STATUTORY/REGULATORY NURSE ANESTHETIST RECOGNITION



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Alabama NPA and SBON R&R CRNAs are a type of advanced practice nurse. Advanced practice nurses are "certified by the Board of Nursing to engage in the practice of advanced practice nursing." [Alabama Nurse Practice Act, sec. 34-21-81(3)] "The nurse anesthetist... is licensed by the Board of Nursing..." [Alabama Nurse Practice Act, sec. 34-21-81(4)(c)] "The Board of Nursing may grant approval for advanced practice nursing as certified registered nurse anesthetists to applicants who meet the requirements of [Board of Nursing rules]." [Alabama Board of Nursing Administrative Code, sec. 610-X-9-.03(1)] Alaska NPA and SBON R&R The SBON R&R sets forth the requirements a certified registered nurse anesthetist needs for initial authorization. [Professional Regulations, ch. 44, art. 5, sec. 12 AAC 44.500] Arizona NPA and SBON R&R The Board of Nursing will certify a registered nurse as a certified registered nurse anesthetist if the registered nurse meets the requirements set forth in the statute. [Arizona Revised Statutes sec. 32-1634.03] Arkansas NPA and SBON R&R CRNAs are a type of advanced practice registered nurse. A license to practice as an advanced practice registered nurse may be issued [b]y application [or] [b]y endorsement. [Nurse Practice Act of the State of Arkansas, sec. 17-87-302(b)] California NPA CRNAs are a type of "advanced practice registered nurse." The board shall issue a certificate to practice nurse anesthesia to any person who qualifies under this article and is licensed pursuant

Page 2 to the provisions of this chapter. [California Nursing Practice Act, ch. 6, art. 7, sec. 2830] Colorado NPA and SBON R&R CRNAs are a type of advanced practice nurse. The board shall establish the advanced practice registry and shall require that a nurse applying for registration identify such nurse s area of specialty. [Colorado Nurse Practice Act, sec. 12-38- 111.5(3)] Connecticut NPA and SBON R&R CRNAs are a type of advanced practice registered nurse. The department of public health may issue an advanced practice registered nurse license to a registered nurse who holds and maintains current certification as a nurse anesthetist from the AANA and who meets additional educational requirements. [General Statutes of Connecticut, ch. 378, sec. 20-94(a)] Delaware NPA and SBON R&R CRNAs are a type of advanced practice nurse. District of Columbia NPA and SBON R&R Advanced practice nurses may be issued a license in their specific area of specialization. [Delaware Board of Nursing Rules and Regulations, sec. 8.9.4] CRNAs are a type of advanced practice registered nurse. Only a person currently licensed as a registered nurse under Chapter 54 of this title shall be eligible to apply for a certificate to practice nurse-anesthesia under this chapter." [DCMR, Title 17, ch. 57, sec. 5701.1] Florida NPA and SBON R&R CRNAs are a type of advanced registered nurse practitioner. When the Board finds that an applicant has complied with the

requirements it shall certify the applicant to the [Florida] Department [of Health] which shall issue the applicant an Advanced Registered Nurse Practitioner certificate in the specialty category which is consistent with the applicant s educational preparation or specialty designation. [Florida SBON R&R, sec. 64B9-4.002(3)] Georgia NPA and SBON R&R CRNAs are a type of advanced practice registered nurse. In order to receive authorization to practice as a CRNA in Georgia, a person must meet certain criteria established by Georgia s SBON R&R [Rules and Regulations of the Georgia Board of Nursing, sec. 410-12-.04(3)] Hawaii NPA and SBON R&R CRNAs are a type of advanced practice registered nurse. Advanced practice registered nurses are granted a license by the Hawaii board of nursing if they meet certain qualifications. [Hawaii Revised Statutes, ch. 457, sec. 457-8.5] Idaho NPA and SBON R&R CRNAs are a type of advanced practice registered nurse. In order to qualify for a license to practice advanced practice registered nursing in Idaho, a person must meet certain criteria established by Idaho s NPA. [Idaho Nursing Practice Act, sec. 54-1409] Illinois NPA and SBON R&R CRNAs are a type of advanced practice nurse. A person shall be qualified for licensure as an advanced practice nurse if that person meets the requirements set forth by the Illinois NPA. [Illinois Nurse Practice Act, 225 ILCS 65/65-5] Indiana NPA CRNAs are a type of advanced practice nurse. Page 3

