Bill Text: NY S04611 | 2013-2014 | General Assembly | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Establishes the nurse practitioners modernization act which allows the practice of registered professional nursing by a certified nurse practitioner to include diagnosis and performance without collaboration of a licensed physician.

Spectrum: Slight Partisan Bill (Democrat 5-3)

Status: (Introduced - Dead) 2014-04-28 - RECOMMIT, ENACTING CLAUSE STRICKEN [S04611 Detail]

Download: New_York-2013-S04611-Introduced.html

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                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                         4611
                              2013-2014 Regular Sessions
                                   I N  S E N A T E
                                    April 15, 2013
                                      ___________
       Introduced  by  Sens.  YOUNG,  AVELLA,  ESPAILLAT,  MONTGOMERY, RITCHIE,
         ROBACH, SAVINO -- 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 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    S 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]  SIXTY-NINE
    7  hundred  ten  of  this  article AND PRACTICING FOR FEWER THAN THIRTY-SIX
    8  MONTHS AND THREE THOUSAND SIX HUNDRED HOURS, may include  the  diagnosis
    9  of  illness  and  physical conditions and the performance of therapeutic
   10  and corrective measures within a specialty area of practice, in  collab-
   11  oration  with  a  licensed  physician  qualified  to  collaborate in the
   12  specialty involved, provided such services are performed  in  accordance
   13  with  a  written  practice agreement and written practice protocols. The
   14  written practice agreement shall include  explicit  provisions  for  the
   15  resolution  of  any disagreement between the collaborating physician and
   16  the nurse practitioner regarding a matter of diagnosis or treatment that
   17  is within the scope of practice of both.  To  the  extent  the  practice
   18  agreement  does not so provide, then the collaborating physician's diag-
   19  nosis or treatment shall prevail. IN THE  EVENT  THAT  (A)  AN  EXISTING
   20  WRITTEN  PRACTICE AGREEMENT WITH A COLLABORATING PHYSICIAN TERMINATES AS
   21  A RESULT OF THE COLLABORATING  PHYSICIAN  MOVING,  RETIRING,  NO  LONGER
   22  NEEDING  THE  SERVICES OF THE NURSE PRACTITIONER, NO LONGER BEING QUALI-
   23  FIED TO PRACTICE OR UPON HIS OR HER DEATH AND THE NURSE PRACTITIONER  IS
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD10172-01-3
       S. 4611                             2
    1  UNABLE  TO  ENTER  INTO  A  NEW  WRITTEN PRACTICE AGREEMENT WITH ANOTHER
    2  COLLABORATING PHYSICIAN; OR IF (B) A NURSE PRACTITIONER OBTAINS APPROVAL
    3  BY THE DEPARTMENT BASED ON A DEMONSTRATION TO  THE  DEPARTMENT  THAT  AN
    4  EXISTING  WRITTEN  PRACTICE  AGREEMENT WAS TERMINATED DUE TO NO FAULT ON
    5  THE PART OF THE NURSE PRACTITIONER, AND THAT THE NURSE  PRACTITIONER  IS
    6  UNABLE  TO  ENTER  INTO  A  NEW  WRITTEN PRACTICE AGREEMENT WITH ANOTHER
    7  COLLABORATING PHYSICIAN FOLLOWING A SHOWING OF GOOD FAITH EFFORT;  THEN:
