NY State Senate Bill 2019-S907

Senate Bill S907

2019-2020 Legislative Session

Authorizes physician assistants under the supervision of a physician to perform most medical services that a physician can perform

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Archive: Last Bill Status - In Senate Committee Health Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 09, 2019	referred to health

2019-S907 (ACTIVE) - Details

Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Amd Pub Health L, generally; amd §§6540, 6542, 6731, 6741, 6807, 6909, 6957 & 7901, add §6545-a, Ed L; amd §461-c, Soc Serv L; amd §§13-b & 13-c, Work Comp L; amd §33.04, Ment Hyg L; amd §406, Gen Bus L
Versions Introduced in Other Legislative Sessions:: 2009-2010: S7357
2011-2012: S766
2013-2014: S2254
2015-2016: S3507
2017-2018: S556

2019-S907 (ACTIVE) - Summary

Authorizes physician assistants under the supervision of a physician to perform most medical services that a physician can perform, including the signing of death certificates.

2019-S907 (ACTIVE) - Sponsor Memo

                                
 
BILL NUMBER: S907

SPONSOR: YOUNG
 
TITLE OF BILL:

An act to amend the public health law, the education law, the social
services law, the workers' compensation law, the mental hygiene law and
the general business law, in relation to clarifying the scope of prac-
tice of licensed physician assistants

 
PURPOSE:

To make conforming changes to current laws to reflect the previously
authorized scope of practice of registered physician assistants. The
bill authorizes physician assistants under the supervision of a physi-
cian to perform most medical services that a physician can perform.

 
SUMMARY OF PROVISIONS:

Section 1 amends section 3700 of the public health law to restate the
definition of the term "physician assistant".

Section 2 amends the public health law by adding a new section, 3704 to
define the performance of medical services under the supervision of a
physician and only when such acts assigned are within the scope of prac-
tice of such supervising physician, prohibit physician assistants from
performing specific functions and duties specifically delegated by law
to those persons licensed as allied health professionals, and to define
the statutory construction to clarify that physician assistants are
authorized to perform any function, with supervision, in any health care
setting, that a statute authorizes or directs a physician to perform
unless it expressly states otherwise.

Section 3 amends section 2305 of the public health law to clarify that
physician assistants are authorized to diagnose or prescribe for a
person who is infected or has been infected with a sexually transmissi-
ble disease including persons under the age of twenty-one years without
the consent or knowledge of the parents or guardian.

Section 4 amends section 2308 of the public health law to clarify that
physician assistants are authorized to attend pregnant women to take or
cause to be taken a sample of blood and submit it to an approved labora-
tory for a test for syphilis.

Section 5 amends section 2498 of the public health law to clarify that
physician assistants are authorized to provide a summary when a hyster-
ectomy is under consideration.

Section 6 amends section 2500-e of the public health law to clarify that
a physician assistant is authorized to certify that a follow-up dose of
hepatitis B vaccine may be detrimental to a child's health making inap-
plicable the requirements of this section.

Section 7 amends section 2502 of the public health law to clarify that
physician assistants are authorized to direct or advise any remedy for
the inflammation or reddening of one or both eyes of an infant within
the age of two weeks.


Section 8 amends section 2503 of the public health law to clarify that
physician assistants are authorized to inform the expectant mother of
the drugs expected to be employed during pregnancy and at birth and of
the possible side effects of such drugs.

Section 9 amends section 2504 of the public health law, to clarify that
physician assistants are authorized to render medical services if the
physician assistant judges an emergency exists and the person is in
immediate need of medical attention without the consent of a parent or
legal guardian.

Section 10 amends section 2570 of the public health law, to order every
institution, except hospitals, operated for the express purpose or
receiving or caring for dependent, neglected, or destitute children to
post the name and address within such institution of a physician assist-
ant of its selection.

Section 11 amends section 2573 of the public health law to clarify that
physician assistants are authorized to make reports concerning the phys-
ical condition and health of the children and the environmental sanita-
tion of the institution as may be required by the state health commis-
sioner or local health officer.

Section 12 amends section 3001 of the public health law to define "qual-
ified medical and health personnel" to include physician assistants.

