A01440
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
931
Session of
2021
INTRODUCED BY TOOHIL, SAYLOR, STEPHENS, FRITZ, LEWIS DELROSSO,
T. DAVIS, HILL-EVANS, NEILSON, CIRESI, WHEELAND, R. BROWN,
SANKEY, SIMS, HARKINS, JONES, FLYNN, BERNSTINE, ZABEL AND
LONGIETTI, MARCH 16, 2021
REFERRED TO COMMITTEE ON PROFESSIONAL LICENSURE, MARCH 16, 2021
AN ACT
Amending the act of May 22, 1951 (P.L.317, No.69), entitled "An
act relating to the practice of professional nursing;
providing for the licensing of nurses and for the revocation
and suspension of such licenses, subject to appeal, and for
their reinstatement; providing for the renewal of such
licenses; regulating nursing in general; prescribing
penalties and repealing certain laws," further providing for
definitions and for registered nurse, clinical nurse
specialist, use of title and abbreviation and providing for
advanced practice registered nurse-certified registered nurse
anesthetist. certified registered nurse anesthetist and
qualifications and for scope of practice for certified
registered nurse anesthetists.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Section 2 of the act of May 22, 1951 (P.L.317,
No.69), known as The Professional Nursing Law, is amended by
adding a clause clauses to read:
Section 2. Definitions.--When used in this act, the
following words and phrases shall have the following meanings
unless the context provides otherwise:
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(16) "Advanced practice registered nurse-certified
registered nurse anesthetist" "Certified registered nurse
anesthesist" means a registered nurse licensed in this
Commonwealth who is certified by the State Board of Nursing as
a n advanced practice registered nurse - certified registered
nurse c ertified registered nurse anesthesist .
(17) "Overall direction" means oversight of anesthesia
services and medical management of patient care by a qualified
individual who is present and available on-site, but not
necessarily present in the same procedure room as a certified
registered nurse anesthetist performing anesthesia services for
the duration of the services provided.
Section 2. Section 3 of the act is amended to read:
Section 3. [Registered Nurse, Clinical Nurse Specialist,]
Use of Title and Abbreviation ["R.N." or "C.N.S."] "R.N.,"
"C.N.S.," "C.N.S." or "C.R.N.A." or "A.P.R.N." ; Credentials;
Fraud.--(a) Any person who holds a license to practice
professional nursing in this Commonwealth, or who is maintained
on inactive status in accordance with section 11 of this act,
shall have the right to use the titles "nurse" and "registered
nurse" and the abbreviation "R.N." No other person shall engage
in the practice of professional nursing or use the titles
"nurse" or "registered nurse" or the abbreviation "R.N." to
indicate that the person using the same is a registered nurse,
except that the title "nurse" also may be used by a person
licensed under the provisions of the act of March 2, 1956 (1955
P.L.1211, No.376), known as the "Practical Nurse Law." No person
shall sell or fraudulently obtain or fraudulently furnish any
nursing diploma, license, record, or registration or aid or abet
therein.
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(b) An individual who holds a license to practice
professional nursing in this Commonwealth who meets the
requirements under sections 6.2 and 8.5 of this act to be a
clinical nurse specialist shall have the right to use the title
"clinical nurse specialist" and the abbreviation "C.N.S." No
other person shall have that right.
(b.1) An individual who holds a license to practice
professional nursing in this Commonwealth who meets the
requirements under section 8.8 of this act to be an advanced
practice registered nurse-certified a certified registered nurse
anesthetist shall have the right to use the title "advanced
practice registered nurse-certified registered nurse
anesthetist," "certified registered nurse anesthetist" and the
abbreviations abbreviation "C.R.N.A." or "A.P.R.N." . No other
person shall have that right.
(c) Notwithstanding subsection (a), this section shall not
prohibit the use by a person of a descriptive title for nurse
assistive personnel. For the purposes of this subsection, the
term "nurse assistive personnel" shall mean an individual
providing health care services under the supervision of a
professional or practical nurse.
Section 3. The act is amended by adding a section sections
to read:
Section 8.8. Advanced Practice Registered Nurse- Certified
Certified Registered Nurse Anesthetist; Qualifications.--(a)
The Board may certify a licensed registered nurse as an a dvanced
practice registered nurse- certified a certified registered nurse
anesthetist if the registered nurse satisfies the requirements
established by this section. Certification of an a dvanced
practice registered nurse- certified a certified registered nurse
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anesthetist by the Board shall expire on the same date as the
license of that registered nurse expires. Beginning on the
effective date of this section, a nurse shall not qualify for
initial certification by the B oard unless the nurse holds a
master's degree, doctoral degree or post-master's certificate
from an educational program in nurse anesthesia that has been
approved by the B oard and that prepares graduates to practice as
an a dvanced practice registered nurse- certified registered nurse
anesthetist and:
(b) Beginning on the effective date of this section, a
registered nurse shall not qualify for initial certification by
the B oard unless the registered nurse holds a master's degree,
doctoral degree or post-master's certificate from an educational
program in nurse anesthesia that has been approved by the B oard
and that prepares graduates to practice as a certified
registered nurse anesthetist and:
(1) holds current national certification as a certified
registered nurse anesthetist from a Board-recognized national
certification organization that requires passing a national
certifying examination in nurse anesthesia ; and
(2) submits an application and the required fee as
established by the Board; and
(2) meets (3) complies with all other Board requirements to
practice as an a dvanced practice registered nurse a certified
registered nurse anesthetist .
