SS/SCS/HCS/HB 390 - This act regulates the licensing and registration of anesthesiologist assistants.

New definitions are provided relating to anesthesiologist assistants, including a definition of "supervision" (Section 334.400). An anesthesiologist assistant can assist the supervising anesthesiologist in developing and implementing an anesthesia care plan for a patient. Anesthesiologist assistants are prohibited from prescribing medications, administering any drugs or devices that are beyond the authority of the supervising anesthesiologist, and practicing without the supervision or the immediate availability of the supervising anesthesiologist. Anesthesiologist assistants must be clearly identified and addressed as such to prevent them from being mistaken as a physician. Faculty members of an anesthesiologist assistant program must be board-certified or board-eligible anesthesiologists. Faculty members cannot concurrently supervise more than two assistant students who are delivering anesthesia (Section 334.402).

An anesthesiologist assistant can apply for a license by filling out the appropriate application forms and paying the required application fee as promulgated by the board of healing arts. Upon approval of the application, the Board shall issue a license to be valid for two years (Section 334.404).

A temporary license may be granted upon the payment of a temporary license fee, the submission of all required documents, and the applicant meeting the necessary qualifications. The temporary license shall be valid until the results of the examination are announced (Section 334.406).

A licensed anesthesiologist assistant may apply to the Board to be placed on the inactive status list. An anesthesiologist assistant may return to active status by notifying the Board of the intention to resume the practice, paying the appropriate fees, and meeting all the licensure requirements of the Board (Section 334.408).

A licensed anesthesiologist assistant that wishes to retire must file with the Board an affidavit stating the date of retirement and any other facts necessary to verify retirement (Section 334.410).

Upon the payment of a fee and documentation of all locations of previous practice and licensure, the Board can issue a license to any licensed out-of-state applicant without examination or additional certification. The Board shall have the authority to negotiate reciprocal compacts with licensing boards of other states for the admission of licensed anesthesiologist assistants from Missouri (Section 334.412).

The Board shall issue a certificate of registration to any applicant that meets the qualifications for an anesthesiologist assistant and has paid the required fee. The Board shall have the authority to issue subpoenas and establish guidelines for anesthesiologist assistants. The Board may refuse to issue, suspend, or renew a certificate of registration or license or may file a complaint for any of the outlined causes in this section. Administrative hearing procedures will apply. Upon a finding by the administrative hearing commission, the Board may censure, place on probation for up to ten years, suspend for up to seven years, or revoke a person's certificate of registration or license. Any person violating any of the provisions of Section 334.400 to Section 334.430 is guilty of a Class A misdemeanor (Section 334.414).

Every licensed anesthesiologist assistant must renew their certificate of registration on or before the renewal date. A blank application form for registration will be mailed to every licensee at their last known office or residence address. The failure to receive the application form does not mitigate the duty to register or exempt the licensee from penalties (Section 334.416).

Section 334.418 prohibits any person from practicing as an anesthesiologist assistant without a current, valid certificate of registration, with exceptions.

In order for a certificate of registration to be renewed, the anesthesiologist assistant must meet the Board's minimum requirements for continuing education, which shall include but not be limited to, successful completion of the examination for continued demonstration of qualifications once every six years. (Section 334.420).

All fees will be collected by the Division of Professional Registration and deposited in the Treasury to the credit of the Board of Registration for the Healing Arts Fund (Section 334.422).

An anesthesiologist assistant can only practice under the direct supervision of an anesthesiologist who is physically present or immediately available. A supervising anesthesiologist may supervise up to four assistants consistent with federal regulations for reimbursement for anesthesia services. The supervising anesthesiologist shall adopt a written practice protocol that delineates the services provided and the manner of supervision. The Board may inspect or audit such written practice protocols (Section 334.424).

Hospitals will have full authority to limit the functions and activities performed by an anesthesiologist assistant (Section 334.426). No person shall portray themselves to the public as a "licensed anesthesiologist assistant", unless they are licensed pursuant to 334.400 to 334.430. Any person found guilty of violating this section will be guilty of an infraction with a maximum fine of $200 (Section 334.428).

The Advisory Commission for Anesthesiologist Assistants is created and will guide, advise, and make recommendations to the Board. The Commission, comprised of five members, will take effect no later than July 1, 2005. Members may receive up to $70 per diem. Implementation of the licensing and other statutory requirements shall not take place until money has been appropriated for such purposes and initial rules have become effective (Section 334.430).

Certified registered nurse anesthetists are not required to enter into collaborative practice arrangements with physicians if such nurse is under the supervision of an anesthesiologist or other physician, dentist or podiatrist who is immediately available if needed (Section 334.104).

This act is similar to SCS/SB 300 (2003).
JIM ERTLE