Senate Bill S7628A

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 7628--A

                            I N  S E N A T E

                              June 8, 2012
                               ___________

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:

  Section  1.  Section  6523 of the education law, as amended by chapter
364 of the laws of 1991, is amended to read as follows:
  S 6523. State board for medicine.  A state board for medicine 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 in accordance with section  sixty-five
hundred  eight  of  this  title. The board shall be composed of not less
than twenty physicians licensed in this state for at least  five  years,
two of whom shall be doctors of osteopathy. The board shall also consist
of not less than two physician's assistants licensed to practice in this
state.  The  participation  of  physician's  assistant  members shall be
limited to matters relating to article one hundred thirty-one-B of  this
[chapter]  TITLE.   THE BOARD OF MEDICINE SHALL ALSO CONSIST OF NOT LESS
THAN TWO ANESTHESIOLOGIST ASSISTANTS LICENSED TO PRACTICE IN THIS STATE.
THE PARTICIPATION OF ANESTHESIOLOGIST ASSISTANTS  SHALL  BE  LIMITED  TO
MATTERS  RELATING  TO  SECTION  SIXTY-FIVE HUNDRED TWENTY-NINE-A OF THIS
ARTICLE. An executive secretary to the board shall be appointed  by  the
board  of  regents  on  recommendation  of the commissioner and shall be
either a physician licensed in this state  or  a  non-physician,  deemed
qualified by the commissioner and board of regents.
  S  2.  The  education law is amended by adding a new section 6529-a to
read as follows:
  S  6529-A.  ANESTHESIOLOGIST  ASSISTANTS.  1.  DEFINITIONS.  FOR   THE
PURPOSES  OF  THIS SECTION, THE FOLLOWING TERMS SHALL HAVE THE FOLLOWING
MEANINGS:

