HB 931 — An Act amending the act of May 22, 1951 (P.L.317, No.69), known as The Professional Nursing Law, further providing for definitions and for registered nurse, clinical nurse specialist, use of title and abbreviation and providing for certified registered nurse anesthetist and qualifications and for scope of practice for certified registered nurse anesthetists.

PRIOR PRINTER'S NO.

926 THEPRINTER'S GENERALNO. ASSEMBLY OF PENNSYLVANIA HOUSE BILL Session of No.

9311714 2021THE INTRODUCEDGENERAL BYASSEMBLY TOOHIL,OF SAYLOR,PENNSYLVANIA STEPHENS,HOUSE FRITZ,BILL LEWISSession DELROSSO, SANKEY, SIMS, HARKINS, JONES, FLYNN, BERNSTINE, ZABEL AND, LONGIETTI, MARCH 16, 2021 REFERRED TO COMMITTEE ON PROFESSIONAL LICENSURE, MARCH 16, 2021 AN ACT Amending the act of MayNo. 22, 1951 (P.L.317, No.69), entitled "An act relating to the practice of professional nursing;

providing931 for2021 theINTRODUCED licensingBY ofTOOHIL, nursesSAYLOR, andSTEPHENS, forFRITZ, theLEWIS revocationDELROSSO, andT. suspension of such licenses, subject to appeal, and for their reinstatement;

DAVIS, HILL-EVANS, NEILSON, CIRESI, R.

BROWN, SANKEY, SIMS, HARKINS, JONES, FLYNN, BERNSTINE, ZABEL, LONGIETTI AND E.

NELSON, MARCH 16, 2021 AS REPORTED FROM COMMITTEE ON PROFESSIONAL LICENSURE, HOUSE OF REPRESENTATIVES, AS AMENDED, JUNE 8, 2021 AN ACT Amending the act of May 22, 1951 (P.L.317, No.69), entitled "An providing for the licensing of nurses and for the revocation and suspension of such licenses, subject to appeal, and for their reinstatement;

prescribing penalties and repealing certain laws," further providing for definitions and for registered nurse, clinical nurse specialist, use of title and abbreviation and providing for advanced practice registered nurse-certified registered nurse <-- anesthetist.

CERTIFIED REGISTERED NURSE ANESTHETIST AND <-- QUALIFICATIONS AND FOR SCOPE OF PRACTICE FOR CERTIFIED REGISTERED NURSE ANESTHETISTS.

Section 2 of the act of May 22, 1951 (P.L.317, No.69), known as The Professional Nursing Law, is amended by adding a clause CLAUSES to read:

<-- Section 2.

* * * (16) "Advanced practice registered nurse-certified <-- registered nurse anesthetist" "CERTIFIED REGISTERED NURSE <-- ANESTHESIST" means a registered nurse licensed in this Commonwealth who is certified by the State Board of Nursing as an advanced practice registered nurse - certified registered nurse.<-- nurse CERTIFIED REGISTERED NURSE ANESTHESIST.

<-- (17) "OVERALL DIRECTION" MEANS OVERSIGHT OF ANESTHESIA <-- SERVICES AND MEDICAL MANAGEMENT OF PATIENT CARE BY A QUALIFIED INDIVIDUAL WHO IS PRESENT AND AVAILABLE ON-SITE, BUT NOT NECESSARILY PRESENT IN THE SAME PROCEDURE ROOM AS A CERTIFIED REGISTERED NURSE ANESTHETIST PERFORMING ANESTHESIA SERVICES FOR THE DURATION OF THE SERVICES PROVIDED.

