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Times Union Letter to the Editor

Legislature could improve rural health care with nurse anesthetist bill

Letter to the editor of the Times Union regarding Officials say updates N.Y. Health infrastructure in Danger, Dec 5, 2023

Mark Blazey, Rochester

For healthcare to remain viable in rural New York, lawmakers must address outdated healthcare delivery models and Medicaid reimbursement in anesthesia. 

The primary providers of anesthesia in rural hospitals are Certified Registered Nurse Anesthetists (CRNAs). Though highly trained, advanced practice providers, we face unnecessary barriers to practice. A CRNA’s scope of practice is not formally written into New York State law. New York is the only state to not formally recognize CRNAs, leading to staffing and financial shortages. Nearly a third of CRNAs trained in New York between 2018 and 2023 have left to practice in other states.

Some1500 CRNAs provide essential care to rural Medicaid patients yet lack of recognition in state law. As a result, hospitals may not be reimbursed for services provided to Medicaid beneficiaries --ruinous for New York’s rural healthcare system. 

Additional barriers to practice, such as physician supervision of CRNAs, comes with an unnecessarily high price tag for patients and medical facilities; study after study prove this redundancy does not increase patient safety or improve outcomes. CRNAs have the skills, the education and expertise to provide rural patients with anesthesia care and pain management services and ensure access to care for populations that would otherwise have to travel long distances from their homes for treatment.

The legislature must pass S769-A/A6958-A, which would move the state toward innovative, evidence-based health care, increasing access to care in rural New York.

The writer is the president of the New York State Association of Nurse Anesthetists
Published December 25, 2023

Mark Blazey's Testimony on the Healthcare Workforce Shortage


Assembly Health Committee Chair Paulin, Assembly Mental Health Chair Gunther, Assembly Committee on People with Disabilities Chair Seawright, Assembly Higher Education Committee Chair Fahy, Assembly Labor Committee Chair Joyner and members of the respective committees, I thank you for this opportunity to submit written testimony for your consideration as you look at the status of the health care workforce in New York State.

My name is Mark Blazey, and I am the President of the New York State Association of Nurse Anesthetists (NYSANA). NYSANA is the statewide professional association representing New York’s nearly 2,200 Certified Registered Nurse Anesthetists (CRNAs) and Resident Registered Nurse Anesthetists (RRNAs). NYSANA has been advocating for state recognition for CRNAs as advanced practitioners commensurate with their national certification, advanced education, clinical training, and experience for over 30 years. One of the most important ways to address the health care workforce issues in New York is....(read on)

Summer Newsletter

The August newsletter covers the following topics:


  • President's newsletter including decison to hold a virtual spring meeting
  • Member poll: District meetings
  • Legislative Update
  • Board Election Update
  • Fall Meeting with Twin Oaks Workshop — click here to register
  • Upcoming Calendar

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June 2023 Newsletter

Stay up-to-date on the latest NYSANA news.

June's newsletter covers the following topics:

  • President’s Message 
  • Legislative Update: end of session 2023
  • Spectrum News Story
  • Invitation to join a NYSANA Committee
  • Peer Wellness
  • NYSANA Election Update
  • Fall Meeting with Twin Oaks Workshop
  • Liberty District Meeting

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Spectrum News Covers NYSANA Fight for Title

Spectrum News featured Sean McGarry and Jeremy Lombardoni in a 3-minute long story which aired Saturday June 3. The story underscores the meaning and importance of title recognition to our profession and healthcare in New York state.

Sean highlights our essential role in providing access to critical anesthesia services in rural and underserved areas. He explains how the passing of legislation would recognize CRNAs formally in state education law to increase both the quality and access to the anesthesia and surgical services across the state.

Jeremy's and Dr. Peter Dowling's story highlights the CRNA's role in addressing the opioid epidemic through opioid-free anesthesia. Jeremy also had a chance to explain the true meaning of physician supervision in anesthesia.

 We are grateful to all who contributed to this story.

Watch and share now

Improving healthcare for LGBTQIA+ Community

June is national LGBTQIA+ pride month. The meaning of Pride month is just as varied and multifaceted as the individuals that make up this unique and diverse community. Pride month is a time to reflect on what it means to live in one's most genuine and authentic truth and to express that truth in a way that is unabashed. Pride is also a time to reflect on the progress that the LGBTQIA+ community has made when it comes to rights and civil liberties while also highlighting further opportunities to close gaps in equity. During pride month the community comes together in the form of parades and celebrations to openly show support for each other and for those that are not yet comfortable living in their truth so that they feel less isolated.

The intersections of the queer community and healthcare highlight a history of disparity based on gender expression and sexual orientation that has been rooted in implicit bias, institutional barriers, and a lack of training in regard to specific community needs. This disparity manifests as decreased access to healthcare, increased prevalence of preventable medical conditions, and increased morbidity and mortality related to mental health when compared to the general population. This disparity becomes even more profound when compounded with belonging to other traditionally underserved communities. We as a society have made great strides in improving these conditions but there is still much work to be done.

