The Vermont Statutes Online

Title 26: Professions and Occupations

Chapter 029: Anesthesiologist Assistants

• Subchapter 001: General Provisions

• §§ 1601-1606. Repealed. 1979, No. 158 (Adj. Sess.), § 2.

• Subchapter 002: State Board of Examiners in Optometry

• §§ 1641-1645. Repealed. 1979, No. 158 (Adj. Sess.), § 2.

• § 1651. Definitions

  As used in this chapter:

  (1) “Anesthesiologist” means a person licensed to practice medicine or osteopathy under chapter 23 or 33 of this title and who either has completed a residency in anesthesiology approved by the American Board of Anesthesiology or the American Osteopathic Board of Anesthesiology or their predecessors or successors or is credentialed by a hospital to practice anesthesiology and engages in the practice of anesthesiology at that hospital full time.

  (2) “Anesthesiologist assistant” means a person certified by the State of Vermont under this chapter who is qualified by education, training, experience, and personal character to provide medical services under the direction and supervision of an anesthesiologist.

  (3) “Board” means the State Board of Medical Practice established under chapter 23 of this title.

  (4) “Contract” means a legally binding written agreement containing the terms of employment of an anesthesiologist assistant.

  (5) “Disciplinary action” means any action taken against a certified anesthesiologist assistant or an applicant by the Board or an appeal of that action when that action suspends, revokes, limits, or conditions certification in any way, or when it results in a reprimand of the person.

  (6) “NCCAA” means the National Commission for Certification of Anesthesiologist Assistants, or its successor, as recognized by the Board.

  (7) “Protocol” means a detailed description of the duties and scope of practice delegated by an anesthesiologist to an anesthesiologist assistant.

  (8) “Supervision” means the direction and review by the supervising physician, as determined to be appropriate by the Board, of the medical services provided by the anesthesiologist assistant. At a minimum, supervision shall mean that an anesthesiologist is readily available at the facility for consultation and intervention. (Added 2003, No. 34, § 1, eff. May 23, 2003.)

• § 1652. Certification and rulemaking

  The Board shall certify anesthesiologist assistants, and the Commissioner of Health shall adopt rules regarding the training, practice, supervision, qualification, scope of practice, places of practice, and protocols for anesthesiologist assistants, and patient notification and consent. (Added 2003, No. 34, § 1, eff. May 23, 2003.)

• § 1653. Application

  (a) Applications for certification shall be accompanied by an application by the proposed supervising anesthesiologist that shall contain a statement that the anesthesiologist shall be responsible for all professional activities of the anesthesiologist assistant.

  (b) Applications for certification shall be accompanied by a protocol signed by the proposed supervising anesthesiologist and a copy of the anesthesiologist assistant employment contract.

  (c) The applicant must submit to the Board any other information the Board considers necessary to evaluate the applicant’s qualifications. (Added 2003, No. 34, § 1, eff. May 23, 2003.)

• § 1654. Eligibility

  To be eligible for certification as an anesthesiologist assistant, an applicant shall have:

  (1) obtained a master’s degree from a board-approved anesthesiologist assistant program at an institution of higher education accredited by the Committee on Allied Health Education and Accreditation, the Commission on Accreditation of Allied Health Education Programs, or their successor agencies, or graduated from a Board-approved anesthesiologist assistant program at an institution of higher education accredited by the Committee on Allied Health Education and Accreditation or the Commission of Accreditation of Allied Health Education Programs, prior to January 1, 1984;

  (2) satisfactorily completed the certification examination given by the NCCAA and be currently certified by the NCCAA; and

  [Subdivision (3) effective 60 days after the adoption of board rules.]

  (3) if the applicant has not engaged in practice as an anesthesiologist assistant within the last three years, complied with the requirements for updating knowledge and skills as defined by Board rules. (Added 2003, No. 34, § 1, eff. May 23, 2003; amended 2011, No. 61, § 3, eff. June 2, 2011.)

• § 1655. Temporary certification

  (a) The Board may issue a temporary certification to a person who applies for certification for the first time in this State and meets the educational requirements under section 1654 of this title.

  (b) Temporary certification may be issued only for the purpose of allowing an otherwise qualified applicant to practice as an anesthesiologist assistant until the applicant takes and passes the next NCCAA examination, and a determination is made of his or her qualifications to practice in this State.

  (c) Temporary certification shall be issued on payment of the specified fee for a fixed period of time to be determined by the Board and shall only be renewed by the Board if the applicant demonstrates proof of an exceptional cause. (Added 2003, No. 34, § 1, eff. May 23, 2003.)

• § 1656. Renewal of certification

  (a) Certifications shall be renewed every two years. At least one month prior to the date on which renewal is required, the Board shall send to each anesthesiologist assistant a renewal application form and notice of the date on which the existing certification will expire. On or before the renewal date, the anesthesiologist assistant shall file an application for renewal, pay the required fee, and submit proof of current active NCCAA certification. The Board shall register the applicant and issue the renewal certification. Within one month following the date renewal is required, the Board shall pay the certification renewal fees into the Medical Practice Board Special Fund.

