Bill Text: FL S1366 | 2022 | Regular Session | Introduced
Bill Title: Anesthesiologist Assistants
Spectrum: Partisan Bill (Republican 1-0)
Status: (Failed) 2022-03-14 - Died in Health Policy [S1366 Detail]
Download: Florida-2022-S1366-Introduced.html
Florida Senate - 2022 SB 1366 By Senator Baxley 12-01116A-22 20221366__ 1 A bill to be entitled 2 An act relating to anesthesiologist assistants; 3 amending ss. 458.3475 and 459.023, F.S.; revising the 4 definitions of the terms “anesthesiologist” and 5 “direct supervision”; revising requirements for the 6 written protocol between an anesthesiologist assistant 7 and a supervising anesthesiologist; revising 8 provisions related to duties and functions 9 anesthesiologist assistants may perform; providing 10 that a certain applicant for clinical hospital 11 privileges may not be denied such privileges if the 12 applicant’s supervising anesthesiologist is a staff 13 member in good standing at that hospital, with an 14 exception; revising licensure requirements for 15 anesthesiologist assistants; providing an effective 16 date. 17 18 Be It Enacted by the Legislature of the State of Florida: 19 20 Section 1. Paragraphs (a) and (g) of subsection (1), 21 paragraph (b) of subsection (2), subsection (3), and paragraphs 22 (a) and (b) of subsection (6) of section 458.3475, Florida 23 Statutes, are amended to read: 24 458.3475 Anesthesiologist assistants.— 25 (1) DEFINITIONS.—As used in this section, the term: 26 (a) “Anesthesiologist” means an allopathic or osteopathic 27 physician who holds an active, unrestricted license; who has 28 successfully completed an anesthesiology training program 29 approved by the Accreditation Council on Graduate Medical 30 Education or its equivalent; and who is certified by the 31 American Board of Anesthesiology, is eligible to take that 32 board’s examination, or is certified by the Board of 33 Certification in Anesthesiology affiliated with the American 34 Association of Physician Specialists. 35 (g) “Direct supervision” means the physical presence of a 36 supervising anesthesiologist on the premises such that the 37 supervising anesthesiologist is reasonably available as needed 38onsite, personal supervision by an anesthesiologist who is39present in the office when the procedure is being performed in40that office, or is present in the surgical or obstetrical suite41when the procedure is being performed in that surgical or42obstetrical suite and who is in all instances immediately43available to provide assistance and direction to the44anesthesiologist assistant while anesthesia services are being45performed. 46 (2) PERFORMANCE OF SUPERVISING ANESTHESIOLOGIST.— 47 (b) An anesthesiologist or group of anesthesiologists must, 48 upon establishing a supervisory relationship with an 49 anesthesiologist assistant, file with the board a written 50 protocol that includes, at a minimum: 51 1. The name, address, and license number of the 52 anesthesiologist assistant. 53 2. The name, address, license number, and federal Drug 54 Enforcement Administration number of each physician who will be 55 supervising the anesthesiologist assistant. 56 3. The address of the anesthesiologist assistant’s primary 57 practice location and the address of any other locations where 58 the anesthesiologist assistant may practice. 59 4. The date the protocol was developed and the dates of all 60 revisions. 61 5. The signatures of the anesthesiologist assistant and 62 either the single supervising anesthesiologist or a supervising 63 anesthesiologist designated by the group, as applicableall64supervising physicians. 65 6. The duties and functions of the anesthesiologist 66 assistant. 67 7. The conditions or procedures that require the personal 68 provision of care by an anesthesiologist. 69 8. The procedures to be followed in the event of an 70 anesthetic emergency. 71 72 The protocol must be on file with the board before the 73 anesthesiologist assistant may practice with the 74 anesthesiologist or group. An anesthesiologist assistant may not 75 practice unless a written protocol has been filed for that 76 anesthesiologist assistant in accordance with this paragraph, 77 and the anesthesiologist assistant may only practice under the 78 direct supervision of an anesthesiologist who is identified in 79 thehassignedtheprotocol. The protocol must be updated 80 biennially. 81 (3) PERFORMANCE OF ANESTHESIOLOGIST ASSISTANTS.