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03/28/2024 08:44 PM
Pennsylvania State Senate
https://www.legis.state.pa.us/cfdocs/Legis/CSM/showMemoPublic.cfm?chamber=S&SPick=20210&cosponId=37582
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Senate of Pennsylvania
Session of 2021 - 2022 Regular Session

MEMORANDUM

Posted: July 20, 2022 10:56 AM
From: Senator Judy Ward
To: All Senate members
Subject: Barring Anesthesiologist Assistants from Practicing in Pennsylvania
 
Recently, I have noticed legislation, as well as job postings, that would permit anesthesiologist assistants (AAs) to practice in Pennsylvania.

AAs provide anesthesia services and care to a patient but can do so only under the direct supervision of an anesthesiologist. This is unlike a certified registered nurse anesthetist (CRNA). A CRNA may provide every type of anesthesia service and care to a patient, whether working with or without a physician anesthesiologist.

Our health systems are currently trying to meet the demand for their services through cost-efficient practices that also ensure public safety. Permitting AAs to practice, however, does nothing to improve accessibility, and actually drives up health care costs. This also does nothing to improve safety for patients in Pennsylvania.

AAs are only permitted to work via licensure in 14 states and are limited by their training and licensure to provide only clinical support in an assistant role. AAs are not required to have any health care education or clinical experience prior to attending anesthesiologist assistant school, and, as such, are trained as dependent providers that are not licensed. The typical AA training program is a 24-28 month master’s degree program, and there is no requirement that a trainee have prior patient-care experience. Because of their lack of education, training and experience, they are the only healthcare providers that are required to be directly supervised by a physician anesthesiologist who is physically present. They are not legally permitted to make any decisions regarding patient care.

In contrast, CRNAs must have completed a four-year Bachelor of Science in Nursing (BSN) and worked as an intensive-care unit (ICU) nurse for 1-2 years before entering the doctoral nurse anesthesia educational program. CRNAs have thus learned to assess and treat a broad range of health issues before entering the anesthesia training program.

Due to this supervisory requirement, permitting AAs to practice in Pennsylvania creates a provider redundancy, which results in one of the costliest delivery models for anesthesia. We should not permit a model in which two providers work simultaneously to provide an identical service that is already available in the Commonwealth, and for a fraction of the cost. The increased health care costs will be absorbed by our facilities through anesthesia stipends – which represents money unnecessarily diverted from other areas of the hospital – or through increased costs that will be borne by patients.

CRNAs and physician anesthesiologists, not AAs, have a long track record of providing safe anesthesia care for Pennsylvanians. With this in mind, I plan to introduce legislation that would bar AAs from practicing in the Commonwealth. Please join me in co-sponsoring this legislation that will prevent AAs from practicing in Pennsylvania and enable providers to avoid unnecessary health care costs while maintaining patient safety and quality of care.