Committee hears competing testimony on licensure for anesthesiologist assistants

House Bill 23-68 would establish a licensure framework for anesthesiologist assistants (AAs) and place them under the oversight of the Kansas Board of Healing Arts. The Committee on House Health and Human Services heard more than an hour of proponent and opponent testimony on workforce, supervision, training and clinical‑education implications.

Under the bill as explained to the committee, an anesthesiologist assistant would be a licensed professional who provides anesthesia services under the direction and supervision of a supervising or designated anesthesiologist. The bill would require credentialing, education and examination evidence, allow temporary one‑year licensure in some circumstances, and authorize the Board of Healing Arts to discipline licensees under existing disciplinary statutes. The bill would also add several cross‑references in state law (including KSA 22-47-14 for background checks and KSA 65-11-63 for student practice) so that AAs would be included in existing licensing and background-check frameworks.

Proponent arguments: Physicians, current practicing AAs and the Kansas Medical Society told the committee the bill would create a regulated role that exists in other states and would add capacity under the anesthesia care-team model. Rochelle Colombo of the Kansas Medical Society described the measure as a licensure act that provides explicit education, training and regulation and said AAs function under direct, in‑person supervision by anesthesiologists. Spencer Jones, a practicing AA, and physician witnesses said AAs practice in Missouri, Oklahoma, Colorado and other states and that in team settings AAs and certified registered nurse anesthetists (CRNAs) are interchangeable on clinical tasks and that billing and reimbursement under the anesthesia care-team model are equivalent.

Supporters said the model enables an anesthesiologist to supervise multiple providers — committee testimony identified common direction that medical direction models in hospitals limit supervision to four assistants per physician — which practitioners said increases capacity in high‑acuity urban centers without changing the way care is billed for team models.

Opposition and primary concerns: The Kansas Association of Nurse Anesthetists opposed the bill, arguing AAs are dependent providers who require an anesthesiologist on site and thus do not expand access in rural Kansas where CRNAs often practice independently. Opponents said allowing AAs could reduce available clinical training sites for student registered nurse anesthetists (SRNAs) at urban hospitals, that AAs cannot supervise SRNAs under current accreditation rules, and that adding AAs could “cannibalize” clinical cases and reduce the pipeline of CRNAs who serve rural communities. The committee heard a retired KU anesthesia‑education director explain that KU and other programs rely on high‑acuity urban cases for clinical training and that adding AAs at those hospitals would limit student access to those cases.

Regulatory and operational points: The bill would require anesthesiologists supervising assistants to be physically present or immediately available in the same facility. It includes a limit on the number of assistants a supervising anesthesiologist may oversee at one time and directs the board to create an advisory council. The bill also standardizes fingerprint/background‑check language in KSA 22-47-14 to reduce rejections in criminal-history checks.

Stakeholders and context: Testimony included Kansas physicians who supervise AAs in Missouri, representatives of AA professional organizations, a Georgia state senator who testified about decades of AA practice in his state, and leaders from the Kansas Medical Society. Opponents included the president of the Kansas Association of Nurse Anesthetists and the former director of clinical education for the KU nurse anesthesia program. Several lawmakers asked about ratios, rural access, training numbers and potential effects on CRNA programs at KU and other institutions.

Next steps and outlook: The committee received extensive written and oral testimony and closed the hearing without taking a committee vote that day. Lawmakers and witnesses said the issue has been considered in prior sessions and in a KDHE technical review; supporters urged statutory licensure for clarity and oversight while opponents urged protections for clinical training and rural access.

Ending: The hearing highlighted competing workforce and training priorities: proponents said licensure would add regulated capacity in anesthesia care teams in urban centers and clarify practice; opponents warned of effects on CRNA training slots and rural anesthesia access and urged additional safeguards before authorizing AAs in statute.