The definitive source of
leadership, advocacy and
education for nurse
anesthesiology in
California.
AB 876 (Flora) protects timely & affordable access to anesthesia services
AB 876 incorporates well-established law into the Nursing Practice Act to maintain Certified Registered Nurse
Anesthetists (CRNAs) ability to provide anesthesia services without physician supervision in California.
It does not create new policies – the bill codifies the 2012 appellate decision in California Society of
Anesthesiologists v Brown.
Despite CRNAs’ longstanding independence – and more than 40 years of proven safe, effective, and efficient
anesthesia care – misinterpretations persist, placing an undue burden on facility administrators and undermining
access to high-quality anesthesia services.
By reaffirming CRNAs’ independent authority, California can address its staffing crisis, prevent costly disruptions,
and increase access to safe, timely anesthesia care.
What is a CRNA?
In California, certified registered nurse
anesthesiologists / anesthetists (CRNAs) have
practiced independently - without physician
supervision - for decades. They administer every
type of anesthesia in any health care setting.
Countless studies find CRNAs as safe and effective
as physician anesthesiologists, including when
practicing independently and in complex cases.
CRNAS are extensively educated, advanced
practice registered nurses specializing in
anesthesia care.
Minimum of 7 - 8½ yrs of education & training
specific to nursing & anesthesiology before
CRNAs are licensed to practice anesthesia.
CRNAs must pass a National Certification
Examination for entry into practice and be re-
certified every 4 years.
Starting in 2025, CRNAs must possess a
Doctoral Degree from a COA-accredited
nurse anesthesia educational program.
CRNAs obtain an average of 9,369 clinical
hours of training prior to becoming a CRNA.
As the demand for care grows, increasing the
number of CRNAs will be key to containing
costs while maintaining quality care.
Did You Know?
CRNAs are the sole anesthesia providers in 4 rural
counties in California, and provide more than 80%
of rural anesthesia nationwide.
Four California counties (7%) rely solely on CRNA
anesthesia services: Colusa, Lassen, Modoc, and Trinity.
CRNAs administer anesthesia independently of physician
anesthesiologists in all practice settings in the 51 counties
(94%) where surgical, obstetric and trauma services are
provided.
Four counties do not currently offer any anesthesia
services (Alpine, Glenn, Mariposa, and Sierra).
Modoc
Lassen
Trinity
Colusa
Surgical or chronic pain can be managed
without opioids. CRNAs are trailblazers in
this form of anesthesia care.
By virtue of education and individual clinical
experience and competency, a CRNA may
practice chronic pain management utilizing a
variety of therapeutic, physiological,
pharmacological, interventional, and
psychological modalities in the management
and treatment of pain.
Trailblazers in Pain Management
About CRNAs
CRNAs, or nurse anesthesiologists, have been providing anesthesia to patients in the United States for more
than 150 years. CRNAs are advanced practice registered nurses (APRNs) who have completed an accredited
graduate level nurse anesthesia program and passed a national certifying examination; starting in 2025,
CRNAs must graduate from an accredited Doctoral Nurse Anesthesiology Program.
Qualified to administer all types of anesthetics independently, CRNAs work in every setting in which
anesthesia is delivered, including hospitals, ambulatory surgical centers and physician/dental offices. CRNA
services include pre-anesthesia evaluation, administering the anesthetic, monitoring and interpreting the
patient’s vital signs and managing the patient throughout surgery. In California, CRNAs are the sole
anesthesia providers in 4 counties, and the primary provider in most rural areas, ensuring patient access to
obstetrical, surgical, trauma stabilization and pain management services.
The California Association of Nurse Anesthesiology (CANA) is the definitive source of leadership, advocacy
and education for the CRNAs of California.