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

                                                           LBD16171-02-2

S. 7628--A                          2

  (A) "ANESTHESIOLOGIST ASSISTANT" MEANS A PERSON WHO IS LICENSED AS  AN
ANESTHESIOLOGIST ASSISTANT PURSUANT TO THIS SECTION.
  (B)   "ANESTHESIOLOGIST"   MEANS  A  PHYSICIAN  WHO  HAS  SUCCESSFULLY
COMPLETED A RESIDENCY IN ANESTHESIOLOGY APPROVED BY THE  AMERICAN  BOARD
OF  MEDICINE  OF  ANESTHESIOLOGY  OR  THE  AMERICAN OSTEOPATHIC BOARD OF
ANESTHESIOLOGY AND WHO IS ACTIVELY AND DIRECTLY ENGAGED IN THE  CLINICAL
PRACTICE OF MEDICINE AS AN ANESTHESIOLOGIST.
  (C) "ADMINISTRATION OF ANESTHESIA IN THE HOSPITAL OR AMBULATORY SURGI-
CAL  CENTER"  MEANS ANESTHESIA SERVICES SHALL BE DIRECTED BY AN ANESTHE-
SIOLOGIST WHO HAS RESPONSIBILITY FOR THE CLINICAL ASPECTS  OR  ORGANIZA-
TION AND DELIVERY OF ALL ANESTHESIA SERVICES PROVIDED BY THE HOSPITAL OR
AMBULATORY  SURGICAL  CENTER.  THAT  ANESTHESIOLOGIST  SHALL  DIRECT THE
ADMINISTRATION ASPECTS OF THE SERVICE,  AND  SHALL  BE  RESPONSIBLE,  IN
CONJUNCTION  WITH  THE  MEDICAL STAFF, FOR RECOMMENDING TO THE GOVERNING
BODY PRIVILEGES TO THOSE PERSONS QUALIFIED  TO  ADMINISTER  ANESTHETICS,
INCLUDING  THE  PROCEDURES  EACH  PERSON IS QUALIFIED TO PERFORM AND THE
LEVELS OF REQUIRED SUPERVISION AS APPROPRIATE. FOR THE PURPOSES OF  THIS
SECTION,  "ADMINISTRATION  OF ANESTHESIA IN OFFICE-BASED SURGERY VENUES"
MEANS THE ANESTHESIA COMPONENT OF THE MEDICAL OR DENTAL PROCEDURE  SHALL
BE  SUPERVISED  BY  AN  ANESTHESIOLOGIST  WHO  IS PHYSICALLY PRESENT AND
AVAILABLE TO IMMEDIATELY DIAGNOSE AND TREAT THE PATIENT  FOR  ANESTHESIA
COMPLICATIONS OR EMERGENCIES.
  (D)  "DEEP  SEDATION"  MEANS  THE  ADMINISTRATION OF MEDICATION BY THE
ORAL, PARENTERAL OR INHALATION ROUTES  WHICH  RESULTS  IN  A  CONTROLLED
STATE  OF DEPRESSED CONSCIOUSNESS ACCOMPANIED BY PARTIAL LOSS OF PROTEC-
TIVE REFLEXES. THERE MAY BE AN INABILITY TO  INDEPENDENTLY  AND  CONTIN-
UOUSLY  MAINTAIN  AN  OPEN  AIRWAY AND/OR REGULAR BREATHING PATTERN WITH
DEEP SEDATION, AND THE ABILITY TO APPROPRIATELY AND  RATIONALLY  RESPOND
TO PHYSICAL STIMULI AND VERBAL COMMANDS IS LOST.
  (E)  "GENERAL  ANESTHESIA" MEANS THE ADMINISTRATION OF A MEDICATION BY
THE PARENTERAL OR INHALATION ROUTES WHICH RESULTS IN A CONTROLLED  STATE
OF UNCONSCIOUSNESS ACCOMPANIED BY A COMPLETE LOSS OF PROTECTIVE REFLEXES
INCLUDING LOSS OF THE ABILITY TO INDEPENDENTLY AND CONTINUOUSLY MAINTAIN
PATIENT  AIRWAY  AND  A  REGULAR  BREATHING  PATTERN.   THERE IS ALSO AN
INABILITY TO RESPOND PURPOSEFULLY  TO  VERBAL  COMMANDS  AND/OR  TACTILE
STIMULATION.
  (F)  "HOSPITAL"  MEANS  AN  INSTITUTION OR FACILITY POSSESSING A VALID
OPERATING CERTIFICATE ISSUED PURSUANT TO  ARTICLE  TWENTY-EIGHT  OF  THE
PUBLIC HEALTH LAW.
  (G)  "AMBULATORY  SURGICAL  CENTER"  MEANS  AN INSTITUTION OR FACILITY
POSSESSING A VALID OPERATING  CERTIFICATE  ISSUED  PURSUANT  TO  ARTICLE
TWENTY-EIGHT OF THE PUBLIC HEALTH LAW.
  (H) "IMMEDIATELY AVAILABLE" MEANS REMAINING PHYSICALLY PRESENT FOR THE
IMMEDIATE  TREATMENT  OF EMERGENCIES AND PROVIDING INDICATED POST-OPERA-
TIVE CARE.
  (I) "MODERATE SEDATION" MEANS A DRUG-INDUCED DEPRESSION OF  CONSCIOUS-
NESS  DURING  WHICH  (I)  THE  PATIENT  RESPONDS  PURPOSEFULLY TO VERBAL
COMMANDS, EITHER ALONE OR ACCOMPANIED BY LIGHT TACTILE STIMULATION; (II)
NO INTERVENTIONS ARE REQUIRED TO MAINTAIN A PATIENT AIRWAY; (III)  SPON-
TANEOUS  VENTILATION  IS  ADEQUATE; AND (IV) THE PATENT'S CARDIOVASCULAR
FUNCTION IS USUALLY MAINTAINED WITHOUT ASSISTANCE.
  (J) "MONITORING" MEANS THE CONTINUAL CLINICAL OBSERVATION OF A PATIENT
AND THE USE OF INSTRUMENTS TO MEASURE, DISPLAY, AND RECORD THE VALUES OF
CERTAIN PHYSIOLOGIC VARIABLES SUCH AS PULSE, OXYGEN SATURATION, LEVEL OF
CONSCIOUSNESS, BLOOD PRESSURE AND RESPIRATION.