" Advanced practice nurse means: (1) a nurse practitioner; (2) a certified nurse midwife; or (3) a clinical nurse specialist; or (4) a certified registered nurse anesthetist; who is a registered nurse qualified to practice nursing in a specialty role based upon the additional knowledge and skill gained through a formal organized program of study and clinical experience. [Indiana Code sec. 25-23-1-1(b)] Iowa NPA and SBON R&R CRNAs are a type of advanced registered nurse practitioner. NEW SUBSECTION. 01. "Advanced registered nurse practitioner" means a person who is currently licensed as a registered nurse under chapter 152 or 152E who is licensed by the board of nursing as an advanced registered nurse practitioner. [Iowa Code, sec. 152.1(.01) Kansas NPA and SBON R&R CRNAs are a type of advanced practice registered nurse. Upon application to the board by any licensed professional nurse in this state and upon satisfaction of the standards and requirements established under this act the board shall grant an authorization to the applicant to perform the duties of a registered nurse anesthetist and be licensed as an advanced practice registered nurse. [Kansas Stat. Ann., sec. 65-1154] Kentucky NPA and SBON R&R CRNAs are a type of advanced practice registered nurse. An applicant for licensure to practice as an advanced practice registered nurse shall file with the board a written application for licensure. [Kentucky Nursing Practice Act, sec. KRS 314.042(1)] Page 4

Louisiana NPA and SBON R&R CRNAs are a type of advanced practice registered nurse. Page 5 Advanced practice registered nurses must meet certain requirements in order to obtain a license to practice in Louisiana. [Louisiana Revised Statutes, sec. 920] Maine NPA and SBON R&R CRNAs are a type of advanced practice registered nurse. Advanced practice registered nurse means an individual who is currently licensed to practice advanced practice registered nursing [Maine Statutes, Title 32, ch. 31, subch. 1, sec. 2102 (5- A)] Maryland NPA and SBON R&R CRNAs are a type of "advanced practice nurse." An applicant for certification as a nurse anesthetist shall [lists requirements]. [Code of Maryland Regulations, Title 10, subtitle 27, ch. 06.02] Massachusetts SBON R&R CRNAs are a type of nurse authorized to practice in the expanded role. When the Board [of Registration in Nursing] determines that an applicant for authorization meets the qualifications set forth the Board will endorse the applicant s license as a registered nurse with a designation authorizing the applicant to practice in an expanded role in the appropriate area of practice. [Code of Massachusetts Regulations, 244 CMR 4.15(2)] Michigan NPA and SBON R&R A specialty certification for a nurse anesthetist will be granted to a registered nurse who satisfies the requirements set forth in the Michigan NPA and Michigan SBON R&R. [Board of Nursing Admin. Rules, part 4, sec. R338.10404(1)]