Opportunities for improvement include but aren't limited to:

- Inclusive sexual health education
- Increased funding to public health resources
- Intentional health screening for queer patients that highlights disease prevention and mental health while maintaining a nonjudgmental atmosphere
- Improved employer benefits for same-sex partners
- Healthcare benefits that include access to gender-affirming care
- Legislation that makes discrimination based on gender expression and sexual orientation illegal on a federal level
- Inclusive and intentional education for healthcare providers about the history of disparity and the specific health needs of the LGBTQIA+ community
- Active recruitment of healthcare providers from the LGBTQIA+ community to help identify and bridge gaps in care that can lead to disparity

As this Pride month begins, now is the time to engage in conversations with our colleagues, teams, departments, and employers about what policies are in place to protect and serve members of the LGBTQIA+ community who are seeking care as well as those who are providing care. Together we can help to make our places of healing to be open and equitable to everyone under the rainbow. 

CBS News Coverage of Advocacy Day 2023

Watch Advocacy Day New Coverage on CBS

NYSANA in New York Daily News

Rural Healthcare Op-Ed by NYSANA members

Thank you to Elyse Gallo, CRNA, Michael Thamsen, CRNA and Sean McGarry, CRNA, for submitting this opinion piece to the New York Daily News, discussing CRNAs practicing at the top of their license as a viable solution to New York's rural healthcare crisis. See Page 6.

Buffalo News Op Ed

Another Voice: Supervision of CRNAs is unnecessary and impedes care

Read President Sean McGarry's op-ed in the Buffalo News.

"Removing unnecessary supervision requirements increases access to care for all New Yorkers. This must be the priority. Right now, New York is the only state in the country that has not formally recognized the title and scope of practice of a CRNA. No more waiting! New York needs to come through for its CRNAs."


April Newsletter

Stay up-to-date on the latest NYSANA news.

In this month's newsletter, NYSANA President, Sean McGarry celebrates the profession of CRNAs.

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February 2023 Newsletter

Stay up-to-date on the latest NYSANA news.

In this month's newsletter, NYSANA President, Sean McGarry discusses the legislative agenda 

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Spectrum News Coverage of Sim Day

Simulation day at the Capital was a great success! We were pleased that news coverage featured NYSANA President Sean McGarry and the testimony of patient Michael Boots. You can watch it here.

Our next meeting at the state capital will be Tuesday, May 9, 2023. This is NYSANA's annual Advocacy Day where we will meet with legislators and push for our legislation. We will show strength through our numbers! Please plan to represent the profession. Registration will close on Friday, April 7 to allow time for the GRC committee to set up meetings for you with your State Senators and Assemblymembers. We hope you will join us!!


AMC Residents win Goldie Brangman Award for 2022

Chris Erlichman, BSN, RN and Yanet Segura, BSN, RN receive the 2022 Goldie Brangman Award

Goldie Brangman, CRNA, MEd, MBA was an accomplished CRNA and exceptional mentor. Goldie served as the first and only African American President of the American Association of Nurse Anesthesiology and President of NYSANA from 1960 - 1961. She famously treated Dr. Martin Luther King Jr., after a near-fatal assassination attempt in 1958.

Every year at the Annual Fall Meeting the Goldie Brangman Award winner is announced. This year, two nurse anesthesia residents were named for their outstanding research and demonstrated work.

Chris Erlichman, BSN, RN and Yanet Segura, BSN, RN (Albany Medical College of Nurse Anesthesia) were recognized for their presentation on Evaluating Analgesic and Pulmonary Outcomes of Ultrasound-Guided Thoracic Fascial Plane Blocks as an Early Intervention in Multiple-Rib Fractures.

Read below to learn more about Chris and Yanet, their research and what it means to be named recipients.

Why is it important to be NYSANA members?

Yanet: Being NYSANA members can only solidify our induction into the profession that has provided anesthesia in the United States for over 150 years. As residents of New York State (the ONLY state remaining without a CRNA scope of practice bill), it is so imperative that we are part of this professional organization. As we fight for recognition, we aim to communicate how vital [CRNAs] are to patients and the country's healthcare system. We owe it to the future of nurse anesthesiology, a career we vigorously fought to join.  

Why does evaluating Analgesic and Pulmonary Outcomes of Ultrasound-Guided Thoracic Fascial Plane Blocks as an Early Intervention in Multiple-Rib Fractures interest or excite you?

Chris: As Trauma ICU nurses, we saw patients with multiple-rib fractures that could have benefited tremendously from regional anesthesia and analgesia. Implementing the latest techniques to combat pain, especially in those with chest trauma, is crucial to improving patient outcomes. We firmly believe many patients go without these services because of a lack of familiarity among those taking care of them daily. There should be a more diligent push to include anesthesia experts’ input wherever there is a conversation about pain management. Thus, as highly trained and skillful anesthesia providers, CRNAs should step up to the call. 

As we currently complete our education to become nurse anesthetists, we strive to practice to the full extent of our training, including using regional anesthesia for pain management across a broad patient population. Acknowledging this early on in our new career allows us to advance the profession, open the door for more jobs, and, most importantly, improve access to care for our patients.

