Committee approves change to CRNA practice language, keeps oversight and reporting requirements

The Senate Government Organization Committee approved a committee substitute for Senate Bill 810 that revises state code language governing certified registered nurse anesthetists (CRNAs), clarifies permitted titles, and requires the Board of Nursing to report to the Legislature on implementation and any issues.

Committee Counsel summarized the substitute: “This bill expands the specifications set in code for allowing certified registered nurse anesthetist to administer anesthesia.” The substitute replaces the prior statutory wording that a CRNA must be “in the presence of and under the supervision” of a physician or dentist with a defined concept of “cooperation,” described in the substitute as teamwork in which each participant contributes their expertise at their respective education and training levels. Counsel told the committee the bill also makes clear a patient’s medical or dental care is directed by the physician, dentist or podiatrist "at all times during such cooperation." The committee substitute removed prescriptive-authority language that had appeared in earlier draft text and removed the title "nurse anesthesiologist" from the list of allowed titles; retained allowed titles include "certified registered nurse anesthetist," "CRNA," "advanced practice registered nurse," and "APRN."

Why it matters: Proponents told the committee the change will expand access to anesthesia and related services, particularly in rural and critical-access hospital settings where physician anesthesiologists are not always immediately available. Dr. Justin James, president of the West Virginia Association of Nurse Anesthesiology, said podiatrists in rural areas reported waiting seven days or longer for supervision that allows a procedure to proceed; he said the substitute lets CRNAs work with podiatrists and other cooperating practitioners to increase access to care.

Safety concerns and reporting: Representatives of the Board of Medicine and an anesthesiologist witness urged caution. Greg Foster, counsel for the Board of Medicine, said the board’s priority is patient safety and that the term "cooperation" is vague compared with the prior statutory term "supervision." A physician anesthesiologist who testified urged the committee to preserve the status quo; he recommended defining who qualifies as a consulting provider for chronic pain practice and asked that the medical community have further input on that section. In response to stakeholder concerns, the substitute includes a Board of Nursing reporting requirement: the board must report annually to the Legislature (first report due 07/01/2026) regarding problems or issues reported by hospitals.

Committee action and amendments: The committee considered several amendments and narrowly debated whether to convert the bill into a study resolution; that motion was rejected. A technical amendment adding clarifying conjunctions to subsection language was adopted. The committee ultimately voted to report the committee substitute, as amended, to the full Senate with a recommendation that it pass.

Ending: Committee members discussed continuing stakeholder engagement and monitoring via the Board of Nursing reports. The committee recessed following the vote; the committee substitute for Senate Bill 810 will be reported to the full Senate for further consideration.