Page 6 Minnesota NPA and SBON R&R CRNAs are a type of advanced practice registered nurse. CRNAs, as a type of APRN, must obtain an APRN license. [Minnesota Statutes 2012, section 148.211(1a)] Mississippi NPA and SBON R&R CRNAs are a type of advanced practice registered nurse. CRNAs who meet certain educational requirements set forth by the SBON R&R will be certified to practice in Mississippi. [Rules and Regulations of the Mississippi Board of Nursing, ch. IV(2)] Missouri NPA and SBON R&R CRNAs are a type of advanced practice registered nurse. Advanced practice registered nurse, a nurse who has education beyond the basic nursing education and is certified by a nationally recognized professional organization as a certified nurse practitioner, certified nurse midwife, certified registered nurse anesthetist, or a certified clinical nurse specialist. The board shall promulgate rules specifying which nationally recognized professional organization certifications are to be recognized for the purposes of this section. Advanced practice nurses and only such individuals may use the title Advanced Practice Registered Nurse and the abbreviation APRN... MO Rev. Stat. 335.016(2) Nurse anesthetists who meet certain educational requirements set forth by the Missouri SBON R&R will be recognized by the board and will be eligible to practice as advanced practice nurses. [Rules of Department of Economic Development, sec. 20 CSR 2200-4.100(2)(A)] Montana NPA and SBON R&R CRNAs are a type of advanced practice registered nurse. Advanced practice registered nurse means a registered nurse

Page 7 licensed by the board to practice as an advanced practice registered nurse pursuant to 37-8-202, MCA, and ARM 24.159.1414. Admin. Rules of Montana, ch. 8, sec. 8.32.305 et seq.] Nebraska NPA and SBON R&R CRNAs are a type of advanced practice registered nurse. An applicant for a license under the Advanced Practice Registered Nurse Licensure Act to practice as a certified registered nurse anesthetist shall meet specified educational and administrative requirements. [Nebraska Revised Statutes, Section 71-1730(1)] Nevada NPA and SBON R&R An applicant for initial approval as a CRNA must meet specified educational and administrative requirements. [Nevada Admin. Code, sec. 632.515] If the board finds that the applicant has met all the appropriate requirements set forth in [the Nevada SBON R&R], he will be issued a certificate of recognition as a certified registered nurse anesthetist. [Nevada Admin. Code, sec. 632.530] New Hampshire NPA and SBON R&R CRNAs are a type of advanced practice registered nurse. New Hampshire registered nurses seeking APRN licensure must meet certain educational and administrative criteria. [New Hampshire RSA, sec. 326-B:18(I)] New Jersey NPA and SBON R&R CRNAs are a type of advanced practice nurse [N.J.A.C. 13:37-7.1(a)] No person shall practice as an advanced practice nurse or present, call or represent himself as an advanced practice nurse unless certified in accordance with [the NPA]. [N.J.S. 45:11-46] A registered professional nurse who wishes to practice as an

advanced practice nurse shall [b]e certified by the Board as an advanced practice nurse. [N.J.A.C. 13:37-7.1(c)] New Mexico NPA and SBON R&R The board may license for advanced practice as a certified registered nurse anesthetist an applicant who furnishes evidence satisfactory to the board. [New Mexico Nursing Practice Act, sec. 61-3-23.3(A)] New York DOH New York does not specify a specific method or process by which it authorizes CRNAs to practice. North Carolina SBON R&R CRNAs are a type of advanced practice registered nurse. The North Carolina Board of Nursing requires CRNAs to obtain recognition to practice. In accordance with G.S. 90-171.21(d)(4) and 21 NCAC 36.0226, a nurse anesthetist must verify his/her certification status with the NC Board of Nursing, and thereafter on a periodic basis, consistent with the nurse anesthetist s certification renewal cycle. CRNAs are issued certificates of recognition. See www.ncbon.com for an application and additional information. North Dakota NPA and SBON R&R CRNAs are a type of advanced practice registered nurse. Applicants for advanced practice registered nurse licensure must meet specific educational and administrative requirements. [North Dakota Century Code, ch. 43-12.1-09(2)(c)] Ohio NPA and SBON R&R CRNAs are a type of advanced practice nurse." Page 8 If the applicant for authorization to practice nursing as a certified registered nurse anesthetist has met all the requirements the Board of Nursing shall issue its certificate of authority to practice nursing as a certified registered nurse anesthetist which shall designate the nursing specialty the nurse is authorized to practice.