[Registered Nurse, Clinical Nurse Specialist,] Use of Title and Abbreviation ["R.N." or "C.N.S."] "R.N.," "C.N.S.," "C.N.S." OR "C.R.N.A." or "A.P.R.N.";

<-- Fraud.--(a) Any person who holds a license to practice professional nursing in this Commonwealth, or who is maintained on inactive status in accordance with section 11 of this act, shall have the right to use the titles "nurse" and "registered nurse" and the abbreviation "R.N." No other person shall engage in the practice of professional nursing or use the titles "nurse" or "registered nurse" or the abbreviation "R.N." to indicate that the person using the same is a registered nurse, except that the title "nurse" also may be used by a person licensed under the provisions of the act of March 2, 1956 (1955 P.L.1211, No.376), known as the "Practical Nurse Law." No person shall sell or fraudulently obtain or fraudulently furnish any nursing diploma, license, record, or registration or aid or abet therein.

20210HB0931PN1714 - 2 - (b) An individual who holds a license to practice professional nursing in this Commonwealth who meets the requirements under sections 6.2 and 8.5 of this act to be a clinical nurse specialist shall have the right to use the title "clinical nurse specialist" and the abbreviation "C.N.S." No other person shall have that right.

(b.1) An individual who holds a license to practice professional nursing in this Commonwealth who meets the requirements under section 8.8 of this act to be an advanced 20210HB0931PN0926<-- - 2 - practice registered nurse-certified A CERTIFIED registered nurse <-- anesthetist shall have the right to use the title "advanced <-- practice registered nurse-certified registered nurse anesthetist," "certified registered nurse anesthetist" and the abbreviations ABBREVIATION "C.R.N.A." or "A.P.R.N.".

No other <-- person shall have that right.

The act is amended by adding a section SECTIONS <-- to read:

Advanced Practice Registered Nurse-Certified <-- CERTIFIED Registered Nurse Anesthetist;

Qualifications.--(a) <-- The Board may certify a licensed registered nurse as an advanced <-- practice registered nurse-certified A CERTIFIED registered nurse <-- anesthetist if the REGISTERED nurse satisfies the requirements <-- established by this section.

Certification of an advanced <-- practice registered nurse-certified A CERTIFIED registered nurse <-- 20210HB0931PN1714 - 3 - anesthetist by the Board shall expire on the same date as the license of that REGISTERED nurse expires.

Beginning on the <-- effective date of this section, a nurse shall not qualify for initial certification by the Board unless the nurse holds a master's degree, doctoral degree or post-master's certificate from an educational program in nurse anesthesia that has been approved by the Board and that prepares graduates to practice as an advanced practice registered nurse-certified registered nurse anesthetist and:

(1)(B) holdsBEGINNING currentON nationalTHE certificationEFFECTIVE asDATE aOF certifiedTHIS registeredSECTION, nurseA anesthetist<-- fromREGISTERED aNURSE Board-recognizedSHALL nationalNOT certificationQUALIFY organizationFOR thatINITIAL requiresCERTIFICATION passingBY aTHE nationalBOARD 20210HB0931PN0926UNLESS -THE 3REGISTERED -NURSE certifyingHOLDS examinationA inMASTER'S nurseDEGREE, anesthesia;DOCTORAL DEGREE OR POST-MASTER'S CERTIFICATE FROM AN EDUCATIONAL PROGRAM IN NURSE ANESTHESIA THAT HAS BEEN APPROVED BY THE BOARD AND THAT PREPARES GRADUATES TO PRACTICE AS A CERTIFIED REGISTERED NURSE ANESTHETIST AND:

and(1) (2)holds meetscurrent allnational othercertification Boardas requirementsa tocertified practiceregistered asnurse ananesthetist advancedfrom practicea registeredBoard-recognized nurse.national certification organization that requires passing a national certifying examination in nurse anesthesia;

(b)and A<-- registered(2) nursemeets who(2) doesSUBMITS notAN haveAPPLICATION aAND graduateTHE degreeREQUIRED requiredFEE under<-- subsectionAS (a)ESTABLISHED shallBY beTHE qualifiedBOARD; for certification as an advanced practice registered nurse-certified registered nurse anesthetist if that nurse:

