CS/HB 1101 2022 CODING: Words stricken are deletions; words underlined are additions. hb1101-01-c1 Page 1 of 9 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S A bill to be entitled 1 An act relating to anesthesiologist assistants; 2 amending ss. 458.3475 and 459.023, F.S.; revising the 3 definitions of the terms "anesthesiologist" and 4 "direct supervision"; revising requirements for the 5 written protocol between an anesthesiologist assistant 6 and a supervising anesthesiologist; revising 7 provisions relating to duties and functions 8 anesthesiologist assistants may perform; revising 9 licensure requirements for anesthesiologist 10 assistants; providing an effective date. 11 12 Be It Enacted by the Legislature of the State of Florida: 13 14 Section 1. Paragraphs (a) and (g) of subsection (1), 15 paragraph (a) subsection (3), and paragraphs (a) and (b) of 16 subsection (6) of section 458.3475, Florida Statutes, are 17 amended to read: 18 458.3475 Anesthesiologist assistants. — 19 (1) DEFINITIONS.—As used in this section, the term: 20 (a) "Anesthesiologist" means an allopathic or osteopathic 21 physician who holds an act ive, unrestricted license; who has 22 successfully completed an anesthesiology training program 23 approved by the Accreditation Council on Graduate Medical 24 Education or its equivalent; and who is certified by the 25 CS/HB 1101 2022 CODING: Words stricken are deletions; words underlined are additions. hb1101-01-c1 Page 2 of 9 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S American Board of Anesthesiology, is eligible to take that 26 board's examination, or is certified by the Board of 27 Certification in Anesthesiology affiliated with the American 28 Association of Physician Specialists. 29 (g) "Direct supervision" means the physical presence of a 30 supervising anesthesiologist on t he premises such that the 31 supervising anesthesiologist is immediately available as needed 32 onsite, personal supervision by an anesthesiologist who is 33 present in the office when the procedure is being performed in 34 that office, or is present in the surgical o r obstetrical suite 35 when the procedure is being performed in that surgical or 36 obstetrical suite and who is in all instances immediately 37 available to provide assistance and direction to the 38 anesthesiologist assistant while anesthesia services are being 39 performed. 40 (3) PERFORMANCE OF ANESTHESIOLOGIST ASSISTANTS. — 41 (a) An anesthesiologist assistant may assist an 42 anesthesiologist in developing and implementing an anesthesia 43 care plan for a patient , may personally administer the 44 prescribed anesthetic under the direct supervision of an 45 anesthesiologist, and may perform tasks and services as 46 specified in a written protocol approved by the supervising 47 anesthesiologist which may include any of the following 48 functions. In providing assistance to an anesthesiologist, an 49 anesthesiologist assistant may perform duties established by 50 CS/HB 1101 2022 CODING: Words stricken are deletions; words underlined are additions. hb1101-01-c1 Page 3 of 9 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S rule by the board in any of the following functions that are 51 included in the anesthesiologist assistant's protocol while 52 under the direct supervision of an anesthesiologist : 53 1. Obtain a comprehensive patient history and present the 54 history to the supervising anesthesiologist. 55 2. Pretest and calibrate anesthesia delivery systems and 56 monitor, obtain, and interpret information from the systems and 57 monitors. 58 3. Assist the supervising anesthe siologist with the 59 implementation of medically accepted monitoring techniques. 60 4. Establish basic and advanced airway interventions, 61 including intubation of the trachea and performing ventilatory 62 support. 63 5. Administer intermittent vasoactive drugs and start and 64 adjust vasoactive infusions. 65 6. Administer anesthetic drugs, adjuvant drugs, and 66 accessory drugs. 67 7. Assist the supervising anesthesiologist with the 68 performance of epidural anesthetic procedures and spinal 69 anesthetic procedures. 70 8. Administer blood, blood products, and supportive 71 fluids. 72 9. Support life functions during anesthesia health care, 73 including induction and intubation procedures, the use of 74 appropriate mechanical supportive devices, and the management of 75 CS/HB 1101 2022 CODING: Words stricken are deletions; words underlined are additions. hb1101-01-c1 Page 4 of 9 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S fluid, electrolyte, and blood component balances. 76 10. Recognize and take appropriate corrective action for 77 abnormal patient responses to anesthesia, adjunctive medication, 78 or other forms of therapy. 79 11. Participate in management of the patient while in the 80 postanesthesia recovery area, including the administration of 81 any supporting fluids or drugs. 82 12. Place special peripheral and central venous and 83 arterial lines for blood sampling and monitoring as appropriate. 84 (6) ANESTHESIOLOGIST ASSISTANT LICENSURE. — 85 (a) Any person desiring to be licensed as an 86 anesthesiologist assistant must apply to the department. The 87 department shall issue a license to any person certified by the 88 board to: 89 1. Be at least 18 years of age. 90 2. Have satisfactorily passed a proficiency examination 91 with a score established by the National Commission on 92 Certification of Anesthesiologist Assistants. 93 3. Be certified in advanced cardiac life support. 94 4. Have completed the application form and remitted an 95 application fee, not to exceed $1, 000, as set by the boards. An 96 application must include: 97 a. A certificate of completion of an approved graduate 98 level program. 99 b. An acknowledgment A sworn statement of any prior felony 100 CS/HB 1101 2022 CODING: Words stricken are deletions; words underlined are additions. hb1101-01-c1 Page 5 of 9 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S convictions. 101 c. An acknowledgment A sworn statement of any prior 102 discipline or denial of licensure or certification in any state. 103 d. Two letters of recommendation from anesthesiologists. 