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A05308 Summary:

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A05308 Floor Votes:

A05308 Text:

 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         5308--A
 
                               2011-2012 Regular Sessions
 
                   IN ASSEMBLY
 
                                    February 15, 2011
                                       ___________
 
        Introduced  by  M.  of  A.  GOTTFRIED, GUNTHER, PAULIN, LIFTON, LUPARDO,
          ENGLEBRIGHT, GABRYSZAK, HOOPER, N. RIVERA, JAFFEE, SCARBOROUGH, ROSEN-
          THAL, CAHILL, PRETLOW,  ORTIZ,  BENEDETTO,  CASTRO,  GIBSON,  BRONSON,
          RUSSELL,  BRINDISI  -- Multi-Sponsored by -- M. of A. BRENNAN, CROUCH,
          CUSICK, GALEF, HEVESI, LATIMER, LAVINE, LENTOL, PEOPLES-STOKES, REILLY

          -- read once and referred to the  Committee  on  Higher  Education  --
          reported  and  referred  to  the Committee on Rules -- Rules Committee
          discharged, bill amended, ordered reprinted as amended and recommitted
          to the Committee on Rules
 
        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
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 
     1    Section 1. Short title. This act shall be known and may  be  cited  as
     2  the "nurse practitioners modernization act".
     3    §  2.  Subdivision 3 of section 6902 of the education law, as added by
     4  chapter 257 of the laws of 1988, is amended to read as follows:

     5    3. (a) (i) The practice of registered professional nursing by a  nurse
     6  practitioner,  certified  under section six thousand nine hundred ten of
     7  this article and practicing for fewer than thirty-six months  and  three
     8  thousand  six  hundred  hours,  may include the diagnosis of illness and
     9  physical conditions and the performance of  therapeutic  and  corrective
    10  measures  within  a  specialty area of practice, in collaboration with a
    11  licensed physician qualified to collaborate in the  specialty  involved,
    12  provided  such services are performed in accordance with a written prac-
    13  tice agreement and written  practice  protocols.  The  written  practice
    14  agreement  shall  include  explicit provisions for the resolution of any
    15  disagreement between the collaborating physician and the  nurse  practi-

    16  tioner  regarding  a matter of diagnosis or treatment that is within the
    17  scope of practice of both. To the extent the practice agreement does not
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD01405-03-2
        A. 5308--A                          2
 
     1  so provide, then the collaborating physician's  diagnosis  or  treatment
     2  shall  prevail.    In  the  event  that (i) an existing written practice
     3  agreement with a collaborating physician terminates as a result  of  the
     4  collaborating physician moving, retiring, no longer needing the services
     5  of the nurse practitioner, no longer being qualified to practice or upon

     6  his  or  her  death and the nurse practitioner is unable to enter into a
     7  new written practice agreement with another collaborating physician;  or
     8  if (ii) a nurse practitioner obtains approval by the department based on
     9  a  demonstration  to  the  department  that an existing written practice
    10  agreement was terminated due to no fault on the part of the nurse  prac-
    11  titioner,  and that the nurse practitioner is unable to enter into a new
    12  written  practice  agreement  within  another  collaborating   physician
    13  following a showing of good faith effort; then:  such nurse practitioner
    14  may  continue  to practice pursuant to this paragraph within a specialty
    15  area of practice for a period of up to six months, in collaboration with

    16  a nurse practitioner who has been certified under section  six  thousand
    17  nine  hundred ten of this article, who has been practicing for more than
    18  thirty-six months and three thousand six hundred hours and who is quali-
    19  fied to collaborate in the specialty involved,  provided  that  services
    20  are  performed in accordance with a written practice agreement and writ-
    21  ten practice protocols; such six month  time  period  for  collaboration
    22  between  nurse practitioners may be extended for a period of time not to
    23  exceed an additional six months upon a showing of good cause subject  to
    24  the approval of the department.
    25    [(b)]  (ii) Prescriptions for drugs, devices and immunizing agents may