— 82 (a) An anesthesiologist assistant may assist an 83 anesthesiologist in developing and implementing an anesthesia 84 care plan for a patient, may personally administer the 85 prescribed anesthetic under the direct supervision of an 86 anesthesiologist, and may perform tasks and services as 87 specified in a written protocol approved by the supervising 88 anesthesiologist, including, but not limited to, any of the 89 following. In providing assistance to an anesthesiologist, an90anesthesiologist assistant may perform duties established by91rule by the board in any of the following functions that are92included in the anesthesiologist assistant’s protocol while93under the direct supervision of an anesthesiologist: 94 1. Obtain a comprehensive patient history and present the 95 history to the supervising anesthesiologist. 96 2. Pretest and calibrate anesthesia delivery systems and 97 monitor, obtain, and interpret information from the systems and 98 monitors. 99 3. Assist the supervising anesthesiologist with the 100 implementation of medically accepted monitoring techniques. 101 4. Establish basic and advanced airway interventions, 102 including intubation of the trachea and performing ventilatory 103 support. 104 5. Administer intermittent vasoactive drugs and start and 105 adjust vasoactive infusions. 106 6. Administer anesthetic drugs, adjuvant drugs, and 107 accessory drugs. 108 7. Assist the supervising anesthesiologist with the 109 performance of epidural anesthetic procedures and spinal 110 anesthetic procedures. 111 8. Administer blood, blood products, and supportive fluids. 112 9. Support life functions during anesthesia health care, 113 including induction and intubation procedures, the use of 114 appropriate mechanical supportive devices, and the management of 115 fluid, electrolyte, and blood component balances. 116 10. Recognize and take appropriate corrective action for 117 abnormal patient responses to anesthesia, adjunctive medication, 118 or other forms of therapy. 119 11. Participate in management of the patient while in the 120 postanesthesia recovery area, including the administration of 121 any supporting fluids or drugs. 122 12. Place special peripheral and central venous and 123 arterial lines for blood sampling and monitoring as appropriate. 124 (b) Nothing in this section or chapter prevents third-party 125 payors from reimbursing employers of anesthesiologist assistants 126 for covered services rendered by such anesthesiologist 127 assistants. 128 (c) After 90 days following the submission of a completed 129 application for clinical privileges at a hospital, an 130 anesthesiologist assistant may not be denied clinical hospital 131 privileges, except for cause, if the supervising 132 anesthesiologist is a staff member in good standing at that 133 hospital. 134 (d) An anesthesiologist assistant must clearly convey to 135 the patient that he or she is an anesthesiologist assistant. 136 (e)(d)An anesthesiologist assistant may perform anesthesia 137 tasks and services within the framework of a written practice 138 protocol developed between the supervising anesthesiologist and 139 the anesthesiologist assistant. 140 (f)(e)An anesthesiologist assistant may not prescribe, 141 order, or compound any controlled substance, legend drug, or 142 medical device, nor may an anesthesiologist assistant dispense 143 sample drugs to patients. Nothing in this paragraph prohibits an 144 anesthesiologist assistant from administering legend drugs or 145 controlled substances; intravenous drugs, fluids, or blood 146 products; or inhalation or other anesthetic agents to patients 147 which are ordered by the supervising anesthesiologist and 148 administered while under the direct supervision of the 149 supervising anesthesiologist. 150 (6) ANESTHESIOLOGIST ASSISTANT LICENSURE.— 151 (a) Any person desiring to be licensed as an 152 anesthesiologist assistant must apply to the department. The 153 department shall issue a license to any person certified by the 154 board to: 155 1. Be at least 18 years of age. 156 2. Have satisfactorily passed a proficiency examination 157 with a score established by the National Commission on 158 Certification of Anesthesiologist Assistants. 159 3. Be certified in advanced cardiac life support. 160 4. Have completed the application form and remitted an 161 application fee, not to exceed $1,000, as set by the boards. An 162 application must include: 163 a. A certificate of completion of an approved graduate 164 level program. 165 b. An acknowledgmentA sworn statementof any prior felony 166 convictions. 