S. 7628--A                          3

  (K) "OFFICE-BASED SURGERY" MEANS ANY SURGICAL OR OTHER INVASIVE PROCE-
DURE, REQUIRING GENERAL ANESTHESIA, MODERATE SEDATION OR DEEP  SEDATION,
AND  ANY  LIPOSUCTION  PROCEDURE,  WHERE SUCH SURGICAL OR OTHER INVASIVE
PROCEDURE OR LIPOSUCTION IS PERFORMED BY A LICENSEE IN A LOCATION  OTHER
THAN  A  HOSPITAL,  EXCLUDING  MINOR PROCEDURES AND PROCEDURES REQUIRING
MINIMAL SEDATION.
  (L) "PATIENT" MEANS AN INDIVIDUAL WHO IS UNDER THE CARE OF A PHYSICIAN
IN A LICENSED FACILITY OR IN AN OFFICE, UNDER THE CARE OF  A  PHYSICIAN,
DENTIST, ORAL SURGEON OR PODIATRIST.
  (M)  "PERI-OPERATIVE  PERIOD" MEANS THE PERIOD OF TIME COMMENCING UPON
THE MEDICAL EVALUATION OF THE PATIENT BEFORE SURGERY AND ENDING UPON THE
PATIENT'S MEDICAL DISCHARGE FROM THE RECOVERY ROOM.
  (N) "PHYSICALLY PRESENT" BY AN ANESTHESIOLOGIST MEANS THE  ABILITY  TO
REACT  AND  RESPOND IN AN IMMEDIATE AND APPROPRIATE MANNER SO AS TO MAKE
POSSIBLE THE CONTINUOUS EXERCISE  OF  MEDICAL  JUDGMENT  THROUGHOUT  THE
ADMINISTRATION OF THE ANESTHESIA.
  (O)  "SUPERVISION"  MEANS  THAT  AN  ANESTHESIOLOGIST SHALL DIRECT THE
ANESTHESIA SERVICES THAT THE ANESTHESIOLOGIST  ASSISTANT  IS  PERFORMING
INCLUDING  BUT  NOT  LIMITED  TO A PRE-ANESTHETIC EXAMINATION AND EVALU-
ATION, PRESCRIBING THE ANESTHESIA, INCLUDING POST-OPERATIVE  MEDICATIONS
AS  NEEDED  FOR  PAIN AND DISCOMFORT, INCLUDING NAUSEA AND VOMITING, AND
SHALL BE IMMEDIATELY AVAILABLE DURING THE ENTIRE  PERI-OPERATIVE  PERIOD
FOR  DIAGNOSIS,  TREATMENT, AND MANAGEMENT OF ANESTHESIA-RELATED COMPLI-
CATIONS OR EMERGENCIES, AND ASSURE THE PROVISION OF  INDICATED  POST-AN-
ESTHESIA CARE.
  2.  LICENSURE.  FOR  ISSUANCE  OF  A LICENSE TO PRACTICE AS A LICENSED
ANESTHESIOLOGIST ASSISTANT THE APPLICANT  SHALL  FULFILL  THE  FOLLOWING
REQUIREMENTS:
  (A)  APPLICATION:  FILE AN APPLICATION WITH THE DEPARTMENT WHICH SHALL
BE IN SUCH FORM AS PROVIDED BY THE COMMISSIONER;
  (B) AGE: BE AT LEAST TWENTY-ONE YEARS OF AGE AND OF GOOD MORAL CHARAC-
TER;
  (C) EDUCATION:
  (I) HAVE OBTAINED A BACHELOR'S OR HIGHER DEGREE APPROVED BY THE  BOARD
OF MEDICINE;
  (II)  HAVE  SATISFACTORILY  COMPLETED  AN  ANESTHESIOLOGIST  ASSISTANT
PROGRAM THAT IS ACCREDITED BY THE COMMISSION ON ACCREDITATION OF  ALLIED
HEALTH EDUCATION PROGRAMS OR BY A PREDECESSOR OR SUCCESSOR ENTITY;
  (III)  PASSED  THE CERTIFYING EXAMINATION ADMINISTERED BY AND OBTAINED
ACTIVE CERTIFICATION FROM THE NATIONAL COMMISSION  ON  CERTIFICATION  OF
ANESTHESIOLOGIST ASSISTANTS OR A SUCCESSOR ENTITY; AND
  (IV)  BIENNIALLY  COMPLETE FORTY HOURS OF CONTINUING MEDICAL EDUCATION
OR HOLD A CURRENT CERTIFICATE  ISSUED  BY  THE  NATIONAL  COMMISSION  ON
CERTIFICATION OF ANESTHESIOLOGIST ASSISTANTS OR ITS SUCCESSOR; AND
  (D)  FEES:  PAY  TO  THE  DEPARTMENT A FEE OF ONE HUNDRED SEVENTY-FIVE
DOLLARS FOR INITIAL LICENSURE AND A TRIENNIAL REGISTRATION  FEE  OF  ONE
HUNDRED FIFTY-FIVE DOLLARS.
  3.  USE  OF TITLE. ONLY A PERSON LICENSED UNDER THIS SECTION SHALL USE
THE TITLE "ANESTHESIOLOGIST ASSISTANT" OR USE THE LETTERS  "A.A."  AFTER
HIS OR HER NAME.
  4. PERFORMANCE OF ANESTHESIOLOGIST ASSISTANTS. THE PRACTICE OF ANESTH-
ESIOLOGIST ASSISTANTS LICENSED UNDER THIS SECTION SHALL:
  (A)  INCLUDE  THE  ADMINISTRATION  OF ANESTHESIA TO A PATIENT BUT ONLY
UNDER THE SUPERVISION OF AN  ANESTHESIOLOGIST WHO IS IMMEDIATELY  AVAIL-
ABLE;

