Bill Text: NY S02945 | 2013-2014 | General Assembly | Amended
Bill Title: Provides for the licensing and regulates the practice of anesthesiologist assistants.
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2014-01-08 - REFERRED TO HIGHER EDUCATION [S02945 Detail]
Download: New_York-2013-S02945-Amended.html
S T A T E O F N E W Y O R K ________________________________________________________________________ 2945--A 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 -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee 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: 1 Section 1. The education law is amended by adding a new section 2 6529-a to read as follows: 3 S 6529-A. ANESTHESIOLOGIST ASSISTANTS. 1. DEFINITIONS. FOR THE 4 PURPOSES OF THIS SECTION, THE FOLLOWING TERMS SHALL HAVE THE FOLLOWING 5 MEANINGS: 6 (A) "ANESTHESIOLOGIST ASSISTANT" MEANS A PERSON WHO IS LICENSED AS AN 7 ANESTHESIOLOGIST ASSISTANT PURSUANT TO THIS SECTION. 8 (B) "ANESTHESIOLOGIST" MEANS A PHYSICIAN WHO HAS SUCCESSFULLY 9 COMPLETED A RESIDENCY IN ANESTHESIOLOGY APPROVED BY THE AMERICAN BOARD 10 OF MEDICINE OF ANESTHESIOLOGY OR THE AMERICAN OSTEOPATHIC BOARD OF 11 ANESTHESIOLOGY AND WHO IS ACTIVELY AND DIRECTLY ENGAGED IN THE CLINICAL 12 PRACTICE OF MEDICINE AS AN ANESTHESIOLOGIST. 13 (C) "ADMINISTRATION OF ANESTHESIA IN THE HOSPITAL OR AMBULATORY SURGI- 14 CAL CENTER" MEANS ANESTHESIA SERVICES SHALL BE DIRECTED BY AN ANESTHE- 15 SIOLOGIST WHO HAS RESPONSIBILITY FOR THE CLINICAL ASPECTS OR ORGANIZA- 16 TION AND DELIVERY OF ALL ANESTHESIA SERVICES PROVIDED BY THE HOSPITAL OR 17 AMBULATORY SURGICAL CENTER. THAT ANESTHESIOLOGIST SHALL DIRECT THE 18 ADMINISTRATION ASPECTS OF THE SERVICE, AND SHALL BE RESPONSIBLE, IN 19 CONJUNCTION WITH THE MEDICAL STAFF, FOR RECOMMENDING TO THE GOVERNING 20 BODY PRIVILEGES TO THOSE PERSONS QUALIFIED TO ADMINISTER ANESTHETICS, 21 INCLUDING THE PROCEDURES EACH PERSON IS QUALIFIED TO PERFORM AND THE 22 LEVELS OF REQUIRED SUPERVISION AS APPROPRIATE. FOR THE PURPOSES OF THIS EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD05775-02-3 S. 2945--A 2 1 SECTION, "ADMINISTRATION OF ANESTHESIA IN OFFICE-BASED SURGERY VENUES" 2 MEANS THE ANESTHESIA COMPONENT OF THE MEDICAL OR DENTAL PROCEDURE SHALL 3 BE SUPERVISED BY AN ANESTHESIOLOGIST WHO IS PHYSICALLY PRESENT AND 4 AVAILABLE TO IMMEDIATELY DIAGNOSE AND TREAT THE PATIENT FOR ANESTHESIA 5 COMPLICATIONS OR EMERGENCIES. 