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Alabama Yes The Council on Certification of Nurse Anesthetists. [Alabama Board of Nursing Admin. Code, 610-X-9-.01(1)(d)] Alaska Yes Current national certification or recertification. [Professional Regulations, Board of Nursing, 12 AAC 44.500(3)] Arizona Yes The National Board of Certification and Recertification for Nurse Anesthetists or another national certifying body recognized by the board of nursing. [Arizona Rev. Stat. Ann., vol. 10, Title 32, ch. 15, sec. 32-1634.03(A)(3)] Arkansas Yes A national certifying body recognized by the board of nursing. [Arkansas Code Ann., 17-87-302(a)(2)(B)] California Yes The California Board of Registered Nursing shall consider the standards of the Council on Certification of Nurse Anesthetists and the Council on Recertification of Nurse Anesthetists. [California Nurse Anesthetists Act, Art. 7, 2826(a)] The "Application to Use the Title of Nurse Anesthetist" issued by the Board of Registered Nursing states that a copy of the nurse's certificate from the Council on Certification or the Council on Recertification of Nurse Anesthetists must be returned with the application. Colorado Yes The AANA Council on Certification of Nurse Anesthetists. [Board of Nursing Rules and Regulations, ch. XIV, II, subsec. 2.3] Connecticut Yes The American Association of Nurse Anesthetists. [Conn. Gen. Stat., ch 378, 20-94a(a)(2)]

Delaware Yes Current certification by a national certifying body in the appropriate APRN role and at least one population focus. [24 Del. Code, subsection 1902(b)(1)] District of Columbia Yes The American Association of Nurse Anesthetists Council on Certification of Nurse Anesthetists or other nationally recognized, Board of Nursing approved certifying agency. [Board of Nursing Rules and Regulations, sec. 8.4] An applicant must receive a passing score on "the national certification examination by the Council on Certification of Nurse Anesthetists or any other nationally recognized certifying body accepted by the Board." [DCMR, Title 17, ch. 57, 5705.1] Florida Yes An appropriate specialty board, including but not limited to the Council on Certification of Nurse Anesthetists, or its predecessor. [Florida Statutes, section 464.012 (1)(b), Rules of the Florida Department of Health, Board of Nursing, Sections 64B9-4.002(2) and 64B9-4.002(3)(a)] Georgia Yes The Council on Certification of Nurse Anesthetists. [Rules and Regulations of the Georgia Board of Nursing, sec. 410-12-.04(1) and sec. 410-12-.12(1)] Page 2

Hawaii Yes Requirements for recognition as an advanced practice registered nurse include "[a] current, unencumbered certification of having passed a national certification examination that measures role and population-focused competencies and is recognized by the board. [Hawaii Rev. Stat., ch. 457, 457-8.5(5)] An applicant for recognition as an advanced practice registered nurse must send certain information to the board of nursing, including: "An official complete transcript of the master's degree in clinical nursing or nursing science sent directly from the school, or evidence of current certification in the nursing specialty sent directly from the recognized national certifying body...." [Hawaii Administrative Rules, sec. 16-89-83(3)] Idaho Yes An organization recognized by the Board of Nursing for the specified APRN role. [Administrative Rules of the Board of Nursing, IDAPA 23.01.01, sec. 285.03] Illinois Yes Council on Certification of the American Association of Nurse Anesthetists. [68 Ill. Adm. Code 1305, sec. 1305.20(a)(2)(C)(i)] Indiana Yes A "certified registered nurse anesthetist" is defined as being "properly certified by successfully completing the certification examination administered by the AANA's Council on Certification of Nurse Anesthetists or its predecessor..." [Indiana Code Ann., 25-23-1-1.4] Iowa Yes A national professional nursing certifying body approved by the board; includes the Council on Certification of Nurse Anesthetists. [Iowa Admin. Code 655-7.1(152)] Page 3

