SB 27 - Currently, a collaborating physician may not enter into a collaborative practice arrangement with more than a specified number of assistant physicians, physician assistants, or advanced practice registered nurses. Such restriction does not apply to arrangements with certified registered nurse anesthetists (CRNAs) providing anesthesia services under the supervision of an anesthesiologist or other physician, dentist, or podiatrist who is immediately available if needed. This act repeals this CRNA exception to the limitations on collaborative practice arrangements.

CRNAs shall not be required to enter into collaborative practice arrangements for the provision of anesthesia care for a patient for a procedure or treatment and shall not be required to obtain a certificate of controlled substance prescriptive authority from the Board of Nursing. A CRNA may issue orders for and administer certain controlled substances and drugs to a patient for treatment, provided that a physician, dentist, or podiatrist has requested anesthesia care and that care is provided in accordance with a plan of anesthesia care developed by the CRNA.

CRNAs shall have the authority, in addition to the other functions and duties of a CRNA, to: (1) provide pre- and post-anesthesia care assessment; (2) develop a plan of anesthesia care for the procedure or treatment; (3) notify the physician, dentist, or podiatrist regarding the plan of anesthesia care; (4) order the method for and administer anesthesia care; (5) initiate and perform patient-specific anesthesia in accordance with the plan; (6) issue orders for and administer Schedule II, III, IV, and V controlled substances during the period of anesthesia care or cause the same to be administered or dispensed during the period of care by a licensed professional or practical nurse; (7) order necessary tests, interpret diagnostic procedures, and apply medical devices during the period of care; (8) support life functions; (9) monitor, assess, evaluate, and take appropriate action to patient responses to anesthesia care; (10) manage the patient's emergence from anesthesia care; and (11) participate in the life support of the patient.

SARAH HASKINS

Statutes affected:
Introduced (0532S.02): 195.070, 334.037, 334.104, 334.735, 335.019, 335.038


Senate Committee Minutes:
SENATE COMMITTEE MINUTES Bill No.: SB 27
Sponsor: Brown (16)
Hearing Date: 3/30/2023


COMMITTEE: Governmental Accountability

CHAIRMAN: Eslinger

DATE REFERRED: 1/12/2023 DATE HEARING REQUESTED: 1/12/2023



STAFF:
Mark Fiegenbaum
Sarah Hawkins
Will Wheeler


WITNESSES GIVING INFORMATION:



WITNESSES FOR:
Denise Stuit - Missouri Association of Nurse Anesthetists
Andrew Palmisano
Bassan Hadi
Jason Wellen
Peter Gochee
Denis Percell
Amy Wellen
Zachary Smith
Chuck Hagedorn
Michael Burns


WITNESSES AGAINST:
Matthew Casey - Missouri Society of Anesthesiologists
Kathy Perryman
Jim Kelly - Missouri Society of Anesthesiologists and Missouri State Medical Association
David Jackson - Missouri Society of Anesthesiologists
Ryan Deboef - Missouri Association of Osteopathic Physicians and Surgeons
Jeff Howell - Missouri State Orthopedic Association