(1)AND meets(3) theCOMPLIES educationalWITH requirementsall forother certifiedBoard registeredrequirements nurseto anesthetistspractice thatas werean inadvanced effectpractice inregistered this Commonwealth at the time the nurse completedA aCERTIFIED nurseREGISTERED anesthesia<-- educationalNURSE program;ANESTHETIST.

and(b) (2)(C) submitsA evidenceregistered ofnurse recertificationwho asdoes not have a certifiedgraduate registered<-- nursedegree fromrequired aunder Board-recognizedsubsection national(a) (B) shall be qualified for <-- certification organizationas thatan requiresadvanced passingpractice aregistered nationalnurse-certified certifying<-- examinationA inCERTIFIED registered nurse anesthesia.anesthetist if that REGISTERED <-- nurse:

(c)20210HB0931PN1714 As- a4 condition- of(1) biennialmeets certificatethe renewaleducational byrequirements thefor Board,certified anregistered advancednurse practiceanesthetists registeredthat nurse-certifiedwere registeredin effect in this Commonwealth at the time the REGISTERED nurse anesthetistcompleted must:a nurse <-- anesthesia educational program;

and <-- (2) submits evidence of recertification as a certified registered nurse ANESTHETIST from a Board-recognized national <-- certification organization that requires passing a national certifying examination in nurse anesthesia.;

<-- (3) SUBMITS AN APPLICATION AND THE REQUIRED FEE AS ESTABLISHED BY THE BOARD;

AND (4) COMPLIES WITH ALL OTHER BOARD REQUIREMENTS TO PRACTICE AS A CERTIFIED REGISTERED NURSE ANESTHETIST.

(c) As a condition of biennial certificate renewal by the <-- Board, an advanced practice registered nurse-certified registered nurse anesthetist must:

(d) For certification under this section, a licensed registered nurse shall file a Board-prepared application with 20210HB0931PN0926 - 4 - the Board and pay a fee as established by the Board by regulation.

(e) (D) The Board may issue a certification as an advanced <-- 20210HB0931PN1714 - 5 - practice registered nurse-certified A CERTIFIED registered nurse <-- anesthetist to a licensed REGISTERED nurse who has completed a <-- course of study considered by the Board to be equivalent to a course of study required in this Commonwealth under section 6.2 of this act and this section at the time the course was completed, or who is licensed or certified by another state, territory or possession of the United States or a foreign country as deemed equivalent to Pennsylvania's certification requirements, and who has met all the requirements, including character, under this act.

(f) An advanced practice registered nurse-certified registered(E) nurseAS anesthetist<-- practicingA inCONDITION thisOF CommonwealthBIENNIAL shallCERTIFICATE maintainRENEWAL aBY levelTHE ofBOARD, professionalA liabilityCERTIFIED coverageREGISTERED asNURSE requiredANESTHETIST forMUST: a nonparticipating health care provider under the act of March 20, 2002 (P.L.154, No.13), known as the "Medical Care Availability and Reduction of Error (Mcare) Act," and shall not be eligible to participate in the Medical Care Availability and Reduction of Error (Mcare) Fund.

(1) VERIFY THAT THE NURSE HOLDS CURRENT NATIONAL RECERTIFICATION FROM A BOARD-RECOGNIZED NATIONAL CERTIFICATION ORGANIZATION THAT REQUIRES PASSING A NATIONAL CERTIFYING EXAMINATION IN NURSE ANESTHESIA.

(2) SUBMIT A RENEWAL APPLICATION TO THE BOARD AND THE REQUIRED FEE AS ESTABLISHED BY THE BOARD.

(3) IN THE TWO YEARS PRIOR TO THE CERTIFICATION RENEWAL, COMPLETE AT LEAST THIRTY (30) HOURS OF CONTINUING EDUCATION APPROVED BY THE BOARD, AS REQUIRED UNDER SECTION 12.1 OF THIS ACT.

(4) COMPLY WITH ALL OTHER REQUIREMENTS OF THE BOARD.