Senate committee hears divided testimony on SB249 to expand CRNA authority

Carson City — The Senate Commerce and Labor Committee heard more than an hour of testimony on SB249, a bill that would change Nevada law to allow certified registered nurse anesthetists (CRNAs) to possess and administer medications needed for anesthesia without a physician order outside of the state’s current critical‑access exemptions.

Proponents said the bill would remove a two‑tiered regulatory system that limits CRNA practice in non‑rural settings, improve access to surgical care and retain newly trained providers in Nevada. Brian Hansen, a CRNA who practices in Las Vegas and at a critical access hospital in Mesquite, told the committee Nevada “lacks much of the basic framework to make our healthcare system great” and said SB249 would “allow surgeons to focus on surgery and CRNAs to focus on anesthesia.”

The bill’s presenters included Paul Young of Tom Clark Solutions, speaking for the Nevada Association of Nurse Anesthetists, and Dr. James Stimpson, director of UNLV’s nurse‑anesthesia program. Stimpson described the CRNA education pathway — including at least two years of critical‑care nursing experience followed by roughly 36 months of anesthesia training with thousands of clinical hours — and said, “not once have I ever had a bad anesthesia outcome” in decades of independent practice in other states.

Hospital and health system representatives also testified in support. Reagan Comas with R&R Partners said UMC supports the measure, and Carson Tahoe Health’s Victoria Supple said the change would “allow highly trained and highly skilled providers to maximize their practice and provide quality care to patients.” Several CRNAs and an ICU nurse who is training to be a CRNA described local workforce shortages and urged passage to retain providers who otherwise move to neighboring states.

Opponents included the Nevada State Society of Anesthesiologists (NVSSA) and the Nevada State Medical Association, which argued the bill would reduce oversight and pose patient‑safety risks. Cassidy Wilson, representing NVSSA, told the committee that “authorizing CRNAs to practice independently without physician supervision raises serious concern regarding patient safety and quality of care.” Multiple physician anesthesiologists calling in from Nevada emphasized longer physician training paths and cited studies they said show higher adverse‑event odds when anesthesia is provided solely by CRNAs.

The Board of Pharmacy’s executive director, Dave Weese, said the board had issued controlled‑substance licenses to “just under 20” CRNAs in critical access settings and reported no public complaints during the last biennium. Committee members asked whether existing critical‑access reporting showed harms; proponents said they were not aware of increased incidents in rural sites where CRNAs already practice without physician orders.

Committee members also asked for comparative safety data from other states. Opponents referenced additional studies and a recent letter from the American Society of Anesthesiologists; bill supporters said they would supply state‑by‑state implementation information and pointed to periods during the COVID‑19 pandemic when supervision waivers did not lead to increases in malpractice claims.

No formal vote on SB249 occurred in the hearing. The committee limited in‑person testimony to two minutes per speaker because it was deadline day. The record includes extensive written comments and follow‑up offers from both sides to provide studies and model statutes for the committee’s review.