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.