[Ohio Revised Code, sec. 4723.42(A)] Oklahoma NPA and SBON R&R CRNAs are a type of advanced practice registered nurse. Page 9 " Advanced Practice Registered Nurse means a licensed Registered Nurse who has obtained a license as an Advanced Practice Registered Nurse in one of the following roles: Certified Registered Nurse Anesthetist, Certified Nurse-Midwife, Clinical Nurse Specialist, or Certified Nurse Practitioner. [Oklahoma Statutes, sec. 567.3a(5)(e)] Oregon NPA and SBON R&R As of September 1, 1998, an individual shall meet the requirements and receive a license as a CRNA in order to use the title CRNA, Certified Registered Nurse Anesthetist or Nurse Anesthetist, and engage in the scope of practice of a CRNA. [Oregon Admin. Rules, sec. 851-052-0020(1)] Pennsylvania SBON R&R Pennsylvania does not specify a specific method or process by which it authorizes certified nurse anesthetists to practice. Puerto Rico NPA Certification is the process through which the Board of Female and Male Nurse Examiners of Puerto Rico recognizes that a nurse meets the study and practice requirements to work in a specialized area of nursing. [Act to Regulate the Practice of Nursing in the Commonwealth of Puerto Rico, sec. 2(g)] Rhode Island NPA and SBON R&R CRNAs are a type of "advanced practice registered nurse." " Advanced practice registered nurse (APRN) is the title given to an individual licensed to practice advanced practice registered nursing within one of the following roles: certified nurse practitioner (CNP), certified registered nurse anesthetist (CRNA) as defined in chapter 5-34.2, or certified clinical nurse specialist (CNS), and who functions

Page 10 in a population focus. [Rhode Island General Laws, sec. 5-34-3(1)] South Carolina NPA and SBON R&R CRNAs are a type of advanced practice registered nurse. License means a current document issued by the board [of nursing] authorizing a person to practice as an advanced practice registered nurse... [Code of Laws of South Carolina, sec. 40-33- 20(36)] South Dakota NPA and SBON R&R CRNAs are a type of advanced practice registered nurse. " Advanced practice registered nurse, or APRN, any person licensed by the board in the role of a clinical nurse specialist or a certified registered nurse anesthetist. [South Dakota Codified Laws sec. 36-9-1(12)] Tennessee NPA CRNAs are a type of advanced practice nurse. "... [N]urse anesthetists... holding such education and practice credentials shall apply to the board for a certificate to practice as an advanced practice nurse..." [Tenn. Code Ann., Title 63, Chapter 7, sec. 63-7-126 (b)] Texas NPA and SBON R&R CRNAs are a type of advanced practice registered nurse. The Texas Board of Nursing will license a registered professional nurse to practice as an advanced practice registered nurse if the nurse meets certain educational and administrative requirements established by the Board. [Texas Board of Nursing Rules and Regulations, sec. 221.4] Utah NPA and SBON R&R CRNAs are a type of advanced practice registered nurse. The division [the Division of Occupational and Professional

Page 11 Licensing] shall issue to a person who qualifies a license in the classification of advanced practice registered nurse CRNA without prescriptive practice. [Utah Code Ann., sec. 58-31b- 301(2)(e)] Vermont NPA and SBON R&R CRNAs are a type of advanced practice registered nurse. The Vermont SBON R&R refer to both endorsement [Vermont Admin. Rules, Ch. 4, Subch. 8(IV)(B)] and registration and endorsement [Vermont Admin. Rules, Ch. 4, Subch. 8(IV)(C)(1)] as methods of recognition for APRNs in Vermont. Virginia NPA and SBON R&R CRNAs are a type of nurse practitioner. The Virginia Board of Nursing will license a nurse practitioner as a CRNA if the nurse practitioner meets certain educational and administrative requirements established by the Board. [Regulations Governing the Licensure of Nurse Practitioners, part II, sec. 18 VAC 90-30-80] Virgin Islands NPA and SBON R&R The Board of Nurse Licensure may issue a certificate to an applicant to practice as a nurse anesthetist if that applicant meets certain educational and administrative requirements established by the Board. [Virgin Islands Code Ann., Title 3, sec. 96] Washington NPA and SBON R&R CRNAs are a type of advanced registered nurse practitioner. A registered nurse applicant for licensure as an advanced registered nurse practitioner must meet specific educational and administrative requirements set forth in the Washington SBON R&R. [Washington Admin. Code, sec. WAC 246-840-340] West Virginia NPA and SBON R&R CRNAs are a type of advanced practice registered nurse."

