2023 23LSO-0488
STATE OF WYOMING
HOUSE BILL NO. HB0122
Anesthesiologist assistants licensing.
Sponsored by: Representative(s) Berger, Banks, Stith and Zwonitzer, Dn and Senator(s) Pappas and Schuler
A BILL
for
1 AN ACT relating to professions and occupations; providing
2 for the licensing of anesthesiologist assistants and
3 specifying scope of practice; creating and amending
4 definitions; creating an advisory committee to the board of
5 medicine; providing for temporary licenses as specified;
6 providing for the imposition of fees; providing for the
7 suspension, restriction, revocation or nonrenewal of
8 licenses as specified; providing for license reinstatement;
9 creating a criminal penalty; providing for a hearing;
10 requiring rulemaking; and providing for an effective date.
11
12 Be It Enacted by the Legislature of the State of Wyoming:
13
14 Section 1. W.S. 33-26-801 through 33-26-811 are
15 created to read:
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2 ARTICLE 8
3 ANESTHESIOLOGIST ASSISTANTS
4
5 33-26-801. Definitions.
6
7 (a) As used in this article:
8
9 (i) "Anesthesiologist" means a physician who has
10 completed a residency in anesthesiology approved by the
11 American Board of Anesthesiology, the American Osteopathic
12 Board of Anesthesiology or its predecessor or successor
13 organization and is licensed under article 3 of this
14 chapter;
15
16 (ii) "Anesthesiologist assistant" means any
17 person licensed under this article who:
18
19 (A) Has graduated from an anesthesiologist
20 assistant education program approved by CAAHEP or its
21 predecessor or successor agency;
22
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1 (B) Has satisfactorily completed a
2 certification examination administered by NCCAA or other
3 national anesthesiologist assistant certifying agency that
4 has been reviewed and approved by the board and is
5 currently certified; and
6
7 (C) Is approved by the board to assist in
8 the practice of medicine under the supervision of an
9 anesthesiologist or group of anesthesiologists approved by
10 the board to supervise the person.
11
12 (iii) "Assist" means the anesthesiologist
13 assistant may personally perform those duties and
14 responsibilities delegated to the anesthesiologist
15 assistant by the supervising anesthesiologist with the
16 supervising anesthesiologist being physically on-site;
17
18 (iv) "Alternate anesthesiologist" means an
19 anesthesiologist designated by the supervising
20 anesthesiologist to ensure supervision of the
21 anesthesiologist assistant in the supervising
22 anesthesiologist's absence. An alternate anesthesiologist
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1 is subject to the same requirements imposed upon the
2 supervising anesthesiologist;
3
4 (v) "Board" means the Wyoming board of medicine;
5
6 (vi) "Certification examination" means the
7 initial certifying examination approved by the board for
8 the certification of anesthesiologist assistants including,
9 but not limited to, the examination administered by NCCAA
10 or other national anesthesiologist assistant certifying
11 agency established for such purpose that has been reviewed
12 and approved by the board;
13
14 (vii) "License" means a license to practice as
15 an anesthesiologist assistant in this state;
16
17 (viii) "Licensee" means a person licensed to
18 practice as an anesthesiologist assistant under this act;
19
20 (ix) "NCCAA" means the national commission on
21 the certification of anesthesiologist assistants;
22
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1 (x) "On-site" means within the facility where
2 anesthesia services may be needed including the operating
3 room suites, intensive care unit, emergency room, obstetric
4 suite, endoscopy suite, radiology suite, cardiac services
5 suite and recovery room;
6
7 (xi) "Supervising anesthesiologist" means an
8 anesthesiologist approved by the board to supervise an
9 anesthesiologist assistant and who agrees to be responsible
10 for the medical acts of an anesthesiologist assistant;
11
12 (xii) "Supervision" means the ready, on-site
13 availability of the supervising anesthesiologist for
14 consultation and direction of the activities of the
15 anesthesiologist assistant.
16
17 33-26-802. Scope.
18
19 (a) This article does not apply to persons enrolled
20 in an anesthesiologist assistant program.