167 c. An acknowledgmentA sworn statementof any prior 168 discipline or denial of licensure or certification in any state. 169 d. Two letters of recommendation from anesthesiologists. 170 (b) A license must be renewed biennially. Each renewal must 171 include: 172 1. A renewal fee, not to exceed $1,000, as set by the 173 boards. 174 2. An acknowledgmentA sworn statementof no felony 175 convictions in the immediately preceding 2 years. 176 Section 2. Paragraphs (a) and (g) of subsection (1), 177 paragraph (b) of subsection (2), subsection (3), and paragraphs 178 (a) and (b) of subsection (6) of section 459.023, Florida 179 Statutes, are amended to read: 180 459.023 Anesthesiologist assistants.— 181 (1) DEFINITIONS.—As used in this section, the term: 182 (a) “Anesthesiologist” means an osteopathic or allopathic 183 physician who holds an active, unrestricted license; who has 184 successfully completed an anesthesiology training program 185 approved by the Accreditation Council on Graduate Medical 186 Education, or its equivalent, or the American Osteopathic 187 Association; and who is certified by the American Osteopathic 188 Board of Anesthesiology or is eligible to take that board’s 189 examination, is certified by the American Board of 190 Anesthesiology or is eligible to take that board’s examination, 191 or is certified by the Board of Certification in Anesthesiology 192 affiliated with the American Association of Physician 193 Specialists. 194 (g) “Direct supervision” means the physical presence of a 195 supervising anesthesiologist on the premises such that the 196 supervising anesthesiologist is reasonably available as needed 197onsite, personal supervision by an anesthesiologist who is198present in the office when the procedure is being performed in199that office, or is present in the surgical or obstetrical suite200when the procedure is being performed in that surgical or201obstetrical suite and who is in all instances immediately202available to provide assistance and direction to the203anesthesiologist assistant while anesthesia services are being204performed. 205 (2) PERFORMANCE OF SUPERVISING ANESTHESIOLOGIST.— 206 (b) An anesthesiologist or group of anesthesiologists must, 207 upon establishing a supervisory relationship with an 208 anesthesiologist assistant, file with the board a written 209 protocol that includes, at a minimum: 210 1. The name, address, and license number of the 211 anesthesiologist assistant. 212 2. The name, address, license number, and federal Drug 213 Enforcement Administration number of each physician who will be 214 supervising the anesthesiologist assistant. 215 3. The address of the anesthesiologist assistant’s primary 216 practice location and the address of any other locations where 217 the anesthesiologist assistant may practice. 218 4. The date the protocol was developed and the dates of all 219 revisions. 220 5. The signatures of the anesthesiologist assistant and 221 either the single supervising anesthesiologist or a supervising 222 anesthesiologist designated by the group, as applicableall223supervising physicians. 224 6. The duties and functions of the anesthesiologist 225 assistant. 226 7. The conditions or procedures that require the personal 227 provision of care by an anesthesiologist. 228 8. The procedures to be followed in the event of an 229 anesthetic emergency. 230 231 The protocol must be on file with the board before the 232 anesthesiologist assistant may practice with the 233 anesthesiologist or group. An anesthesiologist assistant may not 234 practice unless a written protocol has been filed for that 235 anesthesiologist assistant in accordance with this paragraph, 236 and the anesthesiologist assistant may only practice under the 237 direct supervision of an anesthesiologist who is identified in 238 thehassignedtheprotocol. The protocol must be updated 239 biennially. 240 (3) PERFORMANCE OF ANESTHESIOLOGIST ASSISTANTS.— 241 (a) An anesthesiologist assistant may assist an 242 anesthesiologist in developing and implementing an anesthesia 243 care plan for a patient, may personally administer the 244 prescribed anesthetic under the direct supervision of an 245 anesthesiologist, and may perform tasks and services as 246 specified in a written protocol approved by the supervising 247 anesthesiologist, including, but not limited to, any of the 248 following. In providing assistance to an anesthesiologist, an249anesthesiologist assistant may perform duties established by250rule by the board in any of the following functions that are251included in the anesthesiologist assistant’s protocol while252under the direct supervision of an anesthesiologist: 253 1. Obtain a comprehensive patient history and present the 254 history to the supervising anesthesiologist. 