104 (b) A license must be renewed biennially. Each renewal 105 must include: 106 1. A renewal fee, not to exceed $1,000, as set by the 107 boards. 108 2. An acknowledgment A sworn statement of no felony 109 convictions in the immediately preceding 2 years. 110 Section 2. Paragraphs (a) and (g) of subsection (1), 111 paragraph (a) of subsection (3), and paragraphs (a) and (b) of 112 subsection (6) of section 459 .023, Florida Statutes, are amended 113 to read: 114 459.023 Anesthesiologist assistants. — 115 (1) DEFINITIONS.—As used in this section, the term: 116 (a) "Anesthesiologist" means an osteopathic or allopathic 117 physician who holds an active, unrestricted license; who has 118 successfully completed an anesthesiology training program 119 approved by the Accreditation Council on Graduate Medical 120 Education, or its equivalent, or the American Osteopathic 121 Association; and who is certified by the American Osteopathic 122 Board of Anesthesiology or is eligible to take that board's 123 examination, is certified by the American Board of 124 Anesthesiology or is eligible to take that board's examination, 125 CS/HB 1101 2022 CODING: Words stricken are deletions; words underlined are additions. hb1101-01-c1 Page 6 of 9 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S or is certified by the Board of Certification in Anesthesiology 126 affiliated with the American Asso ciation of Physician 127 Specialists. 128 (g) "Direct supervision" means the physical presence of a 129 supervising anesthesiologist on the premises such that the 130 supervising anesthesiologist is immediately available as needed 131 onsite, personal supervision by an anes thesiologist who is 132 present in the office when the procedure is being performed in 133 that office, or is present in the surgical or obstetrical suite 134 when the procedure is being performed in that surgical or 135 obstetrical suite and who is in all instances immed iately 136 available to provide assistance and direction to the 137 anesthesiologist assistant while anesthesia services are being 138 performed. 139 (3) PERFORMANCE OF ANESTHESIOLOGIST ASSISTANTS. — 140 (a) An anesthesiologist assistant may assist an 141 anesthesiologist in d eveloping and implementing an anesthesia 142 care plan for a patient , may personally administer the 143 prescribed anesthetic under the direct supervision of an 144 anesthesiologist, and may perform tasks and services as 145 specified in a written protocol approved by the supervising 146 anesthesiologist which may include any of the following 147 functions. In providing assistance to an anesthesiologist, an 148 anesthesiologist assistant may perform duties established by 149 rule by the board in any of the following functions that are 150 CS/HB 1101 2022 CODING: Words stricken are deletions; words underlined are additions. hb1101-01-c1 Page 7 of 9 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S included in the anesthesiologist assistant's protocol while 151 under the direct supervision of an anesthesiologist : 152 1. Obtain a comprehensive patient history and present the 153 history to the supervising anesthesiologist. 154 2. Pretest and calibrate anesthesia del ivery systems and 155 monitor, obtain, and interpret information from the systems and 156 monitors. 157 3. Assist the supervising anesthesiologist with the 158 implementation of medically accepted monitoring techniques. 159 4. Establish basic and advanced airway interventions, 160 including intubation of the trachea and performing ventilatory 161 support. 162 5. Administer intermittent vasoactive drugs and start and 163 adjust vasoactive infusions. 164 6. Administer anesthetic drugs, adjuva nt drugs, and 165 accessory drugs. 166 7. Assist the supervising anesthesiologist with the 167 performance of epidural anesthetic procedures and spinal 168 anesthetic procedures. 169 8. Administer blood, blood products, and supportive 170 fluids. 171 9. Support life functions d uring anesthesia health care, 172 including induction and intubation procedures, the use of 173 appropriate mechanical supportive devices, and the management of 174 fluid, electrolyte, and blood component balances. 175 CS/HB 1101 2022 CODING: Words stricken are deletions; words underlined are additions. hb1101-01-c1 Page 8 of 9 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S 10. Recognize and take appropriate corrective actio n for 176 abnormal patient responses to anesthesia, adjunctive medication, 177 or other forms of therapy. 178 11. Participate in management of the patient while in the 179 postanesthesia recovery area, including the administration of 180 any supporting fluids or drugs. 181 12. Place special peripheral and central venous and 182 arterial lines for blood sampling and monitoring as appropriate. 183 (6) ANESTHESIOLOGIST ASSISTANT LICENSURE. — 184 (a) Any person desiring to be licensed as an 185 anesthesiologist assistant must apply to the depa rtment. The 186 department shall issue a license to any person certified by the 187 board to: 188 1. Be at least 18 years of age. 189 2. Have satisfactorily passed a proficiency examination 190 with a score established by the National Commission on 191 Certification of Anesth esiologist Assistants. 192 3. Be certified in advanced cardiac life support. 193 4. Have completed the application form and remitted an 194 application fee, not to exceed $1,000, as set by the boards. An 195 application must include: 196 a. A certificate of completion o f an approved graduate 197 level program. 198 b. An acknowledgment A sworn statement of any prior felony 199 convictions. 200 CS/HB 1101 2022 CODING: Words stricken are deletions; words underlined are additions. hb1101-01-c1 Page 9 of 9 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S c. An acknowledgment A sworn statement of any prior 201 discipline or denial of licensure or certification in any state. 202 d. Two letters of recom mendation from anesthesiologists. 203 (b) A license must be renewed biennially. Each renewal 204 must include: 205 1. A renewal fee, not to exceed $1,000, as set by the 206 boards. 207 2. An acknowledgment A sworn statement of no felony 208 convictions in the immediately pr eceding 2 years. 209 Section 3. This act shall take effect July 1, 2022. 210