21
22 (b) An anesthesiologist assistant may perform those
23 duties and responsibilities delegated to the
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1 anesthesiologist assistant by a supervising
2 anesthesiologist and under the supervision of the
3 supervising anesthesiologist. A supervising
4 anesthesiologist may delegate duties to an anesthesiologist
5 assistant within the scope of the supervising
6 anesthesiologist's practice and expertise and within the
7 skills of the anesthesiologist assistant including the
8 following:
9
10 (i) Perform preoperative anesthetic evaluations,
11 postoperative anesthetic evaluations and patient progress
12 notes, all to be co-signed by the supervising
13 anesthesiologist within twenty-four (24) hours;
14
15 (ii) Order and perform preoperative
16 consultations;
17
18 (iii) Order preoperative medications, including
19 controlled substances, which may be administered prior to
20 the co-signature by the supervising anesthesiologist;
21
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1 (iv) Change or discontinue a medical treatment
2 plan after consultation with the supervising
3 anesthesiologist;
4
5 (v) Obtain informed consent for anesthesia or
6 related procedures;
7
8 (vi) Order the perioperative continuation of
9 current medications, which may be administered prior to the
10 co-signature by the supervising anesthesiologist;
11
12 (vii) Calibrate anesthesia delivery systems and
13 obtain and interpret information from the systems and
14 monitors, in consultation with the supervising
15 anesthesiologist;
16
17 (viii) Assist the supervising anesthesiologist
18 with the implementation of medically accepted monitoring
19 techniques;
20
21 (ix) Perform basic and advanced airway
22 interventions, including endotracheal intubation, laryngeal
23 mask insertion and other advanced airways techniques;
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2 (x) Establish peripheral intravenous lines,
3 including subcutaneous lidocaine use;
4
5 (xi) Establish radial and dorsalis pedis
6 arterial lines and central lines;
7
8 (xii) Perform general anesthesia, including
9 induction, maintenance and emergence;
10
11 (xiii) Perform procedures associated with
12 general anesthesia, such as gastric intubation;
13
14 (xiv) Administer intermittent vasoactive drugs
15 and start and titrate vasoactive infusions for the
16 treatment of patient responses to anesthesia;
17
18 (xv) Perform epidural, spinal and intravenous
19 regional anesthesia;
20
21 (xvi) Maintain and manage established neuraxial
22 and regional anesthesia;
23
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1 (xvii) Perform monitored anesthesia care;
2
3 (xviii) Evaluate and manage patient controlled
4 analgesia, epidural catheters and peripheral nerve
5 catheters;
6
7 (xix) Obtain venous and arterial blood samples;
8
9 (xx) Perform, order and interpret appropriate
10 preoperative, point of care, intraoperative or
11 postoperative diagnostic tests or procedures as authorized
12 by the supervising anesthesiologist;
13
14 (xxi) Obtain and administer perioperative
15 anesthesia and related pharmaceutical agents including
16 intravenous fluids and blood products;
17
18 (xxii) Participate in management of the patient
19 while in the preoperative suite and recovery area;
20
21 (xxiii) Order postoperative sedation, anxiolysis
22 and analgesia that may be administered prior to the
23 co-signature by the supervising anesthesiologist;
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2 (xxiv) Order postoperative oxygen therapy,
3 including initial ventilator therapy, which may be
4 administered prior to the co-signature by the supervising
5 anesthesiologist;
6
7 (xxv) Order post-operative respiratory therapy
8 and medicines for the treatment of patient responses to
9 anesthesia, which may be administered prior to the
10 co-signature by the supervising anesthesiologist;
11
12 (xxvi) Provide assistance to a cardiopulmonary
13 resuscitation team in response to a life-threatening
14 situation;
15
16 (xxvii) Participate in administrative, research
17 and clinical teaching activities as authorized by the
18 supervising anesthesiologist;
19
20 (xxviii) Perform other tasks not prohibited by
21 law under the supervision of the supervising
22 anesthesiologist that an anesthesiologist assistant has
23 been trained and is proficient to perform.