  [Subsection (b) effective 60 days after the adoption of board rules.]

  (b) A certification that has lapsed may be reinstated on payment of a renewal fee and a late renewal fee. The applicant shall not be required to pay back renewal fees for the periods when certification was lapsed. However, if such certification remains lapsed for a period of three years, the Board may require the applicant to update his or her knowledge and skills as defined by Board rules. (Added 2003, No. 34, § 1, eff. May 23, 2003; amended 2011, No. 61, § 3, eff. June 2, 2011.)

• § 1657. Supervision and scope of practice

  (a) The number of anesthesiologist assistants permitted to practice under the direction and supervision of a physician shall be determined by the Board after review of the system of care delivery in which the supervising anesthesiologist and anesthesiologist assistants propose to practice. The authority of an anesthesiologist assistant to practice shall terminate immediately upon dissolution of the anesthesiologist assistant’s employment contract, and the supervising anesthesiologist shall immediately notify the Board and the Commissioner of the Department of Health of such termination. The anesthesiologist assistant’s authority to practice shall not resume until he or she provides proof of another employment contract and protocol as approved under this chapter.

  (b) The anesthesiologist assistant’s scope of practice shall be limited to that delegated to the anesthesiologist assistant by the supervising anesthesiologist and for which the anesthesiologist assistant is qualified by education, training, and experience. At no time shall the practice of the anesthesiologist assistant exceed the normal scope of the supervising anesthesiologist’s practice. (Added 2003, No. 34, § 1, eff. May 23, 2003.)

• § 1658. Unprofessional conduct

  (a) The following conduct and the conduct described in section 1354 of this title by a certified anesthesiologist assistant constitutes unprofessional conduct. When that conduct is by an applicant or person who later becomes an applicant, it may constitute grounds for denial of certification:

  (1) fraud or misrepresentation in applying for or procuring an anesthesiologist assistant certificate or in connection with applying for or procuring a periodic renewal of an anesthesiologist assistant certificate;

  (2) occupational advertising that is intended or has a tendency to deceive the public;

  (3) exercising undue influence on, or taking improper advantage of, a person using the anesthesiologist assistant’s services, or promoting the sale of professional goods or services in a manner that exploits a person for the financial gain of the anesthesiologist assistant or of a third party;

  (4) failing to comply with provisions of federal or State statutes or rules governing the profession;

  (5) conviction of a crime related to the profession or conviction of a felony, whether or not related to the practice of the profession;

  (6) conduct that evidences unfitness to practice in the profession;

  (7) making or filing false professional reports or records, impeding or obstructing the proper making or filing of professional reports or records, or failing to file the proper professional report or record;

  (8) practicing the profession when mentally or physically unfit to do so;

  (9) failure to practice competently by reason of any cause on a single occasion or on multiple occasions constitutes unprofessional conduct. Failure to practice competently includes as determined by the Board:

  (A) performance of unsafe or unacceptable patient care; or

  (B) failure to conform to the essential standards of acceptable and prevailing practice;

  (10) accepting and performing responsibilities that the person knows or has reason to know that he or she is not competent to perform;

  (11) making any material misrepresentation in the practice of the profession, whether by commission or omission;

  (12) the act of holding one’s self out as, or permitting one’s self to be represented as, a licensed physician;

  (13) performing otherwise than at the direction and under the supervision of an anesthesiologist licensed by the Board;

  (14) accepting the delegation of, or performing or offering to perform, a task or tasks beyond the person’s scope of practice as defined by the Board;

  (15) administering, dispensing, or prescribing any controlled substance other than as authorized by law;

  (16) failing to comply with an order of the Board or violating any term or condition of a certification restricted by the Board;

  (17) delegating professional responsibilities to a person whom the certified professional knows, or has reason to know, is not qualified by training, experience, education, or licensing credentials to perform;

  (18) in the course of practice, gross failure to use and exercise on a particular occasion or the failure to use and exercise on repeated occasions that degree of care, skill, and proficiency which is commonly exercised by the ordinary skillful, careful, and prudent professional engaged in similar practice under the same or similar conditions, whether or not actual injury to a patient has occurred;

  (19) habitual or excessive use or abuse of drugs, alcohol, or other substances that impair the anesthesiologist assistant’s ability to provide medical services; or

  (20) revocation of certification to practice as an anesthesiologist assistant in another jurisdiction on one or more of the grounds specified in subdivisions (1)-(19) of this subsection.

  (b) A person aggrieved by a final order of the Board may, within 30 days of the order, appeal that order to the Vermont Supreme Court on the basis of the record created before the Board. (Added 2003, No. 34, § 1, eff. May 23, 2003; amended 2011, No. 61, § 3, eff. June 2, 2011.)

• § 1659. Disposition of complaints

  (a) Complaints and allegations of unprofessional conduct shall be processed in accordance with the rules of procedure of the Board.

  (b) Any person, firm, corporation, or public officer may submit a written complaint to the Board alleging any anesthesiologist assistant practicing in the State is engaged in unprofessional conduct, specifying the grounds. The Board shall initiate an investigation of an anesthesiologist assistant when a complaint is received or may act on its own initiative without having received a complaint.