    8  SUCH  NURSE PRACTITIONER MAY CONTINUE TO PRACTICE PURSUANT TO THIS PARA-
    9  GRAPH WITHIN A SPECIALTY AREA OF PRACTICE FOR A  PERIOD  OF  UP  TO  SIX
   10  MONTHS,  IN  COLLABORATION WITH A NURSE PRACTITIONER WHO HAS BEEN CERTI-
   11  FIED UNDER SECTION SIXTY-NINE HUNDRED TEN OF THIS ARTICLE, WHO HAS  BEEN
   12  PRACTICING  FOR  MORE  THAN  THIRTY-SIX  MONTHS  AND  THREE THOUSAND SIX
   13  HUNDRED HOURS AND WHO IS  QUALIFIED  TO  COLLABORATE  IN  THE  SPECIALTY
   14  INVOLVED,  PROVIDED  THAT  SERVICES  ARE  PERFORMED IN ACCORDANCE WITH A
   15  WRITTEN PRACTICE AGREEMENT AND  WRITTEN  PRACTICE  PROTOCOLS;  SUCH  SIX
   16  MONTH  TIME  PERIOD FOR COLLABORATION BETWEEN NURSE PRACTITIONERS MAY BE
   17  EXTENDED FOR A PERIOD OF TIME NOT TO EXCEED  AN  ADDITIONAL  SIX  MONTHS
   18  UPON A SHOWING OF GOOD CAUSE SUBJECT TO THE APPROVAL OF THE DEPARTMENT.
   19    [(b)]  (II) Prescriptions for drugs, devices and immunizing agents may
   20  be issued by a nurse practitioner, under  this  [subdivision]  PARAGRAPH
   21  and  section [six thousand nine] SIXTY-NINE hundred ten of this article,
   22  in accordance with the practice agreement and  practice  protocols.  The
   23  nurse  practitioner  shall obtain a certificate from the department upon
   24  successfully completing a program including an appropriate  pharmacology
   25  component, or its equivalent, as established by the commissioner's regu-
   26  lations,  prior  to  prescribing under this [subdivision] PARAGRAPH. The
   27  certificate issued under section [six thousand nine] SIXTY-NINE  hundred
   28  ten  of  this  article  shall  state  whether the nurse practitioner has
   29  successfully completed such a program or equivalent and is authorized to
   30  prescribe under this [subdivision] PARAGRAPH.
   31    [(c)] (III) Each practice agreement shall provide for patient  records
   32  review  by the collaborating physician OR, WHERE APPLICABLE, THE COLLAB-
   33  ORATING NURSE PRACTITIONER, in a timely fashion but  in  no  event  less
   34  often  than  every three months. The names of the nurse practitioner and
   35  the collaborating physician  OR,  WHERE  APPLICABLE,  THE  COLLABORATING
   36  NURSE  PRACTITIONER  shall  be clearly posted in the practice setting of
   37  the nurse practitioner.
   38    [(d)] (IV)  The  practice  protocol  shall  reflect  current  accepted
   39  medical  and  nursing practice, OR WHERE APPLICABLE THE CURRENT ACCEPTED
   40  NURSING PRACTICE.   The protocols shall be  filed  with  the  department
   41  within  ninety  days  of  the  commencement  of  the practice and may be
   42  updated periodically. The commissioner shall make regulations establish-
   43  ing the procedure for the review of protocols and the disposition of any
   44  issues arising from such review.
   45    [(e)] (V) No physician OR, WHERE APPLICABLE, NURSE PRACTITIONER, shall
   46  enter into practice agreements with more than four  nurse  practitioners
   47  who  are  not located on the same physical premises as the collaborating
   48  physician OR COLLABORATING NURSE PRACTITIONER.