255 2. Pretest and calibrate anesthesia delivery systems and 256 monitor, obtain, and interpret information from the systems and 257 monitors. 258 3. Assist the supervising anesthesiologist with the 259 implementation of medically accepted monitoring techniques. 260 4. Establish basic and advanced airway interventions, 261 including intubation of the trachea and performing ventilatory 262 support. 263 5. Administer intermittent vasoactive drugs and start and 264 adjust vasoactive infusions. 265 6. Administer anesthetic drugs, adjuvant drugs, and 266 accessory drugs. 267 7. Assist the supervising anesthesiologist with the 268 performance of epidural anesthetic procedures and spinal 269 anesthetic procedures. 270 8. Administer blood, blood products, and supportive fluids. 271 9. Support life functions during anesthesia health care, 272 including induction and intubation procedures, the use of 273 appropriate mechanical supportive devices, and the management of 274 fluid, electrolyte, and blood component balances. 275 10. Recognize and take appropriate corrective action for 276 abnormal patient responses to anesthesia, adjunctive medication, 277 or other forms of therapy. 278 11. Participate in management of the patient while in the 279 postanesthesia recovery area, including the administration of 280 any supporting fluids or drugs. 281 12. Place special peripheral and central venous and 282 arterial lines for blood sampling and monitoring as appropriate. 283 (b) Nothing in this section or chapter prevents third-party 284 payors from reimbursing employers of anesthesiologist assistants 285 for covered services rendered by such anesthesiologist 286 assistants. 287 (c) After 90 days following the submission of a completed 288 application for clinical privileges at a hospital, an 289 anesthesiologist assistant may not be denied clinical hospital 290 privileges, except for cause, if the supervising 291 anesthesiologist is a staff member in good standing at that 292 hospital. 293 (d) An anesthesiologist assistant must clearly convey to 294 the patient that she or he is an anesthesiologist assistant. 295 (e)(d)An anesthesiologist assistant may perform anesthesia 296 tasks and services within the framework of a written practice 297 protocol developed between the supervising anesthesiologist and 298 the anesthesiologist assistant. 299 (f)(e)An anesthesiologist assistant may not prescribe, 300 order, or compound any controlled substance, legend drug, or 301 medical device, nor may an anesthesiologist assistant dispense 302 sample drugs to patients. Nothing in this paragraph prohibits an 303 anesthesiologist assistant from administering legend drugs or 304 controlled substances; intravenous drugs, fluids, or blood 305 products; or inhalation or other anesthetic agents to patients 306 which are ordered by the supervising anesthesiologist and 307 administered while under the direct supervision of the 308 supervising anesthesiologist. 309 (6) ANESTHESIOLOGIST ASSISTANT LICENSURE.— 310 (a) Any person desiring to be licensed as an 311 anesthesiologist assistant must apply to the department. The 312 department shall issue a license to any person certified by the 313 board to: 314 1. Be at least 18 years of age. 315 2. Have satisfactorily passed a proficiency examination 316 with a score established by the National Commission on 317 Certification of Anesthesiologist Assistants. 318 3. Be certified in advanced cardiac life support. 319 4. Have completed the application form and remitted an 320 application fee, not to exceed $1,000, as set by the boards. An 321 application must include: 322 a. A certificate of completion of an approved graduate 323 level program. 324 b. An acknowledgmentA sworn statementof any prior felony 325 convictions. 326 c. An acknowledgmentA sworn statementof any prior 327 discipline or denial of licensure or certification in any state. 328 d. Two letters of recommendation from anesthesiologists. 329 (b) A license must be renewed biennially. Each renewal must 330 include: 331 1. A renewal fee, not to exceed $1,000, as set by the 332 boards. 333 2. An acknowledgmentA sworn statementof no felony 334 convictions in the immediately preceding 2 years. 335 Section 3. This act shall take effect July 1, 2022.