S. 7628--A                          4

  (B) EACH ANESTHESIOLOGIST WHO AGREES TO ACT AS THE SUPERVISING ANESTH-
ESIOLOGIST  OF AN ANESTHESIOLOGIST ASSISTANT SHALL ADOPT A WRITTEN PRAC-
TICE PROTOCOL WHICH DELINEATES THE SERVICES  THAT  THE  ANESTHESIOLOGIST
ASSISTANT  IS AUTHORIZED TO PROVIDE AND THE MANNER IN WHICH THE ANESTHE-
SIOLOGIST  WILL  SUPERVISE  THE ANESTHESIOLOGIST ASSISTANT. THE ANESTHE-
SIOLOGIST SHALL BASE THE PROVISIONS OF THE PROTOCOL ON CONSIDERATION  OF
RELEVANT  QUALITY  ASSURANCE  STANDARDS, INCLUDING REGULAR REVIEW BY THE
ANESTHESIOLOGIST OF THE MEDICAL RECORDS OF THE PATIENTS OF THE  ANESTHE-
SIOLOGIST  ASSISTANT.  THE  SUPERVISING ANESTHESIOLOGIST SHALL SUPERVISE
THE ANESTHESIOLOGIST ASSISTANT IN  ACCORDANCE  WITH  THE  TERMS  OF  THE
PROTOCOL  UNDER  WHICH  THE ASSISTANT PRACTICES AND THE RULES FOR SUPER-
VISION OF ANESTHESIOLOGIST ASSISTANTS; AND
  (C) BE CONSISTENT WITH POLICIES AND PROCEDURE APPROVED BY THE  MEDICAL
STAFF  AND  GOVERNING STAFF OF THE HEALTH CARE FACILITY OR FREE STANDING
AMBULATORY SURGICAL CENTER DEFINED UNDER  ARTICLE  TWENTY-EIGHT  OF  THE
PUBLIC HEALTH LAW WHERE APPLICABLE.
  5.    THE  COMMISSIONER IS AUTHORIZED AND DIRECTED TO PROMULGATE REGU-
LATIONS TO IMPLEMENT THE PROVISIONS OF THIS SECTION.
  S 3. This act shall take effect on the  first  of  the  twelfth  month
which commences after this act shall have become a law; provided, howev-
er, that effective immediately, the addition, amendment and/or repeal of
any  rule  or regulation necessary for the implementation of this act on
its effective date is authorized and directed to be made  and  completed
on or before such effective date.