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ARIZONA STATE SENATE
Fifty-Sixth Legislature, First Regular Session
nurse anesthetists; clinical rotations; appropriation
Purpose
Establishes the Student Registered Nurse Anesthetist Clinical Rotation Program (Program) to expand the capacity of preceptor training programs for nurse anesthetists and appropriates $200,000 from the state General Fund (state GF) in FY 2024 to the Arizona Health Care Cost Containment System (AHCCCS) for Program administration. Removes the requirement that certified registered nurse anesthetists (CRNAs) administer anesthetics only under the direction of and in the presence of a physician or surgeon.
Background
Statute allows the Board of Nursing (Board) to certify registered nurses as CRNAs if the nurse: 1) submits a Board-prescribed application; 2) has completed an anesthesia program that is accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs (Council) or another national certifying body recognized by the Board; 3) has received certification by the Council or certifying body; and 4) has paid the applicable certification fee. (A.R.S. § 32-1634.03).
CRNAs are authorized to administer anesthetics under the direction of and in the presence of a physician or surgeon in connection with preoperative, intraoperative or postoperative care of a patient or as part of a procedure performed by a physician or surgeon in a health care institution, ambulance or an office of a medical or osteopathic physician, podiatrist or dentist. The scope of practice of CRNAs includes: 1) issuing medication orders, including for controlled substances, to be administered by a licensed or certified health care provider; 2) assessing the health status of an individual as the status relates to the risks associated with anesthetic management; 3) obtaining informed consent; 4) ordering and evaluating laboratory and diagnostic test results and performing point-of-care testing that the CRNA is qualified to perform; 5) ordering and evaluating radiographic imaging studies that the CRNA is qualified to order and interpret; 6) identifying, developing, implementing and evaluating an aesthetic plan of care for a patient; 7) taking necessary action in response to an emergency situation; and 8) performing therapeutic procedures that the CRNA is qualified to perform (A.R.S. § 32-1634.04).
In relation to the requirement that CRNAs administer anesthesia in the presence of a physician or surgeon, presence means within the same health care institution or office and available as necessary (A.R.S. § 32-1601).
Preceptorship means a mentoring experience in which a nursing preceptor provides a program of personalized instruction, training and supervision to a graduate student to enable the student to obtain an advance nursing degree and become licensed as an advance practice registered nurse (A.R.S. § 32-1607).
SB 1269 appropriates $200,000 from the state GF in FY 2024 to AHCCCS.
Provisions
Student Registered Nurse Anesthetist Clinical Rotation Program
1. Establishes the Program in AHCCCS to expand the capacity of preceptor training programs at health care institutions for nurse anesthetist students.
2. Requires AHCCCS to develop a grant program to distribute Program monies to health care institutions to expand or create clinical training placements for nurse anesthetist students, with preference given to the expansion or development of clinical rotations in obstetrics, pediatrics and cardiovascular care.
3. Specifies that awarded Program grant monies are intended to supplement, not supplant, existing training program expenses covered by the health care institution grantee.
4. Requires AHCCCS to establish an application process for a Program grant.
5. Allows AHCCCS to award grants for multiyear programs.
6. Requires AHCCCS to consider the following factors when determining grant awards:
a) the geographic and population distribution;
b) the number of nurse anesthetist students planned to be trained and retained; and
c) the cost of the proposal for the number of nurse anesthetist students expected to participate and be retained, compared to other proposals.
Program Appropriation
7. Appropriates $200,000 from the state GF in FY 2024 to AHCCCS for administration of the program.
8. Exempts the appropriation from lapsing.
Miscellaneous
9. Removes the requirement that CRNAs administer anesthetics in connection with preoperative, intraoperative or postoperative care only under the direction of and in the presence of a physician or surgeon.
10. Defines terms.
11. Makes technical and conforming changes.
12. Becomes effective on the general effective date.
Prepared by Senate Research
February 3, 2023
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