Kansas Yes "[T]o obtain authorization from the board of nursing to practice as a registered nurse anesthetist an individual shall... successfully [have] completed an examination approved by the board or [have] been certified by a national organization whose certifying standards are approved by the board as equal to or greater than the corresponding standards established under this act for obtaining authorization to practice as a registered nurse anesthetist." [Kansas Stat. Ann. 65-1152(a)(3)] Kentucky Yes The National Board on Certification and Recertification of Nurse Anesthetists. [Kentucky Board of Nursing Administrative Regulations, 201 KAR 20:056, sec. 3(2)(c)] Louisiana Yes 1 A nationally recognized certifying body such as the Council on Certification of Nurse Anesthetists or the Council on Recertification of Nurse Anesthetists. [La. Rev. Stat. 37 913(1)(b)] Maine Yes The Council on Certification of Nurse Anesthetists. [Rules and Regulations of the Maine State Board of Nursing, Chapter 8, 4(1)(B)] 1 "No registered professional nurse licensed in the state of Louisiana who has been employed to administer anesthetics for six months prior to October 1, 1976, shall be required to meet the requirements set forth in Paragraphs (1) [educational requirement] and (2) [certification requirement] of Subsection A herein, and such registered professional nurse may continue to administer anesthetics provided that such employment is continuous in the state of Louisiana and is not broken for a period of more than one year. However, any registered professional nurse licensed in this state who is employed to administer anesthetics after October 1, 1976, shall be required to meet the requirements of this Section." La. Rev. Stat. 37, 930(B)(1). Page 4

Maryland Yes The Council on Certification of Nurse Anesthetists or from another certifying body approved by the Board. [Regulations Governing the Practice of the Nurse Anesthetist, 10.27.06, sec.02(a)(5)] Massachusetts Yes A nationally recognized accrediting body approved by the Board for nurse anesthetists. [244 Code of Massachusetts Regulations 4.13(4)(a)(2)] Michigan No An applicant must possess current certification from the National Board on Certification and Recertification of Nurse Anesthetists (NBCRNA), or a successor organization to be granted specialty certification in Michigan. [Board of Nursing Admin. Rules, R 338.10404(c)] "Specialty certification" is not required to practice, but does entitle a provider to use the title "nurse anesthetist." [Board of Nursing Admin. Rules, R 338.10403] Therefore, according to the Michigan Association of Nurse Anesthetists (MANA), while you are not required to obtain specialty certification, you could not use any title that included "nurse anesthetist" without specialty certification. Practically speaking, the MANA indicates that hospitals would be reluctant to employ perpetually uncertified anesthetists due to increased liability and reimbursement problems. Minnesota Yes A national certifying body recognized by the board in the APRN role and population foci appropriate to educational preparation. [Minnesota Statutes, sec. 148.271(1a)(c)(4)] Page 5

Mississippi Yes A national certification organization recognized by the Board. [Rules and Regulations of the Mississippi Board of Nursing, Title 30, Part 2840, Rule 1.2(A)(8); NPA 73-15-20(1)(b)] Missouri Yes The Council on Certification of Nurse Anesthetists... or other nationally recognized certifying body approved by the board of nursing... [RSMo, sec. 335.016(8)] Montana Yes "Applicants seeking APRN licensure must pass the examination of and be certified by a national certifying body in the congruent area of specialization. [Montana Board of Nursing Rules, sec. 24.159.1414(3)] Nebraska Yes An applicant for a license under the Advanced Practice Registered Nurse Practice Act to practice as a certified registered nurse anesthetist shall: Submit evidence of current certification by the Council on Certification of Nurse Anesthetists. [Neb. Rev. Stat., 38-707(1)] Nevada Yes A nationally organized group recognized by the Nevada Board of Nursing. [Regulations of the Board of Nursing, 632.515(1)(d)] Page 6