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2 (c) Nothing in this article shall be construed to
3 prevent an anesthesiologist assistant from having access to
4 and being able to obtain drugs as directed by the
5 supervising anesthesiologist.
6
7 (d) Nothing in this article shall be construed to
8 conflict with or alter the provisions and requirements of
9 W.S. 33-26-101 through 33-26-410 and 33-26-601 through
10 33-26-703.
11
12 33-26-803. Board powers and duties.
13
14 (a) The board shall review the qualifications and
15 determine the fitness of all persons desiring to practice
16 as anesthesiologist assistants.
17
18 (b) The board shall:
19
20 (i) Grant, renew, refuse to grant or renew,
21 suspend, restrict, revoke and reinstate licenses;
22
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1 (ii) Investigate allegations that an
2 anesthesiologist assistant or supervising anesthesiologist
3 has engaged in conduct constituting a ground for revocation
4 in W.S. 33-26-402 or 33-26-808(a);
5
6 (iii) Conduct informal interviews and contested
7 cases;
8
9 (iv) Promulgate rules governing the licensure
10 and practice of anesthesiologist assistants;
11
12 (v) Appoint members to serve on an advisory
13 committee to the board of medicine. At least two (2) of
14 the members of the advisory committee shall be
15 anesthesiologist assistants and two (2) members shall be
16 anesthesiologists. The committee members are responsible
17 to and shall serve at the board's pleasure. The advisory
18 committee shall review and make recommendations to the
19 board regarding all matters relating to anesthesiologist
20 assistants that come before the board, including:
21
22 (A) Applications for licensure, renewals or
23 reinstatements;
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2 (B) Education standards;
3
4 (C) Scope of practice;
5
6 (D) Licensure requirements;
7
8 (E) Continuing medical education.
9
10 (vi) Retain jurisdiction over only those
11 licensees to whom temporary or full licenses were granted,
12 regardless of whether the license expired, lapsed or was
13 relinquished during or after the alleged occurrence of
14 conduct prescribed in W.S. 33-26-402 by the licensee or
15 after the board receives a court order pursuant to W.S.
16 33-26-808(c) for the licensee;
17
18 (vii) Review the qualifications of physicians
19 desiring to serve as a supervising anesthesiologist or
20 alternate anesthesiologist including the compatibility of
21 the supervising anesthesiologist's or alternate
22 anesthesiologist's specialty and scope of practice with
23 that of the anesthesiologist assistant to be supervised.
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2 33-26-804. License required; application;
3 qualifications; consideration of applications.
4
5 (a) No person shall practice as an anesthesiologist
6 assistant or represent oneself as a "certified
7 anesthesiologist assistant", "licensed anesthesiologist
8 assistant", "anesthesiologist assistant", "C.A.A." or
9 "A.A." without a license granted by the board.
10
11 (b) The board may grant an anesthesiologist assistant
12 license to an applicant who:
13
14 (i) Has graduated from an anesthesiologist
15 assistant program accredited by CAAHEP or its predecessor
16 or successor organization;
17
18 (ii) Has satisfactorily completed a
19 certification examination administered by NCCAA or other
20 national certifying agency that has been reviewed and
21 approved by the board and is currently certified;
22
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1 (iii) Completes an application on a form
2 approved by the board; and
3
4 (iv) Pays the fees set forth in W.S. 33-26-807.
5
6 (c) No person shall act as a supervising
7 anesthesiologist or alternate anesthesiologist without a
8 license granted by the board under article 3 of this
9 chapter. The board shall promulgate rules governing the
10 board's consideration of applications by an
11 anesthesiologist to supervise anesthesiologist assistants.
12 Any application shall include at a minimum:
13
14 (i) The qualifications of the anesthesiologist
15 assistant to be employed, including experience;
16
17 (ii) The professional background of the
18 anesthesiologist;
19
20 (iii) A description by the anesthesiologist of
21 that anesthesiologist's practice and the way in which the
22 anesthesiologist assistant will be utilized, including
23 method of supervision.
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2 (d) The board, with the concurrence of the advisory
3 committee, shall approve