House Bill 224 was familiar to the OSMA as it was reintroduced from previous legislative sessions. Over the period of several years, the OSMA Advocacy team, in cooperation with the Ohio Society of Anesthesiologists (OSA), has been involved in legislative proceedings surrounding this issue. As of December 2019, the latest discussion on a bill regarding CRNA scope of practice seems to have finally reached a conclusion, which the OSMA thankfully believes is suitable and maintains necessary patient protections in anesthesia care.
HB 224 (and its several predecessors) initially proposed to modify the scope of practice of CRNAs by granting them undefined hospital-based prescriptive authority. The physician community expressed a number of serious concerns with the proposal from the start, and the OSMA has been working with the sponsor and proponents for many months to try and come to an understanding.
Fortunately, those efforts have resulted in a solution that protects patient safety and sensibly fits into the care model utilized by anesthesia care teams. The newest version of this legislation, upon which both the OSMA and OSA have taken a position of neutral, maintains the current team-based care model and supervisory relationship between CRNAs and physicians.
The substitute bill gives CRNAs limited authority to select, order and administer drugs to treat side effects associated with the administration of anesthesia for a patient, but only in the immediate post-operative period pursuant to a hospital or facility protocol.
Importantly, this change is permissive, meaning that the supervising physician, podiatrist, or dentist may choose to be the one to select and order the drugs for the patient (rather than the CRNA) as is done under current law, if they determine that it is in the patient’s best interest to do so.
The OSMA is satisfied with the result of our negotiations on this issue and believes that the provisions in the latest substitute bill include appropriate safety guardrails which alleviate previous patient safety concerns and do not dismantle the physician-led, team-based model of care. The physician remains at the head of the care team, overseeing critical patient treatment decisions.