6 (D) "DEEP SEDATION" MEANS THE ADMINISTRATION OF MEDICATION BY THE 7 ORAL, PARENTERAL OR INHALATION ROUTES WHICH RESULTS IN A CONTROLLED 8 STATE OF DEPRESSED CONSCIOUSNESS ACCOMPANIED BY PARTIAL LOSS OF PROTEC- 9 TIVE REFLEXES. THERE MAY BE AN INABILITY TO INDEPENDENTLY AND CONTIN- 10 UOUSLY MAINTAIN AN OPEN AIRWAY AND/OR REGULAR BREATHING PATTERN WITH 11 DEEP SEDATION, AND THE ABILITY TO APPROPRIATELY AND RATIONALLY RESPOND 12 TO PHYSICAL STIMULI AND VERBAL COMMANDS IS LOST. 13 (E) "GENERAL ANESTHESIA" MEANS THE ADMINISTRATION OF A MEDICATION BY 14 THE PARENTERAL OR INHALATION ROUTES WHICH RESULTS IN A CONTROLLED STATE 15 OF UNCONSCIOUSNESS ACCOMPANIED BY A COMPLETE LOSS OF PROTECTIVE REFLEXES 16 INCLUDING LOSS OF THE ABILITY TO INDEPENDENTLY AND CONTINUOUSLY MAINTAIN 17 PATIENT AIRWAY AND A REGULAR BREATHING PATTERN. THERE IS ALSO AN 18 INABILITY TO RESPOND PURPOSEFULLY TO VERBAL COMMANDS AND/OR TACTILE 19 STIMULATION. 20 (F) "HOSPITAL" MEANS AN INSTITUTION OR FACILITY POSSESSING A VALID 21 OPERATING CERTIFICATE ISSUED PURSUANT TO ARTICLE TWENTY-EIGHT OF THE 22 PUBLIC HEALTH LAW. 23 (G) "AMBULATORY SURGICAL CENTER" MEANS AN INSTITUTION OR FACILITY 24 POSSESSING A VALID OPERATING CERTIFICATE ISSUED PURSUANT TO ARTICLE 25 TWENTY-EIGHT OF THE PUBLIC HEALTH LAW. 26 (H) "IMMEDIATELY AVAILABLE" MEANS REMAINING IN PHYSICAL PROXIMITY SO 27 AS TO ALLOW THE ANESTHESIOLOGIST TO RETURN TO RE-ESTABLISH DIRECT 28 CONTACT WITH THE PATIENT IN ORDER TO MEET THE PATIENT'S MEDICAL NEEDS 29 AND ADDRESS ANY URGENT OR EMERGENT CLINICAL PROBLEMS. 30 (I) "MODERATE SEDATION" MEANS A DRUG-INDUCED DEPRESSION OF CONSCIOUS- 31 NESS DURING WHICH (I) THE PATIENT RESPONDS PURPOSEFULLY TO VERBAL 32 COMMANDS, EITHER ALONE OR ACCOMPANIED BY LIGHT TACTILE STIMULATION; (II) 33 NO INTERVENTIONS ARE REQUIRED TO MAINTAIN A PATIENT AIRWAY; (III) SPON- 34 TANEOUS VENTILATION IS ADEQUATE; AND (IV) THE PATENT'S CARDIOVASCULAR 35 FUNCTION IS USUALLY MAINTAINED WITHOUT ASSISTANCE. 36 (J) "MONITORING" MEANS THE CONTINUAL CLINICAL OBSERVATION OF A PATIENT 37 AND THE USE OF INSTRUMENTS TO MEASURE, DISPLAY, AND RECORD THE VALUES OF 38 CERTAIN PHYSIOLOGIC VARIABLES SUCH AS PULSE, OXYGEN SATURATION, LEVEL OF 39 CONSCIOUSNESS, BLOOD PRESSURE AND RESPIRATION. 40 (K) "OFFICE-BASED SURGERY" MEANS ANY SURGICAL OR OTHER INVASIVE PROCE- 41 DURE, REQUIRING GENERAL ANESTHESIA, MODERATE SEDATION OR DEEP SEDATION, 42 AND ANY LIPOSUCTION PROCEDURE, WHERE SUCH SURGICAL OR OTHER INVASIVE 43 PROCEDURE OR LIPOSUCTION IS PERFORMED BY A LICENSEE IN A LOCATION OTHER 44 THAN A HOSPITAL, EXCLUDING MINOR PROCEDURES AND PROCEDURES REQUIRING 45 MINIMAL SEDATION. 