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Minutes for SB223 - Committee on Public Health and Welfare

Short Title

Providing for the licensure of anesthesiologist assistants.

Minutes Content for Mon, Mar 18, 2019

Chairperson Suellentrop opened the hearing on SB223.

Scott Abbott, Staff Revisor, gave an overview of the bill. He answered questions from committee members.

Dr. Jeremy Cook testified as a proponent of the passage of SB223 which will authorize and license a new health care provider in Kansas to assist Physician Anesthesiologist. The provider would be known as a certified Anesthesiologist Assistant (CAA). (Attachment 1)

Dr. Kathy Perryman spoke in support of SB223 stating that the passage of SB223 would enable anesthesiologists to include another highly-trained professional to the anesthesia care team in Kansas. (Attachment 2)

Dr. Greg George stated that the purpose of his testimony was to make aware of the extreme and immediate need for additional mid-level anesthesia providers in the Wichita area. The shortage of mid-level providers affects his practice in a number of ways; 1) Aging population dramatically increases the demand for anesthesia services, 2) the shortage of CRNA's results in increased turnover and 3) providers, including Physician Anesthesiologists and CRNA's working extra hours, which increases the risks associated with fatigue and increases the risk of burnout. (Attachment 3)

Ty Townsend, in his proponent testimony, stated that the passage of SB223 would allow for an inclusive anesthesia care team where under the supervision of a Physician Anesthesiologist - Certified Anesthesiologist Assistants and CRNAs would work side-by-side, interchangeably, providing proven safe anesthesia care to the people of Kansas. (Attachment 4)

Brad Smoot testified as a proponent of SB223 stating that Kansas anesthesiologists and his group of AA's have been seeking licensure of AA's in Kansas for three years.  AA's can only work under the supervision of a licensed Physician Anesthesiologist. He believes that there is a significant need for AA services in Kansas, that Practicing Anesthesiologists, hospitals and medical facilities will benefit from AA licensing, that CRNA's will not be harmed and that Kansas patients will be well served by the skills, training and dedication of Anesthesiologists Assistants. (Attachment 5)

Rachelle Colombo supports SB223 and stated that she believes SB223 is sound policy that is consistent with the mission of the Kansas Medical Society to ensure access to high quality care delivered by a physician-lead team for Kansas patients.SB223 would allow anesthesiologists to grow their teams to include assistants specifically trained in anesthesiology that work under direct supervision. (Attachment 6)

Proponent written only testimony was submitted by:

Dr. Jay Nachtigal, Physician, Anesthesiologists KU Health System and Hospital (Attachment 7)

Jessica Sweeney, MD - Physician Anesthesiologist and Assistant Professor, KU Health System (Attachment 8)

Michael McCartney, MD - Physician Anesthesiologist, Leawood, KS (Attachment 9)

Timothy Walsh, MD - Physician Anesthesiologist (Attachment 10)

Mark Simpsen, MD - Physician Anesthesiologist (Attachment 11)

Jeremy Betts, American Academy of Anesthesiologist Assistants, Atlanta, GA  (Attachment 12)

Martha Cooper gave neutral testimony explaining the credentialing process for SB223. (Attachment 13)

Written only neutral testimony was submitted by:

Kathleen Selzler Lippert, JD, Executive Director, Kansas State Board of Healing Arts (Attachment 14)

Kyle Nevills testified as an opponent of SB223 stating that the introduction of AAs into the state will impact the training of student nurse anesthetists. Additionally, when using AAs the billing results in paying for more than one anesthesia provider, as an AA must require the presence of an Anesthesiologist. Another area of concern is the lack of prior healthcare experience that AAs have prior to attending AA school. There is no requirement that they have to have had prior experience caring for patients. CRNAs, on the other hand, must be a Registered Nurse with a bachelor's degree and have completed courses in chemistry, microbiology, human anatomy, physiology and statistics. They must be certified in Advanced Cardiac Lifesaving and Pediatric Advanced Lifesaving.  (Attachment 15)

Donna Nyght stated in her opponent testimony that if AAs are licensed, it would have a devasting effect on the academic programs for CRNAs in Kansas, and the result would be an inability to provide enough CRNAs for the state of Kansas.Since approximately 85% of the facilities in the state utilize CRNA-only practices (where AAs absolutely cannot work), it makes no sense to harm the nurse anesthesia programs by allowing Anesthesiologists to hire AA's. (Attachment 16)

Bob Wright testified in opposition of SB223 stating that in his opinion as a hospital CEO, that a supervised anesthesiologist assistant model is not financially feasible for the vast majority of hospitals in Kansas. (Attachment 17)

Opponent written only testimony was submitted by:

Jerry Campbell, CRNA (Attachment 18)

Benjamin Anderson, CEO, Kearny County Hospital (Attachment 19)

Jeff Glasgow, Past President, Kansas Association of Nurse Anesthetists (Attachment 20)

Larry Finley, CRNA (Attachment 21)

Juan Quintana, former President, American Association of Nurse Anesthetists (Attachment 22)

Sharon Niemann, Program Director, Newman University Nurse Anesthesia Program (Attachment 23)

Questions were posed by committee members.

Senator Suellentrop closed the hearing on SB223.