New Hampshire Yes An applicant for a license to practice as an Advanced Practice Registered Nurse (includes nurse anesthetists) must "[b]e currently certified by a board-recognized national certifying body in the specialty for which the applicant was educated...." [New Hampshire Revised Statutes, 326-B:18(I)(c)] An applicant for an initial license to practice as an Advanced Practice Registered Nurse in the specialty area of certified nurse anesthetist must hold current certification from the Council on Certification of Nurse Anesthetists." [New Hampshire Code of Administrative Rules, Nur. 302.04(a)(5)] New Jersey Yes An applicant for certification as an advanced practice nurse [which includes CRNAs] shall complete a course of study and successfully complete an examination in an advanced practice nursing specialty credentialed by a national certifying agency, that is accredited by the American Board of Nursing Specialties and/or the National Commission for Certifying Agencies. [N.J.A.C. 13:37-7.1(b)] Each applicant for certification as an advanced practice nurse shall submit [p]roof that the applicant is currently certified by a national certifying agency that is accredited by the American Board of Nursing Specialties and/or the National Commission for Certifying Agencies. [N.J.A.C. 13:37-7.1(d)(4)] New Mexico Yes National board on certification & recertification of nurse anesthetists. [NMAC sec. 16.12.2.14(A)(4)] Page 7

New York Yes The Council on Certification of Nurse Anesthetists or other certifying examination which the commissioner finds to be substantially equivalent. [New York State Hospital Code 10 NYCRR 700.2] North Carolina Yes The Council on Certification of Nurse Anesthetists. [North Carolina Admin. Code T21:36.0226(b)(1)] North Dakota Yes A national nursing organization meeting criteria as established by the board. [North Dakota Century Code 43-12.1-09(2)(c)(2)] Ohio Yes Applicants must [s]ubmit documentation satisfactory to the board of having passed the certification examination of a national certifying organization approved by the board under section 4723.46 of the Revised Code to examine and certify, as applicable, nurse-midwives, registered nurse anesthetists, clinical nurse specialists, or nurse practitioners. [Ohio Revised Code, sec. 4723.41(A)(3)] The board of nursing shall establish a list of national certifying organizations approved by the board to examine and certify registered nurses to practice nursing specialties. [Ohio Revised Code, sec. 4723.46(A)] Oklahoma Yes The Council on Certification of Nurse Anesthetists. [Oklahoma Nursing Practice Act 567.3a(10)(a)(1)] Oregon Yes The American Association of Nurse Anesthetists (AANA) Council on Certification. [Oregon State Board of Nursing Rules, OAR sec. 851-052-0030(3)] Page 8

Pennsylvania Yes The Council on Certification or on Recertification of Nurse Anesthetists of the American Association of Nurse Anesthetists. [Rules and Regulations for Registered Nurses, 21.17(2)] Puerto Rico No Rhode Island Yes The American Association of Nurse Anesthetists Council on Certification of Nurse Anesthetists, or its predecessors or successors. [Rhode Island Nurse Practice Act, 5-34.2-3(c)] South Carolina Yes A board-approved credentialing organization. [Code of Laws of South Carolina, sec. 40-33-34(2)] South Dakota Yes An applicant for certification as a certified registered nurse anesthetist shall submit to the board of nursing written evidence, verified by oath, that said applicant has "passed any examination, written or oral, or both, which the board in its discretion may require." [South Dakota Codified Laws, Registered and Practical Nurses, 36-9-30.1(3)] "The applicant shall provide written evidence that the applicant has passed a board-approved examination that has been validated and scored in accordance with generally accepted testing procedures." [South Dakota Board of Nursing Administrative Rules, 20:48:05:01] Tennessee Yes " 'Advanced practice nurse' means a registered nurse with a Master's degree or higher in a nursing specialty and national specialty certification as a nurse practitioner, nurse anesthetist, nurse midwife, or clinical nurse specialist." [Tenn. Code Ann., Title 63, Chapter 7, sec. 63-7-126 (a)] Page 9