Section 13 amends section 3602 of the public health law to clarify that
physician assistants are authorized to order or prescribe home health
aide and personal care services where not prohibited by federal law or
regulations.

Sections 14 through 19 amend sections 4141, 4141-a, 4142, 4161, 4171,
and 4175 of the public health law to clarify that physician assistants
are authorized to sign and certify death certificates. It also clarifies
that physician assistants are required to record information and file
such certificates in the same manner as physicians must do.

Section 20 amends section 6540 of the education law to define the term
"physician assistant".

Section 21 amends section 6542 of the education law to clarify that
physician assistants are authorized to perform medical services under
the supervision of a physician and within the supervising physician's
scope of practice and to clarify that physician assistants are prohibit-
ed from performing any functions and duties delegated to those persons
licensed as allied health professionals such as radiologic technology or
the practice of optometry.

Section 22 amends the education law by adding a new section, 6545-a to
define statutory construction to clarify that physician assistants are
permitted to perform any function, with supervision, in any health care
setting, that a statute authorizes or directs a physician to perform
unless it expressly states otherwise.

Section 23 amends section 6731 of the education law to clarify that
physician assistants are authorized to order a referral for physical
therapy.

Section 24 amends subdivision 6741 of the education law to clarify that
nothing in this article is intended to affect the overall medical direc-
tion by a licensed physician assistant of a physical therapy assistant.

Section 25 amends section 6807 of the education law to clarify that
pharmacists are authorized to dispense drugs and devices pursuant to a
non-patient specific regimen as prescribed or ordered by a physician
assistant.

Section 26 amends section 6909 of the education law to clarify that a
registered professional nurse is authorized to execute a non-patient
specific regimen prescribed or ordered by a physician assistant.

Section 27 amends section 6957 of the education law to clarify that
nothing in this article shall be construed to affect or prevent or
expand or limit any duty of a licensed physician assistant or physician
assistant student from practicing midwifery.

Section 28 amends section 7901 of the education law to clarify that
physician assistants are authorized to order or prescribe occupational
therapy treatment.

Section 29 amends section 461-c of the social services law to clarify
that an adult care facility is authorized to accept a written report
from a physician assistant upon admission and allows for the resident to
be examined by a physician assistant at least annually thereafter and
submit an annual written report in conformity with the provisions of
this subdivision.

Section 30 amends subdivision 1 of section 13-b of the workers' compen-
sation law to clarify that physician assistants are authorized to and
may (a) render emergency medical care without authorization by the
chair, (b) render care while an injured employee remains in such hospi-
tal and (c) render medical care consistent with article thirty-seven of
the public health law and article one hundred thirty-one-B of the educa-
tion law.

Section 31 amends section 13-c of the workers' compensation law to clar-
ify that physician assistants are authorized to render medical care and
be authorized to render such care pursuant to this chapter and to clari-
fy that physician assistants are authorized to order physical therapy
care and occupational therapy care.

Section 32 amends section 33.04 of the mental hygiene law to clarify
that physician assistants are authorized to order a restraint.

Section 33 amends section 406 of the general business law to clarify
that a physician assistant is authorized to certify freedom from any
infectious or communicable disease.

Section 34 states that this act shall take effect immediately.

 
JUSTIFICATION:

In 1971, the New York State Legislature recognized the extreme shortage
of physicians in many areas of the state and enacted Articles 38 and 131
of the Education Law and Article 37 of the Public Health Law permitting
the licensure of physician assistants within the State. The purpose of
these Articles was "to provide for the registration of physician's asso-
ciates and specialist's assistants who will be available for employment
by physicians to permit medical services to be given to persons not
receiving them now and whose qualifications will assure that the health
of patients are met properly."

Within these Articles, the Legislature clearly and unambiguously estab-
lished that physician assistants are dependent practitioners working
under the supervision of a licensed physician responsible for the
actions of the physician assistant. Further, that the supervising physi-
cian may delegate to the physician assistant any medical procedures or
tasks for which the physician assistant is appropriately trained and
qualified to perform and that are performed within the normal scope of
the physician's practice.

