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A04846 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A4846B
 
SPONSOR: Gottfried (MS)
  TITLE OF BILL: An act to amend the education law, in relation to establishing the nurse practitioners modernization act; and providing for the repeal of such provisions upon the expiration thereof   PURPOSE OR GENERAL IDEA OF BILL: To limit the requirement of a collaboration agreement between a nurse practitioner and a physician as a condition for practice.   SUMMARY OF SPECIFIC PROVISIONS: The bill amends the nurse practitioner provisions in Education Law to modify the requirements for a written collaboration agreement and prac- tice protocols between a nurse practitioner (NP) and physician. It would only apply to NPs who have practiced for less than 3,600 hours. In limited cases, a collaborating physician may be substituted by a collab- orating NP who is past his or her written-collaboration term and is qualified to collaborate in the specialty involved. NPs who have successfully practiced beyond that period will be required to maintain "collaborative relationships" with physicians or Article 28 hospitals with written guidelines covering consultation, care coordi- nation, and emergency referral plans. The written guidelines, on a form provided by the Education Department, must be maintained by the NP and made available to his or her patients, and the department, upon request. Failure to do so will constitute misconduct. The department will survey physicians and NPs on their experience with the new requirements and report its findings and recommendations to the legislature by September 1, 2018. The act will sunset after 6 years, subject to renewal by the Legisla- ture.   JUSTIFICATION: Nurse practitioners practice in a variety of primary and specialty care settings. They are licensed and certified by the State Education Depart- ment to diagnose illness and physical conditions and perform therapeutic and corrective measures, order tests, prescribe medications, medical devices and immunizing agents and, when appropriate, refer patients to other health care providers, without direct supervision. In addition to their advance certification by the Nursing Board, many NPs are certified by national accrediting agencies in one or more practice specialty. Currently, New York requires a written collaboration agreement between an NP and an MD. Ps practice with complete independence in 13 states (AL, AZ, DC, IA, ID, ME, MT, NH, NM, OR, UT, WA, WY). Given the educa- tion, training and advanced certification of NPs, written collaborative agreements no longer serves a clinical purpose. Instead, the require- ment serves as a barrier to practice and a disincentive to advanced certification, and it restricts access to health care for individuals and families in underserved areas of the state.   PRIOR LEGISLATIVE HISTORY: 2008: A.10829 - referred to Higher Education committee 2009-10: A.765-B - referred to Higher Education committee 2011-2012: A.5308-A passed Assembly   FISCAL IMPLICATIONS: Reduces administrative costs for the State Education Department.   EFFECTIVE DATE: The first day of January following the date of enactment.
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