A. A HOSPITAL OR AMBULATORY SURGERY CENTER AUTHORIZED UNDER ARTICLE
TWENTY-EIGHT OF THE PUBLIC HEALTH LAW;
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
S. 769 3
WRITTEN PRACTICE PROTOCOLS DESCRIBED IN SUBDIVISION FOUR OF THIS SECTION
IF APPLICABLE. 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. 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
S. 769 4
NURSE ANESTHETIST SHALL MAINTAIN DOCUMENTATION THAT SUPPORTS SUCH COLLA-
BORATIVE RELATIONSHIPS.
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.
S. 769 5
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.
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
S. 769 6
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 immediately.