  (c) After giving opportunity for hearing, the Board shall take disciplinary action described in subsection 1361(b) of this title against an anesthesiologist assistant or applicant found guilty of unprofessional conduct.

  (d) The Board may approve a negotiated agreement between the parties when it is in the best interest of the public health, safety, or welfare to do so. That agreement may include any of the following conditions or restrictions which may be in addition to, or in lieu of, suspension:

  (1) a requirement that the person submit to care or counseling;

  (2) a restriction that the person practice only under supervision of a named person or a person with specified credentials;

  (3) a requirement that the person participate in continuing education in order to overcome specified practical deficiencies;

  (4) a requirement that the scope of practice permitted be restricted to a specified extent;

  (5) an administrative penalty not to exceed $1,000.00 for each act that constitutes an unprofessional conduct violation. Any money received from the imposition of an administrative penalty imposed under this subsection shall be deposited into the Board of Medical Practice Regulatory Fee Fund and shall not be used for any other purpose other than professional regulation and other responsibilities of the Board, as determined by the Commissioner of Health.

  (e) Upon application, the Board may modify the terms of an order under this section and, if certification has been revoked or suspended, order reinstatement on terms and conditions it deems proper. (Added 2003, No. 34, § 1, eff. May 23, 2003; amended 2011, No. 61, § 3, eff. June 2, 2011.)

• § 1660. Use of title

  Any person who is certified to practice as an anesthesiologist assistant in this State shall have the right to use the title “anesthesiologist assistant” and the abbreviation “A.A.” No other person may assume that title or use that abbreviation, or any other words, letters, signs, or devices to indicate that the person using them is an anesthesiologist assistant. An anesthesiologist assistant shall not so represent himself or herself unless there is currently in existence a valid contract between the anesthesiologist assistant and his or her employer or supervising anesthesiologist, and unless the protocol under which the anesthesiologist assistant’s duties are delegated is on file with, and has been approved by, the Board. (Added 2003, No. 34, § 1, eff. May 23, 2003.)

• § 1661. Legal liability

  (a) The supervising anesthesiologist delegating activities to an anesthesiologist assistant shall be legally liable for such activities of the anesthesiologist assistant, and the anesthesiologist assistant shall in this relationship be the anesthesiologist’s agent.

  (b) Nothing in this chapter shall be construed as prohibiting an anesthesiologist from delegating to an anesthesiologist assistant certain activities relating to medical care and treatment now being carried out by custom and usage when such activities are under the control of the anesthesiologist. Nothing contained in this chapter shall be construed to apply to nurses acting pursuant to chapter 28 of this title. (Added 2003, No. 34, § 1, eff. May 23, 2003.)

• § 1662. Fees

  Applicants and persons regulated under this chapter shall pay the following fees:

  (1)(A)(i) Original application for certification, $120.00;

  (ii) Each additional application, $55.00;

  (B) The Board shall use at least $10.00 of these fees to support the cost of maintaining the Vermont Practitioner Recovery Network, which, for the protection of the public, monitors and evaluates, coordinates services for, and promotes rehabilitation of licensees who have or potentially have an impaired ability to practice medicine with reasonable skill and safety.

  (2)(A)(i) Biennial renewal, $120.00;

  (ii) Each additional renewal, $55.00;

  (B)(i) The Board shall use at least $10.00 of these fees to support the cost of maintaining the Vermont Practitioner Recovery Network, which, for the protection of the public, monitors and evaluates, coordinates services for, and promotes rehabilitation of licensees who have or potentially have an impaired ability to practice medicine with reasonable skill and safety.

  (ii) In addition to the fee, an applicant for certification renewal shall submit evidence in a manner acceptable to the Board that he or she continues to meet the certification requirements of the NCCAA.

  (3) Transfer of certification, $20.00. (Added 2003, No. 34, § 1, eff. May 23, 2003; amended 2003, No. 163 (Adj. Sess.), § 5; 2007, No. 76, § 19; 2011, No. 61, § 3, eff. June 2, 2011; 2015, No. 57, § 14; 2017, No. 39, § 4.)

• § 1663. Notice of use of anesthesiologist assistants

  An anesthesiologist that utilizes the services of an anesthesiologist assistant shall post a notice to that effect in an appropriate place and include language in the patient consent form that the anesthesiologist uses an anesthesiologist assistant. (Added 2003, No. 34, § 1, eff. May 23, 2003.)

• § 1664. Penalty

  (a) A person who, not being certified, holds himself or herself out to the public as being certified under this chapter shall be liable for a fine of not more than $10,000.00.

  (b) In addition to the penalty provided in subsection (a) of this section, the Attorney General or a State’s Attorney may bring a civil action to restrain continuing violations of this section. (Added 2003, No. 34, § 1, eff. May 23, 2003; amended 2011, No. 61, § 3, eff. June 2, 2011.)

• Subchapter 003: Registration

• §§ 1691-1696. Repealed. 1979, No. 158 (Adj. Sess.), § 2.