Senate committee hears hours of testimony on bill to allow independent CRNA practice

Chairwoman Beverly Gossage and the Kansas Senate Public Health and Welfare Committee heard extended testimony on Senate Bill 67, a proposal to authorize certified registered nurse anesthetists (CRNAs) to practice independently and to prescribe drugs, while explicitly prohibiting CRNAs from performing abortions or prescribing drugs to induce abortions.

The measure, presented to the committee as a refiled bill (the sponsor said it mirrors Senate Bill 112 from 2023), would remove enumerated lists of activities in current statute and instead allow CRNAs “to practice as an independent advanced practice registered nurse to the full extent of the licensee’s education and qualifications,” with a narrow statutory exception that would bar doing surgery for implantation of medication reservoirs for drug-delivery devices.

Why it matters: Supporters said the change would expand access to anesthesia and pain-management services in rural and underserved areas, reduce costs and eliminate regulatory barriers they say impede modern practice. Opponents, including physician anesthesiologists and the Kansas Medical Society, said the bill removes important physician oversight and raises patient-safety concerns.

Proponents’ case

Jeremy Salisbury, a practicing CRNA from Wichita and a representative of the Kansas Association of Nurse Anesthetists, told the committee the association represents about 900 members in Kansas and asked lawmakers to “support Senate Bill 67” so CRNAs can “continue to provide safe, high quality patient care without unnecessary barriers.” Salisbury said CRNAs practice in every anesthesia setting, are the primary providers in many rural counties and enable obstetrical, surgical and trauma stabilization services in medically underserved communities.

Jason Worth, a CRNA from Manhattan, described the current practice statutes as limiting patient access, saying, “As a CRNA practicing in rural Kansas, our practice statutes in its present form negatively impact patient access to quality care.” Worth and other proponents said CRNAs provide the majority of anesthesia in Kansas, that the model is cost effective, and that the Federal Trade Commission has previously urged removal of restrictions on advanced practice registered nurses.

Witnesses cited several statistics during testimony: proponents said about 900 CRNAs are actively practicing in Kansas; that CRNAs deliver more than 50 million anesthetics nationwide annually; and that, in Kansas, proponents said CRNAs administer more than 80 percent of anesthetics and that of the state’s 105 counties, 73 rely on CRNAs as the exclusive anesthesia provider, 14 have both CRNAs and physician anesthesiologists, and 18 have no anesthesia providers. Proponents also cited studies and industry analyses (including a referenced 2019 FTC statement) in arguing independent practice would lower costs and increase access.

Opponents’ concerns

Rachelle Colombo, executive director of the Kansas Medical Society, said Senate Bill 67 "goes far beyond" past changes for other APRNs and that the bill would remove the statutory requirement for physician or dentist orders that currently govern CRNA practice. Colombo said prior legislation (House Bill 2279 in 2022) removed a written prescribing protocol for APRNs and allowed specific ordering authority without placing APRNs under the Board of Healing Arts; she argued SB 67 is materially different from that earlier statute and urged caution.

Physician anesthesiologists raised patient-safety concerns. Dr. Kathy Perryman, a physician anesthesiologist and member of the Kansas Society of Anesthesiologists, told the committee, “Removing all of the physician involvement is very concerning to me,” and warned that perioperative physicians play a central role in managing patients before, during and after surgery. Dr. Mark Brady, another anesthesiologist testifying in opposition, said anesthesiologists are less likely to practice in rural areas for multiple reasons but agreed that “for most surgeries in rural Kansas, nurse anesthetists could handle those procedures. But there are some procedures that, maybe not.”

Scope questions and clarifications

Committee members asked specific questions about whether the bill would permit CRNAs to perform interventional pain procedures, implant devices or conduct spine surgeries. Proponents repeatedly said the bill was intended to allow nonsurgical pain management and would not authorize surgical implantation or instrumentation, and that the statutory text specifically excludes surgery for implantation of medication reservoirs. On opioid prescribing, proponents said CRNAs are trained to prescribe controlled substances in other states and that CRNAs practicing in Kansas would need to meet state requirements and, where applicable, obtain retraining or controlled-substance registration to prescribe opioid medications.

Procedure and status

The committee took testimony from multiple proponents and opponents but did not take a final vote on Senate Bill 67 during this meeting; Chairwoman Gossage closed the hearing after questions and testimony and the committee moved on to other bills on the agenda. No committee action (motion or vote) on SB 67 was recorded in the transcript provided.

What was not decided

The transcript records extensive disagreement about whether the bill would increase access in the communities that need it most and whether the statutory change should be broader (apply to all APRNs) or narrower (amend the CRNA practice act specifically). No final committee amendments or formal votes on SB 67 appear in the record provided.

Looking ahead

Committee members and witnesses frequently referenced prior legislative history (House Bill 2279 in 2022 and a similar Senate bill in 2023) and said that any future changes could be achieved either by amending the CRNA practice statute directly or by taking a broader APRN approach. The committee closed the hearing on SB 67 and proceeded to take final action on other bills at the same meeting.