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Only a few session days remain—six in the Senate, three in the House of Representatives—before Pennsylvania’s 2021-22 legislative session ends.


Any bill that hasn’t made it entirely through both chambers of the state General Assembly to get to the governor’s desk for his signature and enactment must be reintroduced and work itself through the whole legislative process again when the new two-year session starts in January 2023.


The end of session is good news when it comes to bad policy like House Bill 1956 and Senate Bill 1258, two companion measures that would license anesthesiologist assistants (AAs) for the first time in Pennsylvania.


Neither bill received consideration and no votes are pending in these waning days of session. But that doesn’t mean the issue is finished—far from it.


The Pennsylvania Association of Nurse Anesthetists (PANA) successfully pushed back against the legislation this year, but we fully expect the measures to be reintroduced in the 2023-24 session.


We’ll be ready, too. We have to be, because we’ve already seen some of tactics proponents will use to advance their bills. Consider the lengths they’ll go:


  • Certified Registered Nurse Anesthetists (CRNAs) and SRNAs heard rumors that the legislation passed. Nope. Never happened. In fact, on April 25, PANA testified against the legislation during a House Professional Licensure Committee hearing. The measure never received a vote.

  • In an unprecedented attempt to circumvent the legislative process, AAs began reaching out directly to both physician-owned and CRNA-owned anesthesia companies with notice that they are authorized to work in Pennsylvania under delegatory authority. The Pennsylvania Department of Health has made clear that anesthesiologist assistants are not recognized as an anesthesia provider in the state and therefore cannot operate as such in the commonwealth.

  • Working with their state and national organizations, anesthesiology assistants also have been claiming publicly that AAs and CRNAs can be used interchangeably, alleging an anesthesia shortage, as part of an attempt to move AAs into facilities where CRNAs are already working. Nonsense. AAs are limited by their training to only provide support as a technical assistant to a physician anesthesiologist and cannot provide anesthesia care apart from their direct supervision. Any scenario that has an AA working apart from a physician anesthesiologist is in direct violation of federal law.

So, while this legislative session is ending, it’s really just the beginning of the fight against a misguided policy that will NOT improve patient safety or enhance care; will NOT reduce health-care costs, but instead contribute to costlier care models; and will NOT improve access to anesthesia services.



Zulmarie Adorno-Maldonado, MSN, CRNA
Zulmarie Adorno-Maldonado, MSN, CRNA

Zulmarie Adorno-Maldonado, MSN, CRNA, is a graduate of the University of Puerto Rico Nurse Anesthesia Program. Zulmarie is the clinical coordinator at UPMC York Memorial Hospital. She takes pride in her work, in her team, and in helping students make the most of their clinical rotation while at UMPC York Memorial Hospital. Her passion for providing safe anesthesia shows with every patient interaction, and she especially lights up when caring for Spanish-speaking patients. When asked what it means to be a Certified Registered Nurse Anesthetist (CRNA) of Hispanic heritage, Zulmarie responded:

“For me, being a CRNA is about serving the community and helping them to have a successful surgery and a quick recovery. I feel honored to be a Latinx CRNA, representing my culture through the care of my patients and being a familiar face for them and a communication tool in their preoperative journey. I'm committed to my profession and the safety my patients.”





🩺💙 For additional #HispanicCRNA stories in our #HispanicHeritageMonth blog series, click here.









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The orgullo, or pride, felt by many Hispanics who are living the American dream is a sentiment expressed by Rigo Lemus, Certified Registered Nurse Anesthetist (CRNA). He shares his experience of being both a health-care hero and an American hero. Thank you for serving our country, Rigo, and happy National Hispanic Heritage Month!

“As a recent graduate of the Allegheny School of Anesthesia at Duquesne University, I’m extremely proud to be a Latino CRNA. Being a second-generation immigrant, you are born with the weight of your parents’ dreams and struggles.


My Honduran parents came to this country with little to no English. I was often asked: ‘How could I not be successful if I was born here and know the language?’ This was usually followed with a motivational idiom like, “ponte las pilas,” which I think translates loosely to “put the batteries in.” So, with the “batteries in,” I went to work.


I proudly served in the U.S. Air Force during the Iraq War. Within a week of being honorably discharged, I started nursing school and worked for 10 years as a nurse. I started on a tele-floor and kept moving up until I worked a few years in a CTICU, always believing that one day I would reach my goal of being a CRNA. Now, as I embark on a new career, I am grateful for my Latin roots. All the years of hard work seem to have paid off just like my parents always preached to me: That an immigrant’s son can accomplish anything he puts his mind to with a little hard work and orgullo.”




🩺💙 For additional #HispanicCRNA stories in our #HispanicHeritageMonth blog series, click here.


Follow us on social for these updates and more!


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