An applicant for licensure as an advanced practice registered nurse must meet specific educational and administrative requirements set forth in the Code of West Virginia sec. 30-7-1a. [Code of West Virginia, sec. 30-7-1a] Wisconsin NPA and SBON R&R CRNAs are a type of advanced practice nurse." Wisconsin does not specify a specific method or process by which it authorizes CRNAs to practice. Wyoming NPA and SBON R&R CRNAs are a type of advanced practice registered nurse. An applicant for initial recognition as an advanced practice registered nurse must meet educational and administrative requirements established by the Wyoming State Board of Nursing. [Wyoming Admin. Rules and Regulations, ch. 2, sec. 2(a)] KEY: NPA: Nurse Practice Act SBON R&R: State Board of Nursing Rules and Regulations MPA: Medical Practice Act DOH: Department of Health Regulations Page 12

Page 13 SUMMARY TABLE: NPA SBON R&R NPA and SBON R&R Dept. of Health California Massachusetts Alabama New York Indiana North Carolina Alaska Puerto Rico Pennsylvania Arizona Tennessee Arkansas Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Iowa Kansas Kentucky Louisiana Maine Maryland Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Jersey New Hampshire

NPA SBON R&R NPA and SBON R&R Dept. of Health New Mexico North Dakota Ohio Oklahoma Oregon Rhode Island South Carolina South Dakota Texas Utah Vermont Virginia Virgin Islands Washington West Virginia Wisconsin Wyoming Total: 4 3 45 1 Page 14

SUMMARY TABLE: Licensure Certification Authorization Approval Registration Recognition No Additional Method Alabama Alabama Alaska Alabama Colorado Missouri Indiana Arkansas Arizona Georgia Nevada Vermont 1 Nevada New York Connecticut California Massachusetts North Carolina Pennsylvania Delaware D.C. Ohio Wyoming Wisconsin Hawaii Florida Idaho Maryland Illinois Michigan Iowa Mississippi Kansas New Jersey Kentucky Puerto Rico Louisiana Tennessee Maine Virgin Islands Minnesota Montana Nebraska New Hampshire New Mexico North Dakota Oklahoma Oregon Rhode Island South Carolina South Dakota Texas Utah Virginia West Virginia Wisconsin Washington Total*: 29 12 4 2 2 4 4 * Some states appear in more than one column. 1 The Vermont SBON R&R refer to both endorsement and registration and endorsement as methods of recognition for APRNs in Vermont. Page 15

Advanced Practice Registered Nurse (APRN) Page 16 Advanced Practice Nurse (APN) SUMMARY TABLE: UMBRELLA TITLE Advanced Registered Nurse Practitioner (ARNP) Nurse in the Expanded Role No Umbrella Title That Includes CRNAs Arkansas* Alabama Florida Massachusetts Alaska California Colorado* Iowa Arizona Connecticut Delaware Virginia** Michigan District of Columbia Illinois Washington Nevada Georgia Indiana New Mexico Hawaii* Maryland New York Idaho* New Jersey Oregon Kansas* Ohio Pennsylvania Kentucky* Tennessee Louisiana* Wisconsin Maine Minnesota* Mississippi Missouri Montana Nebraska New Hampshire North Carolina North Dakota* Oklahoma* Rhode Island* South Carolina South Dakota Texas* Utah Vermont West Virginia* Wyoming* Total: 28 10 4 1 8 *States that have incorporated the APRN Consensus Model concepts of role and population focus. **Virginia uses the umbrella title nurse practitioner or NP.