2021 21LSO-0512
STATE OF WYOMING
SENATE FILE NO. SF0104
Anesthesiologist assistants.
Sponsored by: Senator(s) Pappas and Furphy and Representative(s) Hallinan, Stith, Sweeney and Zwonitzer
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 the imposition of fees; creating a
6 criminal penalty; providing for a hearing; requiring
7 rulemaking; and providing for an effective date.
8
9 Be It Enacted by the Legislature of the State of Wyoming:
10
11 Section 1. W.S. 33-26-801 through 33-26-811 are
12 created to read:
13
14 ARTICLE 8
15 ANESTHESIOLOGISTS ASSISTANTS
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1
2 33-26-801. Definitions.
3
4 (a) As used in this article:
5
6 (i) "Anesthesiologist" means a physician who has
7 completed a residency in anesthesiology approved by the
8 American Board of Anesthesiology, the American Osteopathic
9 Board of Anesthesiology or its predecessor or successor
10 organization and is licensed under article 3 of this
11 chapter;
12
13 (ii) "Anesthesiologist assistant" means any
14 person licensed under this article who:
15
16 (A) Graduates from an anesthesiologist
17 assistant education program approved by CAAHEP or its
18 predecessor or successor agency;
19
20 (B) Satisfactorily completes a
21 certification examination administered by NCCAA or other
22 national anesthesiologist assistant certifying agency that
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1 has been reviewed and approved by the board, and is
2 currently certified; and
3
4 (C) Is approved by the board to assist in
5 the practice of medicine under the supervision of an
6 anesthesiologist or group of anesthesiologists approved by
7 the board to supervise the person.
8
9 (iii) "Assists" means the anesthesiologist
10 assistant may personally perform those duties and
11 responsibilities delegated to the anesthesiologist
12 assistant by the supervising anesthesiologist with the
13 supervising anesthesiologist being physically present in
14 the same facility;
15
16 (iv) "Back-up anesthesiologist" means an
17 anesthesiologist designated by the supervising
18 anesthesiologist to ensure supervision of the
19 anesthesiologist assistant in the supervising
20 anesthesiologist's absence. A back-up anesthesiologist is
21 subject to the same requirements imposed upon the
22 supervising anesthesiologist if the back-up
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1 anesthesiologist is acting as a supervising
2 anesthesiologist;
3
4 (v) "Certification examination" means the
5 initial certifying examination approved by the board for
6 the certification of anesthesiologist assistants including
7 the examination administered by NCCAA or other national
8 anesthesiologist assistant certifying agency that has been
9 reviewed and approved by the board;
10
11 (vi) "License" means a license to practice as an
12 anesthesiologist assistant in this state;
13
14 (vii) "Licensee" means a person licensed to
15 practice as an anesthesiologist assistant under this act;
16
17 (viii) "NCCAA" means the national commission on
18 the certification of anesthesiologist assistants;
19
20 (ix) "On-site" means within the facility where
21 anesthesia services may be needed including the operating
22 room suites, intensive care unit, emergency room, obstetric
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1 suite, endoscopy suite, radiology suite, cardiac services
2 suite and recovery room;
3
4 (x) "Supervising anesthesiologist" means an
5 anesthesiologist approved by the board to supervise an
6 anesthesiologist assistant and:
7
8 (A) Who agrees to be responsible for the
9 medical acts of an anesthesiologist assistant; or
10
11 (B) A back-up anesthesiologist when acting
12 in the absence of the supervising anesthesiologist.
13
14 (xi) "Supervision" means the ready, on-site
15 availability of the supervising anesthesiologist for
16 consultation and direction of the activities of the
17 anesthesiologist assistant.
18
19 33-26-802. Scope.
20
21 (a) This article does not apply to persons enrolled
22 in an anesthesiologist assistant program.
23
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1 (b) The anesthesiologist assistant may perform those
2 duties and responsibilities delegated to the
3 anesthesiologist assistant by the supervising
4 anesthesiologist under the supervision of a supervising
5 anesthesiologist. A supervising anesthesiologist may
6 delegate duties to an anesthesiologist assistant within the
7 scope of the supervising anesthesiologist's practice and
8 expertise and within the skills of the anesthesiologist
9 assistant including the following:
10
11 (i) Perform preoperative anesthetic evaluations,
12 postoperative anesthetic evaluations and patient progress
13 notes, all to be cosigned by the supervising
14 anesthesiologist within twenty-four (24) hours;
15
16 (ii) Order and perform preoperative
17 consultations;
18
19 (iii) Order preoperative medications, including
20 controlled substances, which may be administered prior to
21 the co-signature by the supervising anesthesiologist;
22
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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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1
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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1
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 pass upon 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(c);
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 shall be anesthesiologist assistants and two
15 (2) members shall be anesthesiologists. The committee
16 members are responsible to and shall serve at the board's
17 pleasure. The advisory committee shall review and make
18 recommendations to the board regarding all matters relating
19 to anesthesiologist assistants that come before the board,
20 including:
21
22 (A) Applications for licensure, renewals or
23 reinstatements;
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1
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 proscribed 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) Pass upon the qualifications and ability
19 of physicians desiring to serve as a supervising
20 anesthesiologist or back-up anesthesiologist including the
21 compatibility of the supervising anesthesiologist's or
22 back-up anesthesiologist's specialty and scope of practice
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1 with that of the anesthesiologist assistant to be
2 supervised.
3
4 33-26-804. License required; application;
5 qualifications; consideration of applications.
6
7 (a) No person shall practice as an anesthesiologist
8 assistant or represent that he is a "certified
9 anesthesiologist assistant", "licensed anesthesiologist
10 assistant", "anesthesiologist assistant", "C.A.A." or
11 "A.A." without a license granted by the board.
12
13 (b) The board may grant an anesthesiologist assistant
14 license to an applicant who:
15
16 (i) Has graduated from an anesthesiologist
17 assistant program accredited by CAAHEP or its predecessor
18 or successor organization;
19
20 (ii) Has satisfactorily completed a
21 certification examination administered by NCCAA or other
22 national certifying agency that has been reviewed and
23 approved by the board and is currently certified;
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1
2 (iii) Completes an application on a form
3 approved by the board; and
4
5 (iv) Pays the fees set forth in W.S. 33-26-807.
6
7 (c) The board may issue a temporary license to any
8 person who successfully completes a CAAHEP or other board
9 approved program for the education and training of an
10 anesthesiologist assistant but has not yet passed a
11 certification examination. To allow the opportunity to
12 take the next available certification examination, any
13 temporary license issued pursuant to this subsection shall
14 be issued for a period not to exceed one (1) year and under
15 conditions as the board determines pursuant to W.S.
16 33-26-805.
17
18 (d) The board shall promulgate rules governing the
19 board's consideration of applications by an
20 anesthesiologist to supervise anesthesiologist assistants.
21 Any application shall include at a minimum:
22
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1 (i) The qualifications of the anesthesiologist
2 assistant to be employed, including exper