Michigan Association of Nurse Anesthetists

Eliminating Michigan’s CRNA Supervision Law

Goal: To build support for passing Michigan House Bill 4359 which would remove the supervision requirement for nurse anesthetists in the state


Michigan has around 2,600 Certified Registered Nurse Anesthetists (CRNAs) who manage anesthesia in surgeries and other medical settings. The Michigan Association of Nurse Anesthetists (MANA) tried for many years to get lawmakers to align Michigan’s anesthesia regulations with the vast majority of states that allowed CRNAs to practice independent of mandatory physician supervision. In 2021, MANA asked Martin Waymire to assist it in getting legislation passed, House Bill 4359, that would remove the supervision requirement.

Martin Waymire created and executed a strategy to educate lawmakers and key audiences about the need for change, support the bill through the legislative process and counter opposing messages from physicians and physician anesthesiologists. In doing so, Martin Waymire relied on its experience working with MANA in previous years to lift the supervision requirement, including planning and organizing a 2015 video campaign to promote removing the requirement that was viewed by almost 800,000 and, in 2020, organizing the “CRNAs Now” campaign to generate support for CRNAs during the pandemic in key legislative districts.

Action Plan & Communication Overview:

To carry out its 2021 strategy, Martin Waymire employed a combination of earned media, digital media and direct advocacy for the bill. Ahead of the bill introduction, Michigan health care reporters were briefed on the legislation through a Zoom press conference that featured legislators and CRNAs explaining the need for HB 4359 and answering reporters’ questions. A press release on the bill’s introduction was sent to the Capitol press corps, op-eds featuring bill advocates were placed in major publications and newspapers were contacted urging them to write editorials supporting the legislation.

Social and digital media graphics were created by the Martin Waymire team and used in a paid Facebook campaign targeted to the geographical districts of lawmakers critical to passage of the bill. Martin Waymire oversaw the creation of a video for news media to use and used resulting clips for targeted social media promotion. Martin Waymire mobilized MANA members to support the bill by providing sample letters they could send to the media or to their respective lawmakers to support the bill. Graphics, including an infographic, were either created or updated for use during the campaign.


 HB 4359 passed with overwhelming support, removing the physician supervision requirement after years of effort. Martin Waymire was able to rely on its experience and deliverables from previous work with MANA to provide the momentum needed to persuade lawmakers to pass the bill. Among its successful efforts, Martin Waymire engaged health care reporters on the issue and secured positive press and op-eds about eliminating the physician supervision requirement. The targeted social media posts and paid ads played an important part in educating lawmakers so they understood why the law needed to change. The successful passage of this law resulted in Martin Waymire working with the Virginia Association of Nurse Anesthetists to eliminate a similar supervision requirement in that state.

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