Patients in Michigan Gain Increased Access to Affordable, Quality Anesthesia Care

PARK RIDGE, Ill. (AANA)— Michigan patients now have increased access to safe, affordable care with the signing of HB 4359 by Governor Gretchen Whitmer. The law removes supervision requirements for nurse anesthetists and grants them the authority to collaboratively participate in a patient-centered healthcare team.

Michigan is now the 43rd state that does not require physician supervision of Certified Registered Nurse Anesthetists (CRNAs) in the state nurse practice act. 

“Removing barriers to CRNA practice allows Michigan hospitals to select the anesthesia delivery model that maximizes their workforce and increases access to safe, affordable care for all patients,” said Toni Schmittling, DNAP, MBA, CRNA, president of the Michigan Association of Nurse Anesthetists (MANA). “By signing this important legislation, Michigan recognizes that CRNAs are qualified to make decisions regarding all aspects of anesthesia care based on their education, licensure, and certification.”

Anesthesia services are provided predominantly by CRNAs in Michigan’s critical access hospitals offering surgical services in 99% of its rural hospitals.  They comprise 68% of the state’s anesthesia care providers.

In March 2020, to maximize healthcare resources during the outbreak of the COVID-19 pandemic, Gov. Whitmer enacted an executive order removing physician supervision for CRNAs.  This legislation makes that order permanent. CRNAs are experts in airway management, hemodynamic monitoring, management of patients on ventilators, and overall management of critically ill patients.  

“Throughout the COVID-19 pandemic Michigan CRNAs have been essential in addressing the deadliest part of the disease in addition to providing top-of-the-line anesthesia care,” said President Schmittling. “With years of critical care nursing experience before anesthesia training, CRNAs expertly care for the whole patient, not just his or her condition, and makes patient care more affordable and accessible. In rural Michigan, this access to surgical, obstetrical and emergency services close to home is vital.”

The new law provides that a nurse anesthetist may, within the scope of practice, select, order, prescribe and administer anesthesia and analgesic agents during the perioperative, periobstetrical, or periprocedural period, consistent with health care facility policy. CRNAs collaboratively participate in a patient-centered care team, which is a group of health care professionals including, but not limited to, a physician, dentist or podiatrist, who directly or indirectly care for a patient by each contributing specialized knowledge, skill and experience.

“The American Association of Nurse Anesthetists (AANA) applauds Gov. Whitmer for recognizing the important role CRNAs have in delivering safe anesthesia care in Michigan,” said Steven M. Sertich, CRNA, MAE, JD, Esquire, AANA president. “Increased demand, limited resources, and the rural nature of the state dictate that a system capable of meeting the needs of all Michigan residents be maintained and this law provides that.”