LICENSURE OF ANESTHESIOLOGIST ASSISTANTS

House Bill 5507 as introduced

Sponsor:  Rep. Hank Vaupel

Committee:  Health Policy

Complete to 11-27-16

SUMMARY:

House Bill 5507 would amend the Public Health Code to describe the responsibilities of an anesthesiologist and to create a new, state-licensed "anesthesiologist assistant" (AA), who may practice anesthesiology under the supervision of an anesthesiologist.  The bill would take effect 90 days after enactment.

Fees for an anesthesiologist assistant

An anesthesiologist assistant would be required to pay a $20 application processing fee to apply for licensure, a $50 license fee per year of licensure, and a $25 educational limited license.  The educational limited license may be issued by the Board of Medicine for otherwise qualified individuals who have not taken the certifying examination, and would be valid for up to one year, as determined by the Board, or until the results of the certifying examination. 

Definitions

An anesthesiologist is a physician who has been trained in the specialty of anesthesiology by completing a residency in anesthesiology approved by the American Board of Anesthesiology or the American Osteopathic Board of Anesthesiology or by completing another residency in anesthesiology or other training program, which residency or program is approved by the board.

Practice as an anesthesiologist assistant means the practice of anesthesiology performed under the supervision of an anesthesiologist.

Immediately available, as it applies to engaging in practice as an anesthesiologist assistant, means that a medically directing anesthesiologist is in the physical proximity of an anesthesiologist assistant that allows the anesthesiologist to return and reestablish direct contact with the patient to meet the patient's medical needs and address any of the patient's urgent or emergent clinical problems.

Qualification for licensure

The Board of Medicine, in consultation with the Department of Licensing and Regulatory Affairs (LARA), would promulgate rules that specify the standards and qualifications for licensure as an anesthesiologist assistant, which would include at least all of the following:

·         Completion of a graduate level training program accredited by the Commission on Accreditation of Allied Health Education Programs or its successor agency and approved by LARA.  

·         Successful completion of a certifying examination for anesthesiologist assistants administered by the National Commission for Certification of Anesthesiologist Assistants or its successor agency and approved by LARA.

·         Successful completion of a course in advanced cardiac life-support techniques offered or approved by the American Heart Association, the American Red Cross, or a similar organization and approved by LARA.

In addition, the Board, in consultation with LARA, would promulgate rules to do all of the following:

·         Establish and, where appropriate, limit the duties and activities related to the practice of anesthesiology that may be performed by anesthesiologist assistants.

·         Require immediate availability of the supervising anesthesiologist at all times.

·         Require the supervising anesthesiologist to ensure that all activities, functions, services, and treatment measures performed by an anesthesiologist assistant are properly documented by the anesthesiologist assistant.

·         Require the anesthesiologist assistant to inform the supervising anesthesiologist of serious adverse events.

·         Establish an appropriate ratio of supervising anesthesiologists to anesthesiologist assistant, except in emergency cases.

Once these rules take effect, an individual may not engage in practice as an AA unless licensed or otherwise authorized.  Additionally, the bill would prohibit anyone without the requisite training from using the terms "anesthesiologist assistant" and "A.A."

            Continuing Education requirements

The Board would also prescribe continuing education requirements as a condition for renewal of licensure.  The AA would be required to submit proof of completion of these requirements every two years.

Anesthesiologist Assistant roster

After issuing a license, the Board must register the to an anesthesiologist assistant on an AA roster, which would include the AA's name and address and other Board-required information.

MCL 333.17001 and 333.17011

FISCAL IMPACT:

House Bill 5507 would establish fees for the licensing of Anesthesiologist Assistants, with a $20.00 license processing fee, a $50.00 yearly license fee, and a $25.00 fee for an educational limited license. The Department of Licensing and Regulatory Affairs (LARA) is likely to experience increased administrative costs that will result from rules promulgation for the field of anesthesiology assisting and the licensing of the profession. LARA and the board must promulgate rules to specify standards and qualifications for licensure as an anesthesiologist assistant, continuing education requirements, and rules regarding the activities of the anesthesiology assistant.  The bill would not likely have a significant fiscal impact on other units of state or local government.

                                                                                        Legislative Analyst:   Jenny McInerney

                                                                                                Fiscal Analyst:   Marcus Coffin

■ This analysis was prepared by nonpartisan House Fiscal Agency staff for use by House members in their deliberations, and does not constitute an official statement of legislative intent.