S3289-2011 Actions

• Jun 13, 2012: PRINT NUMBER 3289A
• Jun 13, 2012: AMEND (T) AND RECOMMIT TO HIGHER EDUCATION
• Jan 4, 2012: REFERRED TO HIGHER EDUCATION
• Feb 15, 2011: REFERRED TO HIGHER EDUCATION

S3289-2011 Memo

BILL NUMBER:S3289

TITLE OF BILL:
An act
to amend the education law,
in relation to services performed by nurse practitioners

PURPOSE OR GENERAL IDEA OF BILL:
To end 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 practice
act in Education law to delete the requirements for collaboration
agreements and practice protocols between nurse practitioners and
physicians.

JUSTIFICATION:
Nurse Practitioners (NPs) practice in a variety of
primary and specialty care settings including ambulatory, acute, long
term care, and primary care. Nurse practitioners are licensed and
certified by the State Education Department 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 advanced certification by the Nursing Board, many NPs are
certified by national accrediting agencies in one or more practice
specialty.

Currently, New York requires a mandatory collaboration relationship
between a NP and a MD.
That relationship is defined by a written practice agreement which can
be as narrow or as broad as the MD is willing. Elsewhere, NPs
practice with complete independence in 13 states (AL, AZ, DC, IA, ID,
ME, MT, NH, NM, OR, UT, WA, WY). Given the education, training and
advanced certification of NPs, mandatory collaboration no longer
serves a clinical purpose.
Instead, mandatory collaboration serves as a barrier to practice and a
disincentive to advanced certification, and it restricts access to
primary health care for individuals and families in underserved areas
of the state.

PRIOR LEGISLATIVE HISTORY:
Based on 2009-10: S.8005

FISCAL IMPLICATIONS:
Reduces administrative costs for the State Education Department.

EFFECTIVE DATE:
180 days after the date of enactment.

S3289-2011 Text

 S T A T E   O F   N E W   Y O R K
 
 
                                         3289
 2011-2012 Regular Sessions
 I N  SENATE
 February 15, 2011
 
 Introduced  by  Sen.  YOUNG  -- read twice and ordered printed, and when
 printed to be committed to the Committee on Higher Education
 

AN ACT to amend the education law, in relation to services performed  by
 nurse practitioners
 

THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM
 BLY, DO ENACT AS FOLLOWS:

 

Section 1.  Short title. This act shall be known and may be  cited  as
 the "nurse practitioners modernization act".
 

S  2.  Subdivision 3 of section 6902 of the education law, as added by
 chapter 257 of the laws of 1988, is amended to read as follows:

 3. (a) The practice of registered  professional  nursing  by  a  nurse
 practitioner,  certified  under section six thousand nine hundred ten of
 this article, may include the diagnosis of illness and  physical  condi
 tions  and the performance of therapeutic and corrective measures within
 a specialty area of practice[, in collaboration with a  licensed  physi-
 cian  qualified  to collaborate in the specialty involved, provided such
 services are performed in accordance with a written  practice  agreement
 and  written  practice  protocols.  The written practice agreement shall
 include explicit provisions  for  the  resolution  of  any  disagreement
 between the collaborating physician and the nurse practitioner regarding
 a  matter of diagnosis or treatment that is within the scope of practice
 of both. To the extent the practice agreement does not so provide,  then
 the collaborating physician's diagnosis or treatment shall prevail].
 (b)  Prescriptions  for  drugs,  devices  and immunizing agents may be
 issued by a nurse practitioner, under this subdivision and  section  six
 thousand nine hundred ten of this article[, in accordance with the prac-
 tice  agreement  and  practice  protocols]. The nurse practitioner shall
 obtain a certificate from the department upon successfully completing  a
 program  including  an appropriate pharmacology component, or its equiv
 alent, as  established  by  the  commissioner's  regulations,  prior  to
 prescribing under this subdivision. The certificate issued under section
 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD01405-02-1
 
       S. 3289                             2
 six  thousand  nine  hundred ten of this article shall state whether the
 nurse practitioner has successfully completed such a program  or  equiv
 alent and is authorized to prescribe under this subdivision.
 (c)  [Each practice agreement shall provide for patient records review
 by the collaborating physician in a timely fashion but in no event  less
 often  than  every three months. The names of the nurse practitioner and
 the collaborating physician shall be  clearly  posted  in  the  practice
 setting of the nurse practitioner.
 (d)  The  practice protocol shall reflect current accepted medical and
 nursing practice. The protocols shall be filed with the department with-
 in ninety days of the commencement of the practice and  may  be  updated
 periodically.  The  commissioner shall make regulations establishing the
 procedure for the review of protocols and the disposition of any  issues
 arising from such review.
 (e)  No  physician shall enter into practice agreements with more than
 four nurse practitioners who are not located on the same physical  prem-
 ises as the collaborating physician.
 (f)]  Nothing in this subdivision shall be deemed to limit or diminish
 the practice of the profession of nursing as a  registered  professional
 nurse  under  this article or any other law, rule, regulation or certif
 ication, nor to deny any registered professional nurse the right  to  do
 any  act  or  engage  in  any practice authorized by this article or any
 other law, rule, regulation or certification.
 [(g)] (D) The provisions of this subdivision shall not  apply  to  any
 activity  authorized,  pursuant  to  statute,  rule or regulation, to be
 performed by a registered professional nurse in a hospital as defined in
 article twenty-eight of the public health law.
 

S 3. This act shall take effect on the one hundred eightieth day after
 it shall have become a law; provided, however, that effective immediate
 ly, the addition, amendment and/or repeal  of  any  rule  or  regulation
 necessary  for  the implementation of this act on its effective date are
 authorized and directed to be made  and  completed  on  or  before  such
 effective date.

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