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.
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