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Committee advances CRNA regulatory draft after extensive public comment over wording
Summary
The BRN Nurse Practice Committee advanced draft CRNA regulations tied to AB 876 for further drafting after lengthy public comment from practicing CRNAs and professional groups who objected to removing the terms 'anesthetist' and 'independent' and to use of the undefined phrase 'anesthesia provider.' The committee directed staff to refine role and liability language before full board consideration.
The California Board of Registered Nursing (BRN) Nurse Practice Committee moved to advance draft regulatory language proposing CRNA requirements under Assembly Bill 876, but directed staff to continue refining role and liability provisions after prolonged public comment from CRNAs and professional organizations.
Staff and Executive Officer Loretta Melby explained that the draft text implements AB 876 by providing policy and operational guidance for certified registered nurse anesthetists (CRNAs). Several edits in the proposed text were framed as clarifying changes rather than substantive policy reversals, but public commenters urged the committee to restore language the advisory committee previously recommended.
Speakers representing practicing CRNAs and their associations expressed substantive concerns. Thomas Batchelor, secretary of the California Association of Nurse Anesthesiology, said the revised language in the nurse anesthetist role and liability section was "unnecessarily confusing," called out repeated use of "presume" and "assume," and urged restoring concise language or using "independent of physician supervision" to preserve clarity. Dr. Jeffrey Darna, a CRNA educator, said the draft removed the term "anesthetist" and replaced CRNA‑specific language with the vague term "anesthesia provider," which he said is not defined in California statute and could create confusion. Multiple CRNA speakers, including Deborah Varella, Elizabeth Bengochea, Chuck Griffith, Greg Crawford and Melanie Roe, echoed those concerns and asked the board to restore the April 7 advisory‑committee text.
Lucas Evenson, speaking for the California Medical Association, thanked staff for considering CMA comments and said CMA was still reviewing recent edits. Several CRNA speakers alleged the draft changes had been made in response to comments by stakeholder groups with competing professional interests; counsel and staff rejected the implication that staff had inappropriately favored any party. Reza Pejuhash, BRN legal counsel, said it is appropriate for staff to consider stakeholder concerns and offer suggested language for committee review, and he reminded members the committee may accept, reject or further amend the proposal.
Staff described several specific edits: strike‑out of the bare term "anesthetist" (to avoid public confusion without the "nurse" qualifier), removal of language that referenced staffing (e.g., scrub assistant) because staffing and employment are outside BRN jurisdiction, and careful handling of the word "independent" because California law treats APRN independence differently from the colloquial sense used by some commenters. Melby said the committee could reopen item two (nurse anesthetist role and liability) for more meaningful revision before the full board.
Board member Vicki Granowitz moved to recommend approval of the proposed CRNA regulatory text with continued work on the nurse anesthetist responsibility/role/liability provisions (items 1 and 2) before advancing to the full board. The motion passed; Granowitz and Chair Patel recorded yes votes and the committee moved the draft forward for further refinement, with staff to coordinate with DCA regulatory counsel and legal counsel on precise language and with the expectation the text will go through public comment at Office of Administrative Law review.
Next steps include drafting clearer language to align definitions with statute (for example, using "nurse anesthetist" where useful and avoiding undefined umbrellas such as "anesthesia provider"), resolving whether role/liability text inadvertently regulates staffing or employer terms, and publishing the draft for further public comment as it proceeds to board review and the OAL notice period.