What does it mean to you both to be awarded this recognition?

Yanet: As minority students who are both first-generation college graduates, we have a unique appreciation for this award. Ms. Brangman made considerable contributions to our profession, and we only hope to one day fill a small portion of her shoes. Here's to her providing the foundation while we stand on the shoulders of giants and try to contribute our piece to the history of nurse anesthesia.

What do you hope to gain from being members of NYSANA?

Chris: As students, we experienced and interacted with members of national and state organizations and saw firsthand how vital it is to the advancement of CRNAs. NYSANA provides the infrastructure needed for nurse anesthetists in New York to unite and protect this profession. We hope that with our active membership, we can tackle the challenges we face on our home turf.

President's address, September 2022

Stay up to date on the latest NYSANA news.

In this month's newsletter, NYSANA President, Giovanna Mahar, recaps her year and welcomes new President Sean McGarry

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NYSANA urges the U.S. Department of Veterans Affairs to create national standards of practice that will allow Certified Registered Nurse Anesthetists (CRNAs) to practice at the full extent of their training, education, and licensure.

As we take the time this month to honor the more than 892,000 veterans who live in New York State, it is important to remember that we owe America’s veterans far more than words of gratitude. They have earned the best, most timely healthcare—without long waits and red tape—through the Veterans Administration (VA). As President of the New York State Association of Nurse Anesthetists I urge the U.S. Department of Veterans Affairs to create national standards of practice that will allow Certified Registered Nurse Anesthetists (CRNAs) to practice at the full extent of their training, education, and licensure. Removing barriers so that advanced practice providers, including CRNAs, can practice to the top of the education and licensure is the right policy and honors those who have served our country.

This move will not only expand access to care for veterans but decrease wait times so that care can be delivered when they need it most, while decreasing the cost of that care for the VA.  In addition, it would allow the VA needed flexibility with rural facilities and providers working across state lines.

During the public health emergency caused by the COVID-19 pandemic, the unique skills and expertise of CRNAs have allowed us to step forward in a way few others can, to treat veterans and others, leading the way in terms of advanced airway and ventilation management, which have been essential in addressing the deadliest part of this unforgiving virus.

To help meet the needs of veterans during the COVID-19 pandemic, the VA issued Directive 1899 in April 2020, which encouraged VA medical facilities to utilize VA healthcare professionals to practice and operate within the full scope of their license, registration or certification to increase veterans’ access to healthcare. It is now time to make that action permanent.

National standards of practice will allow all healthcare professionals working in the VA system to have consistent scope and requirements of practice, notwithstanding any state license, registration or other requirements. Since nearly one-third of all VA medical facilities have one or more sites of care in another state, and 14 percent of licensed healthcare professionals employed by the VA have a state license, registration or certification in another state than their main VA medical facility, having national standards of practice would allow these providers to care for veterans where and when they need it most.

In 2016, the United States Federal Trade Commission (FTC) reviewed a proposed rule to remove physician supervision requirements for advanced practice nurses (APNs), including CRNAs. The FTC praised the proposed rule as a way to increase the VA’s “ability to provide timely, efficient, and effective” care for our nation’s veterans and increase their access to needed healthcare and decrease wait times for patient appointments. The FTC noted theses changes in the VA would also benefit healthcare consumers in private markets.

Yet today, while all other types of APNs can practice to the full extent of their training, education, and licensure, CRNAs cannot. In fact, CRNAs are the only advanced practice nurses without full practice authority in the VA healthcare system.

This is despite the fact that the ability of CRNAs to provide high-quality care, even under the most difficult circumstances, has been recognized by every branch of the U.S. military. CRNAs have full practice authority in the U.S. Army, Navy, and Air Force and are the predominant provider of anesthesia on forward surgical teams and in combat support hospitals, where 90 percent of forward surgical teams are staffed by CRNAs.

The current barrier to CRNA in the VA health system is an anti-competitive action recognized by the FTC, AMVETS, one of the largest veterans’ service organizations in the United States, and others. It is time to bust the healthcare monopoly within the VA and ensure our veterans have the care they need and deserve for their sacrifice and services.

Visit to ask New York State Congressional leaders to contact U.S. Department of Veterans Affairs (VA) Secretary Denis McDonough in support of the VA’s effort to establish National Standards of Practice for Healthcare Professionals, and to support allowing CRNAs to practice to the full extent of their education and training.


CRNAs provide critical service to the military and veterans

CRNAs are the primary providers of anesthesia care to U.S military personnel and our nation’s veterans. We thank these CRNAs for their critical service.

Nurses first provided anesthesia on the battlefields of the American Civil War. During World War I, nurse anesthetists became the predominant providers of anesthesia care to wounded soldiers on the front lines. Today, CRNAs have full practice authority in every branch of the military and are the primary providers of anesthesia care to U.S. military personnel on front lines, navy ships, and aircraft evacuation teams around the globe.

Learn more here.