For more than 30 years, NJANA has been committed to protecting the rights of our members and ensuring safe, affordable anesthesia care for patients by educating lawmakers and the public about issues that can potentially impact the ability of Certified Registered Nurse Anesthetists (CRNA) and Advanced Practice Nurses in Anesthesia (APN-A) to practice in New Jersey and beyond our borders.

  • NJANA welcomes meetings with legislators on the State and Federal level.
  • NJANA conducts frequent member surveys to understand key issues.
  • NJANA sponsors “Call to Action”  campaigns to allow our member voices to be heard on important issues.
  • NJANA provides information and resources to outline the impact of pending or current legislation or regulations.

Top NJ Issue #1: Joint Protocol

The COVID-19 Pandemic resulted in the Governor signing Executive Order #112 to temporarily lift the Joint Protocol practice in New Jersey to increase the number of nurse anesthetists available to assist where needed to provide care for patients across the state.

There is pending legislation currently in the Assembly Health Care Committee that would permanently remove the Joint Protocol in NJ it is called the “Consumer Access to Health Care Act ” A-1760.    This legislation would help to keep trained anesthesia professionals in the state and increase patient access to high quality, more affordable health care services.

The Issue: The “Joint Protocol” that was enacted in 2009 created an unfair, restrictive barrier that tied the hands of APN-Anesthesia and Certified Registered Nurse Anesthetists (CRNA) by only allowing them to work under the supervision of a licensed physician anesthesiologists. Prior to 2009, APN/CRNA’s could work under the supervision of qualified surgeons, dentists, dermatologists and other physicians. The restrictions of Joint Protocol are also causing a severe shortage of CRNA and APN professionals.

The Challenge:  With only 1,200 physician anesthesiologists and around 900 CRNA’s/APN-Anesthesia providers in the state, this severely restricts independent employment opportunities for advanced practice nurses, drives up the costs of anesthesia care and ultimately reduces the accessibility of quality anesthesia care for patients.

The Brain Drain: NJ institutions provide a rigorous but outstanding education for APN-A’s who graduate with doctorates and more than 10,000 hours of specialized medical training. 100 percent of all APN-A’s are nationally board-certified to practice anesthesia at the same level as our physician anesthesiologist colleagues. Unfortunately, 50% of these highly trained professionals leave to practice in states without “Joint Protocol”, such as NY, PA and DE, because of the tremendously different impact they can have on patient care.

The Climate: Over the past 25 years, 18 states have opted out of physician supervision of APN-A/CRNA’s because of proven cost-effectiveness and the exemplary safety records in every type of health care setting. Not one state has ever reversed that decision.

Top NJ Issue #2: Workforce Classification

Many nurse anesthesia professionals work as  “Independent Contractors” for multiple employers.  If  Senate Bill 863, is passed it could drastically change New Jersey’s legal definition of an independent contractor which could significantly impact the way CRNA/APN-A’s are employed.

Working as a 1099 provider comes with specific tax benefits in the form of income deductions and special retirement plans not offered to traditional company employees who typically file a 1040 tax form for a W-2 employment position with that company.  This type of regulation would restrict income options and autonomy within the profession.  Additionally, many offices would be more likely to turn away NJ based independent contractor CRNA/APN-A’s out of fear that they would have to hire them as a full-time W-2 employee.

A similar policy in California just passed creating chaos among freelance workers and small businesses.

If passed this bill will negatively impact not only CRNA/APN-A’s, but also all the locations anesthesia is needed, which could negatively impact the ability for patients in NJ to receive high quality, affordable anesthesia care.