Senate subcommittee advances bill to license certified anesthesiologist assistants after debate over training slots

A Virginia Senate subcommittee voted 4-0 to report Senate Bill 882 to the full committee after hearings in which supporters said licensing certified anesthesiologist assistants (CAAs) would expand the state’s anesthesia workforce and educators warned the change could reduce clinical training opportunities for Certified Registered Nurse Anesthetist (CRNA) students.

Senator Locke presented the bill as a Joint Commission on Health Care recommendation to license CAAs in Virginia, saying the measure would “expand access to care and reduce the strain on the current anesthesia workforce.” The bill would create a licensure and regulatory pathway for CAAs, who supporters described as graduate-trained members of anesthesia care teams practicing under anesthesiologist supervision in 22 other states.

The bill’s supporters included Sarah Graham Taylor, testifying on behalf of the Virginia Academy of Anesthesiologist Assistants, who said the bill would allow highly trained professionals to return to Virginia. “This bill is about highly skilled, highly trained medical professionals ... who want to be a part of our healthcare ecosystem in Virginia,” Taylor said.

Nicole Moore, who identified herself as a Virginia resident and president of the American Academy of Anesthesiologist Assistants, told the subcommittee she currently must commute to Washington, D.C., because Virginia does not license CAAs. “As a CAA of 8 years and a Virginia resident, I strongly encourage your support of CAA legislation so Virginia patients can benefit from the highly trained care that CAAs can provide,” Moore said.

Students and trainees also spoke in support. Daniella Flamenco, a graduate student in an anesthesia program who said she grew up in Prince William County, said passage would be “life changing” for her and classmates. Felipe Hoglar Viera, Shannon Moore and other trainees said licensing would permit them to work near family and in underserved parts of the state.

Hospital and health-system groups told the panel they supported the bill as a workforce tool. Julie Dime of the Virginia Hospital and Healthcare Association said the state is at a competitive disadvantage relative to the District of Columbia and North Carolina, which license CAAs.

Speakers opposing or urging caution included Michelle Satterlund of the Virginia Association of Nurse Anesthetists and educators from CRNA programs. Satterlund said the state already has three CRNA training programs (Virginia Commonwealth University, Old Dominion University and Mary Baldwin) and that those programs struggle to secure clinical placement slots in Virginia. She said licensing CAAs could “exacerbate the problem before we fix the underlying problem” by reducing available clinical training seats.

Derek Owens, representing CRNA educators at Mary Baldwin, described how CAAs, once licensed and practicing, would occupy clinical cases that CRNA students currently rely on for training. CRNA educators provided application statistics: Mary Baldwin reported about 173 applicants for 25 slots; VCU reported several hundred applicants and selected a fraction of qualified candidates because of limited in-state clinical placements. CRNA educators testified that CRNA programs are typically 36 months with roughly 24 months of clinical training, while CAA programs are commonly described as 24–28 months with students immersed in clinical training in their final 12–16 months.

Subcommittee members asked follow-up questions about training duration and workforce effects. Senator Pillian and others emphasized the workforce shortage; proponents noted CAAs practice in other states and are recognized by Medicare and major insurers. Opponents and educators urged safeguards so CRNA education in Virginia would not be displaced.

After public comment and discussion, Senator Locke moved that the subcommittee report SB 882 to the full committee. The motion was seconded and the subcommittee voted to report the bill, Aye 4, No 0.

SB 882 will be considered next by the full Senate committee, where members said they expect further debate on training-slot protections and regulatory details.