   49    [(f)] (B) (I) THE PRACTICE OF REGISTERED  PROFESSIONAL  NURSING  BY  A
   50  NURSE  PRACTITIONER,  CERTIFIED  UNDER SECTION SIXTY-NINE HUNDRED TEN OF
   51  THIS ARTICLE AND PRACTICING FOR MORE THAN THIRTY-SIX  MONTHS  AND  THREE
   52  THOUSAND  SIX  HUNDRED  HOURS,  MAY INCLUDE THE DIAGNOSIS OF ILLNESS AND
   53  PHYSICAL CONDITIONS AND THE PERFORMANCE OF  THERAPEUTIC  AND  CORRECTIVE
   54  MEASURES WITHIN A SPECIALTY AREA OF PRACTICE.
   55    (II)  PRESCRIPTIONS  FOR  DRUGS,  DEVICES AND IMMUNIZING AGENTS MAY BE
   56  ISSUED BY A NURSE PRACTITIONER, UNDER THIS PARAGRAPH AND SECTION  SIXTY-
       S. 4611                             3
    1  NINE  HUNDRED TEN OF THIS ARTICLE. THE NURSE PRACTITIONER SHALL OBTAIN A
    2  CERTIFICATE FROM THE DEPARTMENT UPON SUCCESSFULLY COMPLETING  A  PROGRAM
    3  INCLUDING  AN  APPROPRIATE PHARMACOLOGY COMPONENT, OR ITS EQUIVALENT, AS
    4  ESTABLISHED  BY  THE  COMMISSIONER'S  REGULATIONS,  PRIOR TO PRESCRIBING
    5  UNDER THIS PARAGRAPH; PROVIDED THAT ANY CERTIFICATE ISSUED  PURSUANT  TO
    6  SUBPARAGRAPH (II) OF PARAGRAPH (A) OF THIS SUBDIVISION SHALL ALSO SATIS-
    7  FY  THE REQUIREMENTS OF THIS SUBPARAGRAPH.  THE CERTIFICATE ISSUED UNDER
    8  SECTION SIXTY-NINE HUNDRED TEN OF THIS ARTICLE SHALL STATE  WHETHER  THE
    9  NURSE  PRACTITIONER  HAS SUCCESSFULLY COMPLETED SUCH A PROGRAM OR EQUIV-
   10  ALENT AND IS AUTHORIZED TO PRESCRIBE UNDER THIS PARAGRAPH.
   11    (III) A NURSE PRACTITIONER, CERTIFIED UNDER SECTION SIXTY-NINE HUNDRED
   12  TEN OF THIS ARTICLE AND PRACTICING FOR MORE THAN THIRTY-SIX  MONTHS  AND
   13  THREE THOUSAND SIX HUNDRED HOURS, SHALL HAVE COLLABORATIVE RELATIONSHIPS
   14  WITH  ONE  OR  MORE  LICENSED PHYSICIANS QUALIFIED TO COLLABORATE IN THE
   15  SPECIALTY INVOLVED OR A HOSPITAL, LICENSED UNDER ARTICLE TWENTY-EIGHT OF
   16  THE PUBLIC HEALTH LAW, THAT PROVIDES SERVICES  THROUGH  LICENSED  PHYSI-
   17  CIANS  QUALIFIED  TO  COLLABORATE  IN  THE SPECIALTY INVOLVED AND HAVING
   18  PRIVILEGES AT SUCH INSTITUTION BUT SHALL NOT BE REQUIRED TO HAVE A WRIT-
   19  TEN PRACTICE AGREEMENT, PROVIDED  THAT  SUCH  NURSE  PRACTITIONER  SHALL
   20  COMPLETE  AND  MAINTAIN  A  FORM, CREATED BY THE DEPARTMENT, WHICH NURSE
   21  PRACTITIONER SHALL ATTEST TO, THAT SUMMARIZES  WRITTEN  PRACTICE  PROTO-
   22  COLS, PROVIDES THE CRITERIA TO BE USED REGARDING CONSULTATION, INCLUDING
   23  METHODS  AND FREQUENCY OF HOW CONSULTATION SHALL BE PROVIDED, COLLABORA-
   24  TIVE MANAGEMENT AND REFERRAL, AND EMERGENCY REFERRAL PLANS,  TO  ADDRESS
   25  THE  HEALTH  STATUS AND RISK OF PATIENTS. SUCH FORMS SHALL BE UPDATED AS
   26  NEEDED AND MAY BE SUBJECT TO REVIEW BY THE DEPARTMENT. THE NURSE PRACTI-
   27  TIONER SHALL MAKE CURRENT INFORMATION CONTAINED IN THIS  FORM  AVAILABLE
   28  TO  HIS  OR HER PATIENTS UPON REQUEST.  DOCUMENTATION OF SUCH COLLABORA-
   29  TIVE RELATIONSHIPS SHALL BE MAINTAINED BY THE NURSE PRACTITIONER AND MAY
   30  BE SUBJECT TO REVIEW BY THE DEPARTMENT.   FAILURE  TO  COMPLY  WITH  THE
   31  REQUIREMENTS FOUND IN THIS SUBPARAGRAPH SHALL BE SUBJECT TO PROFESSIONAL
