PRIOR PRINTER'S NOS. 413, 872
PRINTER'S NO. 910
THE GENERAL ASSEMBLY OF PENNSYLVANIA
SENATE BILL
No.
416
Session of
2021
INTRODUCED BY GORDNER, J. WARD, ARGALL, STEFANO, TARTAGLIONE,
YAW, COLLETT, BAKER, HUTCHINSON, SCHWANK, SABATINA, YUDICHAK,
MENSCH AND REGAN, MARCH 12, 2021
AS AMENDED ON THIRD CONSIDERATION, JUNE 15, 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," providing for the
definition of "advanced practice registered nurse-certified
registered nurse anesthetist"; further providing for
DEFINITIONS AND FOR registered nurse, clinical nurse
specialist, use of title and abbreviation "R.N." or "C.N.S."
and credentials and fraud; and providing for 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 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) "Certified registered nurse anesthetist" means a
registered nurse licensed in this Commonwealth who is certified
by the State Board of Nursing as a certified registered nurse
anesthetist .
(17) "Overall direction" means oversight of anesthesia
services and medical management of patient care by a qualified
individual who is present and available onsite, 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,
Certified Registered Nurse Anesthetist, Use of Title and
Abbreviation ["R.N." or] "R.N.," "C.N.S." o r "C.R.N.A." ;
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.
(b) An individual who holds a license to practice
professional nursing in this Commonwealth who meets the
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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 a certified
registered nurse anesthetist shall have the right to use the
title "certified registered nurse anesthetist" and use the
abbreviation "C.R.N.A." 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 sections to read:
Section 8.8. Certified Registered Nurse Anesthetist;
Qualifications.--(a) The Board may certify a licensed
registered nurse as a certified registered nurse anesthetist if
the REGISTERED nurse satisfies the requirements established by
this section . Certification of a certified registered nurse
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 Board unless the nurse holds a
master's degree, doctoral degree or post-master's certificate
from an accredited educational program in nurse anesthesia that
has been approved by the Board and that prepares graduates to
practice as a certified registered nurse anesthetist and:
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(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 ACCREDITED
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 which required passing of 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 a certified registered nurse anesthetist .
(b) (C) A registered nurse who does not have a graduate
degree as required under subsection (a) (B) shall be qualified
for certification as a certified registered nurse anesthetist if
that REGISTERED nurse:
(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 which required passing of 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
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AS A CERTIFIED REGISTERED NURSE ANESTHETIST.
(c) As a condition of biennial certificate renewal by the
Board, a certified registered nurse anesthetist must:
(1) Verify that the nurse holds current recertification from
a Board-recognized national certification organization which
required passing of 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 certification renewal,
complete at least thirty (30) hours of continuing education
approved by the Board, as required by 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) (D) The Board may issue a certification as 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.
(E) 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
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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) 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 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.
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(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
(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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