ORGANIZATION  ACCEPTABLE  TO  THE  DEPARTMENT;  OR (C) HAS MEDICAL STAFF
 PRIVILEGES TO PROVIDE ANESTHESIA SERVICES AT THE  HEALTH  CARE  FACILITY
 AND WITH THE ENDORSEMENT OF THE HEALTH CARE FACILITY.
   4. FEES. THE FEE FOR EACH LIMITED PERMIT SHALL BE THIRTY-FIVE DOLLARS.
   § 6926. 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 THIS STATE UNDER APPROPRIATE
 SUPERVISION; OR
   4. 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 SUCH NURSE ANESTHETIST UNDER THE UNITED  STATES  STATUTES,  PROVIDED
 SUCH  PERSON  DOES  NOT  REPRESENT OR HOLD THEMSELVES OUT AS A CERTIFIED
 REGISTERED NURSE ANESTHETIST REGISTERED TO PRACTICE IN THIS STATE.
   § 6927. SPECIAL PROVISIONS.   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, BUT MEETS THE OTHER  REQUIREMENTS  OF  SECTION  SIXTY-NINE
 HUNDRED  TWENTY-FOUR OF THIS ARTICLE, TO CONTINUE SUCH PRACTICE PROVIDED
 THAT SUCH CERTIFIED REGISTERED NURSE ANESTHETIST:
   1. SUBMITS EVIDENCE OF CERTIFICATION AS A CERTIFIED  REGISTERED  NURSE
 ANESTHETIST  BY  AN  APPROPRIATE NATIONAL CERTIFYING BODY TO THE DEPART-
 MENT;
   2.  HAS  CONTINUALLY  MAINTAINED  ACTIVE,  UP-TO-DATE  RECERTIFICATION
 STATUS  AS  A  CERTIFIED  REGISTERED NURSE ANESTHETIST BY AN APPROPRIATE
 NATIONAL RECERTIFYING BODY; AND
   3. HAS SUBMITTED AN APPLICATION FOR LICENSURE.
   § 2. Section 6903 of the education law, as amended by chapter  323  of
 the laws of 2006, is amended to read  as follows:
 S. 357                              5
 
   § 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 eighteen months after  it  shall  have
 become a law.