Texas Yes Nurses who graduate from an advanced practice program on or after January 1, 1996, must be certified by "a national certification body recognized by the board [of nurse examiners]." [Board of Nurse Examiners for the State of Texas Rules and Regulations 221.4(b)] Utah Yes Applicants for licensure as an advanced practice registered nurse (which includes CRNAs) must be currently certified by a program approved by the division in collaboration with the board [Utah Code, 58-31b-302 (4)(i)] An applicant for licensure as a CRNA shall pass the examination of the Council on Certification of Nurse Anesthetists. [Utah Administrative Code, R156-31b- 302c(1)(c)] Vermont Yes A national certifying organization which is recognized by the Vermont Board of Nursing. [Board of Nursing Administrative Rules, Chapter 4, Subch. 8(II)(A)(2)] Virginia Yes The Council on Certification of Nurse Anesthetists. Professional certification from other certifying agencies may be accepted by the board on the recommendation of the Committee of the Joint Boards of Nursing and Medicine provided that the certification is awarded on the basis of completion of an educational program meeting the Board of Nursing's criteria, and achievement of a passing score on an examination. [Nurse Practitioner Regulations, 18 VAC 90-30-90(A)(3)] Page 10

Virgin Islands Yes, under certain circumstances The Virgin Islands Board of Nurse Licensure may issue certificates attesting to the qualifications of the several nursing specialties provided that the certificate for each specialty "includes certification by a specialty board accepted by the former Virgin Islands Board of Nurse Examiners, or graduation from an accredited program leading to a Master's Degree in a nursing clinical specialty area..." [Virgin Islands Code Ann. Title 3, 96(a)(2)] The Virgin Islands Board of Nurse Licensure recognizes two categories of nurse anesthetists. A nurse may be categorized as either a (1) Certified Registered Nurse Anesthetist (CRNA) or (2) Registered Nurse Anesthetist (RNA). (1) "A Registered Nurse who has graduated from an approved program of Nurse Anesthesia and has successfully passed the American Association of Nurse Anesthetists Certification Boards shall be known as a Certified Registered Nurse Anesthetist - CRNA." (2) "A Registered Nurse who has graduated from an approved program of Nurse Anesthesia and is Board eligible shall be known as a Registered Nurse Anesthetist - RNA." [Virgin Islands Nurse Anesthetist Rules, (b)] Washington Yes For CRNA designation, the Council on Certification of Nurse Anesthetists. [Washington Admin. Code 246-840-302(2)] Page 11

West Virginia Yes "The practice of advanced practice registered nurse is a registered nurse who has acquired advanced clinical knowledge and skills preparing him or her to provide direct and indirect care to patients, who has completed a board-approved graduatelevel education program and who has passed a board-approved national certification examination. [Code of West Virginia, sec. 30-7-1(a)] Wisconsin Yes, under certain circumstances Nurse anesthetists are required to be currently certified by a national certifying body approved by the board [of nursing] to use the title advanced practice nurse or to be an advanced practice nurse prescriber. [Wisconsin Admin. Code, ch. N8, sec. N 8.02(1)(b) and N 8.03(2)] According to the Wisconsin Association of Nurse Anesthetists (WANA), legal counsel for the Wisconsin Department of Regulation and Licensure/Board of Nursing has indicated that a nurse anesthetist is not required to be an advanced practice nurse or an advanced practice nurse prescriber. An uncertified nurse anesthetist could not use the title advanced practice nurse and would not be eligible to become an advanced practice nurse prescriber. Bear in mind, however, that many facilities may not be willing to utilize perpetually uncertified nurse anesthetists. Wyoming Yes An advanced practice registered nurse is required to take and pass a national certification examination. [Wyoming Statutes, sec. 33-21-120(a)(i)(D)] Page 12

TOTALS: 49 states, the District of Columbia, and the Virgin Islands require certification. 1 state and Puerto Rico do not require certification. Page 13