    26  be issued by a nurse practitioner, under  this  [subdivision]  paragraph
    27  and section six thousand nine hundred ten of this article, in accordance
    28  with  the  practice  agreement and practice protocols. The nurse practi-
    29  tioner shall obtain a certificate from the department upon  successfully
    30  completing a program including an appropriate pharmacology component, or
    31  its  equivalent, as established by the commissioner's regulations, prior
    32  to prescribing  under  this  [subdivision]  paragraph.  The  certificate
    33  issued under section six thousand nine hundred ten of this article shall
    34  state  whether  the nurse practitioner has successfully completed such a
    35  program or equivalent and is authorized to prescribe under this  [subdi-
    36  vision] paragraph.

    37    [(c)]  (iii) Each practice agreement shall provide for patient records
    38  review by the collaborating physician or, where applicable, the  collab-
    39  orating  nurse  practitioner,  in  a timely fashion but in no event less
    40  often than every three months. The names of the nurse  practitioner  and
    41  the  collaborating  physician  or,  where  applicable, the collaborating
    42  nurse practitioner shall be clearly posted in the  practice  setting  of
    43  the nurse practitioner.
    44    [(d)]  (iv)  The  practice  protocol  shall  reflect  current accepted
    45  medical and nursing practice, or where applicable the  current  accepted
    46  nursing  practice.    The  protocols  shall be filed with the department
    47  within ninety days of the  commencement  of  the  practice  and  may  be

    48  updated periodically. The commissioner shall make regulations establish-
    49  ing the procedure for the review of protocols and the disposition of any
    50  issues arising from such review.
    51    [(e)] (v) No physician or, where applicable, nurse practitioner, shall
    52  enter  into  practice agreements with more than four nurse practitioners
    53  who are not located on the same physical premises as  the  collaborating
    54  physician or collaborating nurse practitioner.
    55    (b)  (i)  The  practice  of registered professional nursing by a nurse
    56  practitioner, certified under section six thousand nine hundred  ten  of
        A. 5308--A                          3
 
     1  this  article  and  practicing for more than thirty-six months and three

     2  thousand six hundred hours, may include the  diagnosis  of  illness  and
     3  physical  conditions  and  the performance of therapeutic and corrective
     4  measures within a specialty area of practice.
     5    (ii)  Prescriptions  for  drugs,  devices and immunizing agents may be
     6  issued by a nurse practitioner, under this  paragraph  and  section  six
     7  thousand  nine hundred ten of this article. The nurse practitioner shall
     8  obtain a certificate from the department upon successfully completing  a
     9  program  including  an appropriate pharmacology component, or its equiv-
    10  alent, as  established  by  the  commissioner's  regulations,  prior  to
    11  prescribing  under  this paragraph; provided that any certificate issued

    12  pursuant to subparagraph (ii) of paragraph (a) of this subdivision shall
    13  also satisfy the requirements of this  subparagraph.    The  certificate
    14  issued under section six thousand nine hundred ten of this article shall
    15  state  whether  the nurse practitioner has successfully completed such a
    16  program or equivalent and is authorized to prescribe  under  this  para-
    17  graph.
    18    (iii)  A nurse practitioner, certified under section six thousand nine
    19  hundred ten of this article and  practicing  for  more  than  thirty-six
    20  months and three thousand six hundred hours, shall either have a written
    21  practice agreement and written practice protocols with a licensed physi-
    22  cian  in  conformity with the requirements set forth in paragraph (a) of

    23  this subdivision or shall have collaborative relationships with  one  or
    24  more  licensed  physicians  qualified  to  collaborate  in the specialty
    25  involved or a hospital,  licensed  under  article  twenty-eight  of  the
    26  public  health  law,  that provides services through licensed physicians
    27  having privileges at such institution and qualified  to  collaborate  in
    28  the  specialty  involved.  Such collaborative relationship shall include
    29  written guidelines for practice that provide for the criteria to be used
    30  regarding consultation, including methods and frequency of how consulta-
    31  tion shall be provided, collaborative management and referral, including
    32  emergency referral plans, to address the  health  status  and  risks  of

