Nearly 200 Florida CRNAs rallied at the State Capitol to support Senate Bill 810 and House Bill 257, advocating for legislative changes to eliminate mandatory supervisory agreements with physicians and permit independent prescription of pre-anesthetic medications

Nearly 200 Certified Registered Nurse Anesthetists (CRNAs) from across Florida gathered at the State Capitol on Thursday for CRNA Day in advocation of the advancement of Senate Bill 810 and House Bill 257.

As outlined in the legislative proposals, Advanced Practice Registered Nurses (APRNs), including CRNAs, would no longer be mandated to maintain a written supervision agreement with a physician or dentist. This requirement, as stipulated by existing state law, necessitates CRNAs to enter into formal arrangements with a supervising physician, often incorporating a financial aspect where CRNAs remit a portion of their earnings to their supervisory physician.

Furthermore, the bills, if adopted, would authorize CRNAs to prescribe pre-anesthetic medications independently, circumventing the current limitations imposed by the supervisory protocols.

Advocates for the bill argue that the existing supervisory requirements are a significant factor in the shortage of CRNAs across Florida. They assert that these regulations drive many CRNAs to seek employment in states with less stringent rules. This shortage has considerable implications, notably contributing to the discontinuation of essential healthcare services, including obstetrics departments in hospitals, predominantly affecting rural healthcare infrastructure.

“As members of one of America’s most trusted professions, CRNAs have always served on the front lines of patient care, and we continue to answer the call to help keep patients healthy and safe,” said Karla Maldonado, President of the Florida Association of Nurse Anesthesiology. “However, as a professor, I have unfortunately seen almost three out of every five graduates leave the state to practice in states that do not mandate illusory written supervisory agreements with physicians.”

According to data aggregated by the American Association of Nurse Anesthesiology, the state of Florida loses 32.8 percent of nurse anesthesiology graduates to other states each year. A secondary subset of data shows that 84.5 percent of graduates leaving Florida relocate to one of the 43 states that do not hold supervision requirements in their nursing or medical laws.

Between 2018 and 2023, Florida State University experienced the highest rate of nurse anesthesiology graduates relocating, with 65 percent of its students moving away. This was followed by Keiser University, where 55.9 percent of graduates left Florida, and Florida Gulf Coast University, with a 43.3 percent departure rate.

The University of Miami saw 29.5 percent of its graduates leave the state. Meanwhile, Barry University and the University of North Florida had departure rates of 23.6 percent and 24.8 percent, respectively. Advent Health University reported that 22.8 percent of its graduates left Florida, while the University of South Florida had a slightly higher rate at 23.7 percent. Florida International University had the lowest rate, with 20.3 percent of its graduates moving out of state.

“Now is the time for Florida to modernize our laws and join other states that have already eliminated obstacles and unnecessary supervision requirements related to highly trained CRNAs – allowing them to practice to the full scope of their education and training,” added Maldonado, who penned an op-ed piece for The Capitolist on Thursday, continued.  “On behalf of Florida’s more than 6,000 CRNAs we thank our champions and bill sponsors for looking for innovative ways to address Florida’s healthcare workforce shortages while maintaining the quality of care that is delivered to Floridians.”

House Bill 257 was scheduled to appear in the House Healthcare Regulation Committee, but the bill was not taken up, with bill sponsor Rep. Mike Giallombardo electing to wait to further consult with stakeholders.

“I chose to wait on presenting HB 257 today to continue discussions with committee members,” he said. “All members I have spoken with are committed to addressing Florida anesthesia workforce issues.”