Amd §§6542, 902 & 6810, Ed L; amd §§3701, 3702, 3703 & 3302, Pub Health L
Modifies physician assistant standards in the state of New York by allowing physician assistants to practice without supervision if they have practiced for more than eight thousand hours or completed a program approved by the department of education and department of health, as well as, expanding where physician assistants can practice and their ability to treat patients; requires the department of education and department of health to develop rules and regulations for such new standards.
STATE OF NEW YORK
________________________________________________________________________
8378
2023-2024 Regular Sessions
IN ASSEMBLY
December 13, 2023
___________
Introduced by M. of A. PAULIN -- read once and referred to the Committee
on Higher Education
AN ACT to amend the education law and the public health law, in relation
to amending physician assistant practice standards
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Section 6542 of the education law, as amended by chapter 48
2 of the laws of 2012, subdivisions 3 and 5 as amended by section 1 of
3 part T of chapter 57 of the laws of 2013, is amended to read as follows:
4 § 6542. Performance of medical services. 1. Notwithstanding any other
5 provision of law, a physician assistant may perform medical services,
6 but only when under the supervision of a physician and only when such
7 acts and duties as are assigned to him or her are within the scope of
8 practice of such supervising physician unless otherwise permitted by
9 this section.
10 2. [Supervision shall be continuous but shall not be construed as
11 necessarily requiring the physical presence of the supervising physician
12 at the time and place where such services are performed] A physician
13 assistant may practice without the supervision of a physician under the
14 following circumstances:
15 (a) where the physician assistant, licensed under section sixty-five
16 hundred forty-one of this article has practiced for more than eight
17 thousand hours; and
18 (i) is practicing in primary care. For the purposes of this paragraph,
19 "primary care" shall mean non-surgical care in the fields of general
20 pediatrics, general adult medicine, general geriatric medicine, general
21 internal medicine, obstetrics and gynecology, family medicine, or such
22 other related areas as determined by the commissioner of health; or
23 (ii) is employed by a health system or hospital established under
24 article twenty-eight of the public health law, and the health system or
25 hospital determines the physician assistant meets the qualifications of
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD13627-01-3
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1 the medical staff bylaws and the health system or hospital gives the
2 physician assistant privileges; and
3 (b) where a physician assistant licensed under section sixty-five
4 hundred forty-one of this article has completed a program approved by
5 the department of health, in consultation with the department, when such
6 services are performed within the scope of such program.
7 3. [No physician shall employ or supervise more than four physician
8 assistants in his or her private practice] Where supervision is required
9 by this section, it shall be continuous but shall not be construed as
10 necessarily requiring the physical presence of the supervising physician
11 at the time and place where such services are performed.
12 4. Nothing in this article shall prohibit a hospital from employing
13 physician assistants provided they [work under the supervision of a
14 physician designated by the hospital and not beyond the scope of prac-
15 tice of such physician. The numerical limitation of subdivision three of
16 this section shall not apply to services performed in a hospital] meet
17 the qualifications of the medical staff bylaws and are given privileges
18 and otherwise meet the requirements of this section.
19 5. [Notwithstanding any other provision of this article, nothing shall
20 prohibit a physician employed by or rendering services to the department
21 of corrections and community supervision under contract from supervising
22 no more than six physician assistants in his or her practice for the
23 department of corrections and community supervision] A physician assist-
24 ant shall be authorized to prescribe, dispense, order, or procure items
25 to commence or complete a course of therapy.
26 6. [Notwithstanding any other provision of law, a trainee in an
27 approved program may perform medical services when such services are
28 performed within the scope of such program] (a) A physician assistant
29 may prescribe and order a patient specific order or non-patient specific
30 regimen to a licensed pharmacist or registered professional nurse,
31 pursuant to regulations promulgated by the commissioner of health, and
32 consistent with the public health law, for:
33 (i) administering immunizations;
34 (ii) the emergency treatment of anaphylaxis;
35 (iii) administering purified protein derived (PPD) tests or other
36 tests to detect or screen for tuberculosis infections;
37 (iv) administering tests to determine the presence of the human immu-
38 nodeficiency virus;
39 (v) administering tests to determine the presence of the hepatitis C
40 virus;
41 (vi) the urgent or emergency treatment of opioid related overdose or
42 suspected opioid related overdose;
43 (vii) screening of persons at increased risk of syphilis, gonorrhea,
44 and chlamydia;
45 (viii) administering electrocardiogram tests to detect signs and symp-
46 toms of acute coronary syndrome;
47 (ix) administering point-of-care blood glucose tests to evaluate acute
48 mental status changes in persons with suspected hypoglycemia;
49 (x) administering tests and intravenous lines to persons that meet
50 severe sepsis and septic shock criteria; and
51 (xi) administering tests to determine pregnancy.
52 (b) Nothing in this subdivision shall authorize unlicensed persons to
53 administer immunizations, vaccines, or other drugs.