    33  patients.  Documentation  of  such  collaborative relationships shall be
    34  maintained by the nurse practitioner and the  nurse  practitioner  shall
    35  make information about such collaborative relationships available to his
    36  or  her  patients upon request.  Failure to comply with the requirements
    37  found in this subparagraph shall be subject to  professional  misconduct
    38  provisions as set forth in article one hundred thirty of this title.
    39    (iv)  The  written  guidelines  for  practice  shall  reflect  current
    40  accepted medical and nursing  practice  and  shall  be  filed  with  the
    41  department,  along with an attestation by the nurse practitioner identi-
    42  fying the physician, physicians, or hospital that have agreed to partic-

    43  ipate in the collaborative relationship pursuant to such written  guide-
    44  lines, within ninety days of the commencement of the practice and may be
    45  updated periodically. The commissioner shall make regulations establish-
    46  ing the procedures for the review of written guidelines and the disposi-
    47  tion of any issues arising from such review.
    48    [(f)]  (c)  Nothing  in  this  subdivision shall be deemed to limit or
    49  diminish the practice of the  profession  of  nursing  as  a  registered
    50  professional nurse under this article or any other law, rule, regulation
    51  or  certification,  nor  to  deny  any registered professional nurse the
    52  right to do any act or engage in any practice authorized by this article
    53  or any other law, rule, regulation or certification.

    54    [(g)] (d) The provisions of this subdivision shall not  apply  to  any
    55  activity  authorized,  pursuant  to  statute,  rule or regulation, to be
        A. 5308--A                          4
 
     1  performed by a registered professional nurse in a hospital as defined in
     2  article twenty-eight of the public health law.
     3    (e)  The  department shall review the components commonly found in the
     4  written guidelines for practice filed with the department and shall also
     5  establish a survey form, which shall be made available to physicians and
     6  nurse practitioners licensed in the state, in order to solicit  comments
     7  regarding  the  practical implementation and functionality of collabora-
     8  tive agreements between nurse practitioners and collaborative  relation-

     9  ships  between  a  nurse  practitioner and a physician and the impact of
    10  such agreements and  relationships  to  the  provision  of  health  care
    11  services  within  the  state. The commissioner, in consultation with the
    12  commissioner of health, shall issue a report that summarizes the  compo-
    13  nents  commonly  found  in  the  written guidelines for practice and the
    14  comments received relating to collaborative agreements and collaborative
    15  relationships along with information that includes, but is  not  limited
    16  to:  the number of nurse practitioners practicing for fewer than thirty-
    17  six months and three thousand six hundred hours that  practice  pursuant
    18  to a collaborative agreement with a physician; the number of nurse prac-

    19  titioners practicing for fewer than thirty-six months and three thousand
    20  six  hundred  hours  that practice pursuant to a collaborative agreement
    21  with a nurse practitioner for six months and the number of  these  nurse
    22  practitioners  that  extend  a collaborative agreement for an additional
    23  six months upon a showing of good cause subject to the approval  of  the
    24  department;  the  number of nurse practitioners practicing for more than
    25  thirty-six months and three thousand six  hundred  hours  that  practice
    26  pursuant  to a collaborative relationship with a physician; other infor-
    27  mation the department deems relevant, including but not limited to,  any
    28  recommendations  for the continuation or amendments to the provisions of

    29  this section  relating  to  collaborative  agreements  or  collaborative
    30  relationships.  The  commissioner shall submit this report to the gover-
    31  nor, the speaker of the assembly, the temporary president of the senate,
    32  and the chairs of the assembly and senate higher education committees by
    33  September first, two thousand sixteen.
    34    § 3. This act shall take effect on the one hundred eightieth day after
    35  it shall have become a law and shall expire June 30, 2018 when upon such
    36  date the provisions of this act  shall  be  deemed  repealed;  provided,
    37  however,  that  effective  immediately,  the  addition, amendment and/or
    38  repeal of any rule or regulation necessary  for  the  implementation  of
    39  this act on its effective date is authorized and directed to be made and
    40  completed on or before such effective date.