Board of Registered Nursing backs bill to clarify nurse‑anesthetist authority in hospitals and clinics

The Board of Registered Nursing voted unanimously March 20 to support Assembly Bill 8 76, legislation that would amend the Nurse Anesthetist Act to explicitly authorize certified registered nurse anesthetists (CRNAs) to provide preoperative, intraoperative and postoperative care, order and interpret certain diagnostic tests, and select and administer medications in acute care, outpatient and dental settings.

Board members said the change is intended to remove regulatory uncertainty that, they and many commenters said, has led to interruptions in anesthesia services. "AB 8 76 prevents these unnecessary disruptions by reaffirming that nurse anesthesiologists can administer anesthesia independently and clarifies that our role extends across the full continuum of anesthesia care," said Julia Harris, a CRNA who testified during public comment.

The bill, as discussed by staff, would add definitions and explicit statements about scope and supervision. Under the proposal a CRNA would be recognized as an advanced practice registered nurse authorized to perform independent anesthesia services and would not be required to provide anesthesia under the direct supervision of a physician, podiatrist or dentist. The text also says a physician or other clinician present in the same location shall not be deemed to be supervising a CRNA by virtue of proximity alone.

Board staff Executive Officer Lori Melby summarized the impetus for the legislation as an effort to prevent future regulatory confusion. "We did start the process with the nurse anesthetist advisory committee to draft regulations, and it was difficult tying it back to specific areas in the statute because our statute's very limited," Melby said during the meeting. The board previously relied on executive‑officer letters and legal opinions to clarify CRNA practice, staff said.

Multiple CRNAs and representatives of the California Association of Nurse Anesthesiology urged support at the meeting. Emily Frank, president of the association and a practicing CRNA, told the board the bill is needed because separate Title 22 or survey activity has, in recent years, led to cancellations and delays in care. "This is our attempt to put it in one place, make it really clear and then build regulations on that in that order," Frank said. In written comments read on her behalf, board advanced practice representative Nilu Patel also urged support, saying the bill "recognizes CRNAs' advanced education, training and expertise in providing safe and high quality anesthesia care."

Public commenters recounted the consequences of past enforcement actions. Several speakers described a 2024 incident in Modesto in which survey activity led to canceled surgeries; one public commenter said the event resulted in "nearly 1,000" cancellations and harmed access in rural and safety‑net hospitals.

The board voted 5‑0 to support the bill. The motion carried after a public comment period in which nursing educators, student CRNAs and practicing CRNAs urged passage.

The board made clear in discussion that supporters view AB 8 76 as a clarification, not an expansion, of CRNA scope: it would codify current independent CRNA practice and the ability to perform ancillary clinical tasks tied to anesthesia care, staff said. The board also discussed distinctions between the CRNA practice of selecting and administering medications during anesthesia and outpatient prescriptions governed by pharmacy law.

Next steps: with the board's support, staff will include the board position in the legislative record; the bill will continue through the Legislature. The board did not propose additional regulatory text at this meeting beyond its legislative position.