   32  MISCONDUCT PROVISIONS AS SET FORTH IN ARTICLE ONE HUNDRED THIRTY OF THIS
   33  TITLE.
   34    (C)  Nothing  in this subdivision shall be deemed to limit or diminish
   35  the practice of the profession of nursing as a  registered  professional
   36  nurse  under  this article or any other law, rule, regulation or certif-
   37  ication, nor to deny any registered professional nurse the right  to  do
   38  any  act  or  engage  in  any practice authorized by this article or any
   39  other law, rule, regulation or certification.
   40    [(g)] (D) The provisions of this subdivision shall not  apply  to  any
   41  activity  authorized,  pursuant  to  statute,  rule or regulation, to be
   42  performed by a registered professional nurse in a hospital as defined in
   43  article twenty-eight of the public health law.
   44    (E) THE COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER OF HEALTH,
   45  SHALL ISSUE A REPORT ON THE IMPLEMENTATION OF  THE  PROVISIONS  OF  THIS
   46  SECTION ALONG WITH INFORMATION THAT INCLUDES, BUT IS NOT LIMITED TO: THE
   47  NUMBER  OF  NURSE  PRACTITIONERS  PRACTICING  FOR  FEWER THAN THIRTY-SIX
   48  MONTHS AND THREE THOUSAND SIX HUNDRED HOURS THAT PRACTICE PURSUANT TO  A
   49  COLLABORATIVE  AGREEMENT  WITH  A PHYSICIAN; THE NUMBER OF NURSE PRACTI-
   50  TIONERS PRACTICING FOR FEWER THAN THIRTY-SIX MONTHS AND  THREE  THOUSAND
   51  SIX  HUNDRED  HOURS  THAT PRACTICE PURSUANT TO A COLLABORATIVE AGREEMENT
   52  WITH A NURSE PRACTITIONER FOR SIX MONTHS AND THE NUMBER OF  THESE  NURSE
   53  PRACTITIONERS  THAT  EXTEND  A COLLABORATIVE AGREEMENT FOR AN ADDITIONAL
   54  SIX MONTHS UPON A SHOWING OF GOOD CAUSE SUBJECT TO THE APPROVAL  OF  THE
   55  DEPARTMENT;  THE  NUMBER OF NURSE PRACTITIONERS PRACTICING FOR MORE THAN
   56  THIRTY-SIX MONTHS AND THREE THOUSAND SIX  HUNDRED  HOURS  THAT  PRACTICE
       S. 4611                             4
    1  PURSUANT  TO COLLABORATIVE RELATIONSHIPS WITH PHYSICIANS; OTHER INFORMA-
    2  TION THE DEPARTMENT DEEMS RELEVANT, INCLUDING BUT NOT  LIMITED  TO,  ANY
    3  RECOMMENDATIONS  FOR THE CONTINUATION OR AMENDMENTS TO THE PROVISIONS OF
    4  THIS  SECTION  RELATING  TO  COLLABORATIVE  AGREEMENTS  OR COLLABORATIVE
    5  RELATIONSHIPS. THE COMMISSIONER SHALL SUBMIT THIS REPORT TO  THE  GOVER-
    6  NOR, THE SPEAKER OF THE ASSEMBLY, THE TEMPORARY PRESIDENT OF THE SENATE,
    7  AND THE CHAIRS OF THE ASSEMBLY AND SENATE HIGHER EDUCATION COMMITTEES BY
    8  SEPTEMBER FIRST, TWO THOUSAND SEVENTEEN.
    9    S 3. This act shall take effect on the one hundred eightieth day after
   10  it shall have become a law and shall expire June 30, 2019 when upon such
   11  date  the  provisions  of  this  act shall be deemed repealed; provided,
   12  however, that effective  immediately,  the  addition,  amendment  and/or
   13  repeal  of  any  rule  or regulation necessary for the implementation of
   14  this act on its effective date is authorized and directed to be made and
   15  completed on or before such effective date.