54 7. Where a physician assistant licensed under section sixty-five
55 hundred forty-one of this article has completed a program approved by
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1 the department of health, in consultation with the department, when such
2 services are performed within the scope of such program.
3 8. Nothing in this article, or in article thirty-seven of the public
4 health law, shall be construed to authorize physician assistants to
5 perform those specific functions and duties specifically delegated by
6 law to those persons licensed as allied health professionals under the
7 public health law or this chapter.
8 § 2. Subdivision 1 of section 3701 of the public health law, as
9 amended by chapter 48 of the laws of 2012, is amended to read as
10 follows:
11 1. to promulgate regulations defining and restricting the duties
12 [which may be assigned to] of physician assistants [by their supervising
13 physician, the degree of supervision required and the manner in which
14 such duties may be performed] consistent with section sixty-five hundred
15 forty-two of the education law;
16 § 3. Subdivisions 1 and 3 of section 3702 of the public health law, as
17 amended by chapter 48 of the laws of 2012, are amended to read as
18 follows:
19 1. Inpatient medical orders. A licensed physician assistant employed
20 or extended privileges by a hospital may, if permissible under the
21 bylaws, rules and regulations of the hospital, write medical orders,
22 including those for controlled substances and durable medical equipment,
23 for inpatients [under the care of the physician responsible for his or
24 her supervision. Countersignature of such orders may be required if
25 deemed necessary and appropriate by the supervising physician or the
26 hospital, but in no event shall countersignature be required prior to
27 execution].
28 3. Prescriptions for controlled substances. A licensed physician
29 assistant, in good faith and acting within his or her lawful scope of
30 practice, and to the extent assigned by his or her supervising
31 physician, as applicable pursuant to section sixty-five hundred forty-
32 two of the education law, may prescribe controlled substances as a prac-
33 titioner under article thirty-three of this chapter, to patients under
34 the care of such physician responsible for his or her supervision. The
35 commissioner, in consultation with the commissioner of education, may
36 promulgate such regulations as are necessary to carry out the purposes
37 of this section.
38 § 4. Section 3703 of the public health law, as amended by chapter 48
39 of the laws of 2012, is amended to read as follows:
40 § 3703. Statutory construction. A physician assistant may perform any
41 function in conjunction with a medical service lawfully performed by the
42 physician assistant, in any health care setting, that a statute author-
43 izes or directs a physician to perform and that is appropriate to the
44 education, training and experience of the licensed physician assistant
45 and within the ordinary practice of the supervising physician, as appli-
46 cable pursuant to section sixty-five hundred forty-two of the education
47 law. This section shall not be construed to increase or decrease the
48 lawful scope of practice of a physician assistant under the education
49 law.
50 § 5. Paragraph a of subdivision 2 of section 902 of the education law,
51 as amended by chapter 376 of the laws of 2015, is amended to read as
52 follows:
53 a. The board of education, and the trustee or board of trustees of
54 each school district, shall employ, at a compensation to be agreed upon
55 by the parties, a qualified physician, a physician assistant, or a nurse
56 practitioner to the extent authorized by the nurse practice act and
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1 consistent with subdivision three of section six thousand nine hundred
2 two of this chapter, to perform the duties of the director of school
3 health services, including any duties conferred on the school physician
4 or school medical inspector under any provision of law, to perform and
5 coordinate the provision of health services in the public schools and to
6 provide health appraisals of students attending the public schools in
7 the city or district. The physicians, physicians assistants, or nurse
8 practitioners so employed shall be duly licensed pursuant to applicable
9 law.
10 § 6. Subdivision 5 of section 6810 of the education law, as added by
11 chapter 881 of the laws of 1972, is amended to read as follows:
12 5. Records of all prescriptions filled or refilled shall be maintained
13 for a period of at least five years and upon request made available for
14 inspection and copying by a representative of the department. Such
15 records shall indicate date of filling or refilling, [doctor's]
16 prescriber's name, patient's name and address and the name or initials
17 of the pharmacist who prepared, compounded, or dispensed the
18 prescription. Records of prescriptions for controlled substances shall
19 be maintained pursuant to requirements of article thirty-three of the
20 public health law.
21 § 7. Subdivision 27 of section 3302 of the public health law, as
22 amended by chapter 92 of the laws of 2021, is amended to read as
23 follows:
24 27. "Practitioner" means:
25 A physician, physician assistant, dentist, podiatrist, veterinarian,
26 scientific investigator, or other person licensed, or otherwise permit-
27 ted to dispense, administer or conduct research with respect to a
28 controlled substance in the course of a licensed professional practice
29 or research licensed pursuant to this article. Such person shall be
30 deemed a "practitioner" only as to such substances, or conduct relating
31 to such substances, as is permitted by [his] their license, permit or
32 otherwise permitted by law.
33 § 8. This act shall take effect on the one hundred twentieth day after
34 it shall have become a law. Effective immediately, the department of
35 education and the department of health are authorized to promulgate,
36 amend and/or repeal any rule or regulation necessary for the implementa-
37 tion of section one of this act on or before such effective date.