46 (L) "PATIENT" MEANS AN INDIVIDUAL WHO IS UNDER THE CARE OF A PHYSICIAN 47 IN A LICENSED FACILITY OR IN AN OFFICE, UNDER THE CARE OF A PHYSICIAN, 48 DENTIST, ORAL SURGEON OR PODIATRIST. 49 (M) "PERI-OPERATIVE PERIOD" MEANS THE PERIOD OF TIME COMMENCING UPON 50 THE MEDICAL EVALUATION OF THE PATIENT BEFORE SURGERY AND ENDING UPON THE 51 PATIENT'S MEDICAL DISCHARGE FROM THE RECOVERY ROOM. 52 (N) "PHYSICALLY PRESENT" BY AN ANESTHESIOLOGIST MEANS THE ABILITY TO 53 REACT AND RESPOND IN AN IMMEDIATE AND APPROPRIATE MANNER SO AS TO MAKE 54 POSSIBLE THE CONTINUOUS EXERCISE OF MEDICAL JUDGMENT THROUGHOUT THE 55 ADMINISTRATION OF THE ANESTHESIA. S. 2945--A 3 1 (O) "SUPERVISION" MEANS THAT AN ANESTHESIOLOGIST SHALL DIRECT THE 2 ANESTHESIA SERVICES THAT THE ANESTHESIOLOGIST ASSISTANT IS PERFORMING 3 INCLUDING BUT NOT LIMITED TO A PRE-ANESTHETIC EXAMINATION AND EVALU- 4 ATION, PRESCRIBING THE ANESTHESIA, INCLUDING POST-OPERATIVE MEDICATIONS 5 AS NEEDED FOR PAIN AND DISCOMFORT, INCLUDING NAUSEA AND VOMITING, AND 6 SHALL BE IMMEDIATELY AVAILABLE DURING THE ENTIRE PERI-OPERATIVE PERIOD 7 FOR DIAGNOSIS, TREATMENT, AND MANAGEMENT OF ANESTHESIA-RELATED COMPLI- 8 CATIONS OR EMERGENCIES, AND ASSURE THE PROVISION OF INDICATED POST-AN- 9 ESTHESIA CARE. 10 2. LICENSURE. FOR ISSUANCE OF A LICENSE TO PRACTICE AS A LICENSED 11 ANESTHESIOLOGIST ASSISTANT THE APPLICANT SHALL FULFILL THE FOLLOWING 12 REQUIREMENTS: 13 (A) APPLICATION: FILE AN APPLICATION WITH THE DEPARTMENT WHICH SHALL 14 BE IN SUCH FORM AS PROVIDED BY THE COMMISSIONER; 15 (B) AGE: BE AT LEAST TWENTY-ONE YEARS OF AGE AND OF GOOD MORAL CHARAC- 16 TER; 17 (C) EDUCATION: 18 (I) HAVE OBTAINED A BACHELOR'S OR HIGHER DEGREE APPROVED BY THE BOARD 19 OF MEDICINE; 20 (II) HAVE SATISFACTORILY COMPLETED AN ANESTHESIOLOGIST ASSISTANT 21 PROGRAM THAT IS ACCREDITED BY THE COMMISSION ON ACCREDITATION OF ALLIED 22 HEALTH EDUCATION PROGRAMS OR BY A PREDECESSOR OR SUCCESSOR ENTITY; 23 (III) PASSED THE CERTIFYING EXAMINATION ADMINISTERED BY AND OBTAINED 24 ACTIVE CERTIFICATION FROM THE NATIONAL COMMISSION ON CERTIFICATION OF 25 ANESTHESIOLOGIST ASSISTANTS OR A SUCCESSOR ENTITY; AND 26 (IV) BIENNIALLY COMPLETE FORTY HOURS OF CONTINUING MEDICAL EDUCATION 27 OR HOLD A CURRENT CERTIFICATE ISSUED BY THE NATIONAL COMMISSION ON 28 CERTIFICATION OF ANESTHESIOLOGIST ASSISTANTS OR ITS SUCCESSOR; AND 29 (D) FEES: PAY TO THE DEPARTMENT A FEE OF ONE HUNDRED SEVENTY-FIVE 30 DOLLARS FOR INITIAL LICENSURE AND A TRIENNIAL REGISTRATION FEE OF ONE 31 HUNDRED FIFTY-FIVE DOLLARS. 