(b) (c) A registered nurse who does not have a graduate
degree required under subsection (a) (b) shall be qualified for
certification as an a dvanced practice registered nurse- certified
a certified registered nurse anesthetist if that registered
nurse:
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(1) meets the educational requirements for certified
registered nurse anesthetists that were in effect in this
Commonwealth at the time the registered nurse completed a nurse
anesthesia educational program; and
(2) submits evidence of recertification as a certified
registered nurse anesthetist from a Board-recognized national
certification organization that requires passing a national
certifying examination in nurse anesthesia . ;
(3) submits an application and the required fee as
established by the Board; and
(4) complies with all other Board requirements to practice
as a certified registered nurse anesthetist.
(c) As a condition of biennial certificate renewal by the
Board, an a dvanced practice registered nurse- certified
registered nurse anesthetist must:
(1) Verify that the nurse holds current national
recertification from a Board-recognized national certification
organization that requires passing a national certifying
examination in nurse anesthesia.
(2) Submit a renewal application to the Board.
(3) Pay a renewal fee as set by the Board.
(4) In the two years prior to the certification renewal,
complete at least thirty (30) hours of continuing education
approved by the Board, as required under section 12.1 of this
act.
(d) For certification under this section, a licensed
registered nurse shall file a Board-prepared application with
the Board and pay a fee as established by the Board by
regulation.
(e) (c) The Board may issue a certification as an advanced
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practice registered nurse-certified a certified registered nurse
anesthetist to a licensed registered nurse who has completed a
course of study considered by the Board to be equivalent to a
course of study required in this Commonwealth under section 6.2
of this act and this section at the time the course was
completed, or who is licensed or certified by another state,
territory or possession of the United States or a foreign
country as deemed equivalent to Pennsylvania's certification
requirements, and who has met all the requirements, including
character, under this act.
(d) As a condition of biennial certificate renewal by the
Board, a certified registered nurse anesthetist must:
(1) Verify that the nurse holds current national
recertification from a Board-recognized national certification
organization that requires passing a national certifying
examination in nurse anesthesia.
(2) Submit a renewal application to the Board and the
required fee as established by the Board.
(3) In the two years prior to the certification renewal,
complete at least thirty (30) hours of continuing education
approved by the Board, as required under section 12.1 of this
act.
(4) Comply with all other requirements of the Board.
(f) An a dvanced practice registered nurse- certified (e) A
certified registered nurse anesthetist practicing in this
Commonwealth shall maintain a level of professional liability
coverage as required for a nonparticipating health care provider
under the act of March 20, 2002 (P.L.154, No.13), known as the
"Medical Care Availability and Reduction of Error (Mcare) Act,"
and shall not be eligible to participate in the Medical Care
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Availability and Reduction of Error (Mcare) Fund.
Section 8.9. Scope of Practice for Certified Registered
Nurse Anesthetists.--(a) A certified registered nurse
anesthetist shall have the authority to perform anesthesia
services in cooperation with a physician, podiatrist or dentist
involved in a procedure for which anesthesia care is being
provided if the anesthesia services are performed under the
overall direction of any of the following:
(1) A physician licensed by the State Board of Medicine or
the State Board of Osteopathic Medicine who has completed an
accredited residency training program in anesthesiology.
(2) A physician licensed by the State Board of Medicine or
the State Board of Osteopathic Medicine who is performing the
procedure for which the certified registered nurse anesthetist
is performing anesthesia services.
(3) A podiatrist licensed by the State Board of Podiatry who
is performing the procedure for which the certified registered
nurse anesthetist is performing anesthesia services.
(4) A dentist licensed by the State Board of Dentistry and
permitted by the act of May 1, 1933 (P.L.216, No.76), known as
"The Dental Law" or the State Board of Dentistry to administer,
supervise or direct the administration of anesthesia.
(b) Nothing in this section shall be construed to:
(1) prohibit a certified registered nurse anesthetist who
would otherwise require direction from providing brief periods
of care in the event of an emergency that temporarily prevents
or interferes with overall direction;
(2) r estrict the authority of a health care facility to
provide for additional oversight requirements for a certified
registered nurse anesthetist practicing within the facility; or
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(3) l imit or prohibit a certified registered nurse
anesthetist from engaging in those activities which normally
constitute the practice of nursing as defined in section 2.
Section 4. The State Board of Nursing shall promulgate final
regulations to implement the amendment or addition of sections
2(16), 3 and 8.8 of the act within 18 months of the effective
date of this section.
Section 5. This act shall take effect in 60 days.
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