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Committee advances bill to remove written supervision protocol for CRNAs after contested debate
Summary
The House Health and Human Services Committee voted 18-7 to report House Bill 649 favorably, which would remove a required physician- or dentist-signed written protocol for certified registered nurse anesthetists (CRNAs). Supporters said the change would increase access in underserved areas; opponents raised patient-safety and training concerns.
The Health and Human Services Committee advanced House Bill 649 on a voice roll call after extended debate, reporting the measure favorably by an 18-7 vote.
The bill, presented by Representative Gilles Lombardo, would remove a state requirement that CRNAs maintain a written, physician- or dentist-signed supervisory protocol in order to provide anesthesia. Lombardo told the committee the measure “does not increase the scope” of practice but would allow CRNAs to practice without that paperwork requirement.
Supporters, including several CRNAs and professional groups, told the committee the change would modernize Florida’s Nurse Practice Act and help address an anesthesia workforce shortage. Michelle Canale, a CRNA and assistant dean at the University of South Florida, described CRNAs’ training and experience and said the paperwork requirement is “a generic piece of paperwork CRNAs just have to have on file.” Jan Setner, president of the American Association of Nurse Anesthesiology, said it is “an outright, falsehood that HB 649 will replace anesthesiologists or change the scope of practice for CRNAs,” and urged passage to improve access.
Opponents, led by Dr. Charles Chase of the Florida Medical Association, focused on patient safety and training differences between physician anesthesiologists and CRNAs. Chase said “patient safety is the number 1 reason,” described the longer medical training of anesthesiologists, and warned of studies he said show worse outcomes where independent practice has been expanded. Committee members repeatedly asked the sponsor for data on outcomes, access and cost savings; Lombardo cited CMS billing data and out‑of‑state comparisons, and offered to provide follow‑up documentation to members.
Committee members raised particular questions about whether the bill would guarantee additional providers in rural counties and whether physicians would still be present or held responsible in practice settings. Lombardo responded the measure removes the written protocol requirement but does not mandate delivery models; she said hospitals and surgery centers would remain free to adopt their own staffing arrangements. Members also discussed malpractice insurance, with Lombardo noting CRNAs are required to carry malpractice coverage under current law.
After public testimony and debate, the committee took a roll call and reported the bill favorably. The final vote was 18 yeas and 7 nays.
The bill now moves to the next committee or the full House (the committee report lists the bill as reported favorably).