32 3. USE OF TITLE. ONLY A PERSON LICENSED UNDER THIS SECTION SHALL USE 33 THE TITLE "ANESTHESIOLOGIST ASSISTANT" OR USE THE LETTERS "A.A." AFTER 34 HIS OR HER NAME. 35 4. PERFORMANCE OF ANESTHESIOLOGIST ASSISTANTS. THE PRACTICE OF ANESTH- 36 ESIOLOGIST ASSISTANTS LICENSED UNDER THIS SECTION SHALL: 37 (A) INCLUDE THE ADMINISTRATION OF ANESTHESIA TO A PATIENT BUT ONLY 38 UNDER THE SUPERVISION OF AN ANESTHESIOLOGIST WHO IS IMMEDIATELY AVAIL- 39 ABLE; 40 (B) EACH ANESTHESIOLOGIST WHO AGREES TO ACT AS THE SUPERVISING ANESTH- 41 ESIOLOGIST OF AN ANESTHESIOLOGIST ASSISTANT SHALL ADOPT A WRITTEN PRAC- 42 TICE PROTOCOL WHICH DELINEATES THE SERVICES THAT THE ANESTHESIOLOGIST 43 ASSISTANT IS AUTHORIZED TO PROVIDE AND THE MANNER IN WHICH THE ANESTHE- 44 SIOLOGIST WILL SUPERVISE THE ANESTHESIOLOGIST ASSISTANT. THE ANESTHE- 45 SIOLOGIST SHALL BASE THE PROVISIONS OF THE PROTOCOL ON CONSIDERATION OF 46 RELEVANT QUALITY ASSURANCE STANDARDS, INCLUDING REGULAR REVIEW BY THE 47 ANESTHESIOLOGIST OF THE MEDICAL RECORDS OF THE PATIENTS OF THE ANESTHE- 48 SIOLOGIST ASSISTANT. THE SUPERVISING ANESTHESIOLOGIST SHALL SUPERVISE 49 THE ANESTHESIOLOGIST ASSISTANT IN ACCORDANCE WITH THE TERMS OF THE 50 PROTOCOL UNDER WHICH THE ASSISTANT PRACTICES AND THE RULES FOR SUPER- 51 VISION OF ANESTHESIOLOGIST ASSISTANTS; AND 52 (C) BE CONSISTENT WITH POLICIES AND PROCEDURE APPROVED BY THE MEDICAL 53 STAFF AND GOVERNING STAFF OF THE HEALTH CARE FACILITY OR FREE STANDING 54 AMBULATORY SURGICAL CENTER DEFINED UNDER ARTICLE TWENTY-EIGHT OF THE 55 PUBLIC HEALTH LAW WHERE APPLICABLE. S. 2945--A 4 1 5. AN INDIVIDUAL WHO IS DULY ENROLLED IN A PROGRAM OF EDUCATIONAL 2 PREPAREDNESS TO BECOME AN ANESTHESIOLOGIST ASSISTANT MAY ADMINISTER 3 ANESTHESIA TO A PATIENT BUT ONLY UNDER THE DIRECT PERSONAL SUPERVISION 4 OF AN ANESTHESIOLOGIST. 5 6. THE COMMISSIONER IS AUTHORIZED AND DIRECTED TO PROMULGATE REGU- 6 LATIONS TO IMPLEMENT THE PROVISIONS OF THIS SECTION. 7 S 2. This act shall take effect on the first of the twelfth month 8 which commences after this act shall have become a law; provided, howev- 9 er, that effective immediately, the addition, amendment and/or repeal of 10 any rule or regulation necessary for the implementation of this act on 11 its effective date is authorized and directed to be made and completed 12 on or before such effective date.