In the years since the enactment of these articles, physician assistants
have become an integral part of New York's health caregiver team. Physi-
cian assistants practice in every health care setting with physician
supervision and have authority to diagnose and treat patients with a
range of medical conditions. From patient education to surgical assist-
ing and patient management, physician assistants are versatile members
of the medical team. With education and skills that make them adaptable
and flexible, physician assistants complement the work of their super-
vising physicians.

However, regulatory and judicial interpretations of separate and subse-
quent legislative acts have erroneously served to erode the legisla-
ture's initial intent in enacting the above mentioned articles. Some
regulators and courts have begun to constrict the original scope of
practice mandate of physician assistants by requiring subsequent legis-
lative acts that authorize or direct physicians to perform certain
procedures to expressly authorize physician assistants to perform such
acts. In the absence of express statutory authorization, they have
reasoned, physician assistants are not able to perform these functions
under the supervision of a physician.

Therefore, the Legislature hereby finds and declares that a clarifica-
tion and restatement of the scope of practice of a physician assistant
is in order. Simply stated, the Legislature finds and declares that
physician assistants may perform any function, with appropriate physi-
cian supervision, in any health care setting, that a statute authorizes
a physician to perform and that is within the normal practice of that
physician, unless the statute expressly states otherwise.

 
PRIOR LEGISLATIVE HISTORY:

2017,2018: S.556 Referred to Health
2015,2016: S.3507-A Referred to Health
2013,2014: S.2254-A Referred to Health
2011,2012: S.766 Referred to Health
2009,2010: S.7357A Referred to Health
2003,2004:  S.7057 Advanced to 2nd Calendar

 
EFFECTIVE DATE:
Immediately.

2019-S907 (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    907
 
                        2019-2020 Regular Sessions
 
                             I N  S E N A T E
 
                              January 9, 2019
                                ___________
 
 Introduced  by  Sen.  YOUNG  -- read twice and ordered printed, and when
   printed to be committed to the Committee on Health
 
 AN ACT to amend the public health law, the  education  law,  the  social
   services  law,  the  workers' compensation law, the mental hygiene law
   and the general business law, in relation to clarifying the  scope  of
   practice of licensed physician assistants
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1.  Subdivision 1 of section 3700 of the public health law, as
 amended by chapter 48 of the  laws  of  2012,  is  amended  to  read  as
 follows:
   1.  Physician  assistant.  The  term  "physician  assistant"  means  a
 [person] DEPENDENT PRACTITIONER  WORKING  UNDER  THE  SUPERVISION  OF  A
 LICENSED  PHYSICIAN RESPONSIBLE FOR THE ACTIONS OF THE PHYSICIAN ASSIST-
 ANT AND who is licensed as a physician  assistant  pursuant  to  section
 sixty-five hundred forty-one of the education law.
   §  2. The public health law is amended by adding a new section 3704 to
 read as follows:
   § 3704. PERFORMANCE OF MEDICAL SERVICES. 1.  A PHYSICIAN ASSISTANT MAY
 PERFORM MEDICAL SERVICES, BUT ONLY  WHEN  UNDER  THE  SUPERVISION  OF  A
 PHYSICIAN  AND ONLY WHEN SUCH ACTS ASSIGNED TO HIM OR HER ARE WITHIN THE
 SCOPE OF PRACTICE OF SUCH SUPERVISING PHYSICIAN. THE SUPERVISING  PHYSI-
 CIAN  MAY  DELEGATE TO THE PHYSICIAN ASSISTANT ANY MEDICAL PROCEDURES OR
 TASKS FOR WHICH THE PHYSICIAN ASSISTANT  IS  APPROPRIATELY  TRAINED  AND
 QUALIFIED  TO  PERFORM AND THAT ARE PERFORMED WITHIN THE NORMAL SCOPE OF
 THE PHYSICIAN'S PRACTICE.
   2. NOTHING IN THIS ARTICLE OR IN ARTICLE ONE HUNDRED  THIRTY-ONE-B  OF
 THE  EDUCATION  LAW SHALL BE CONSTRUED TO AUTHORIZE PHYSICIAN ASSISTANTS
 TO PERFORM THOSE SPECIFIC FUNCTIONS AND DUTIES SPECIFICALLY DELEGATED BY
 LAW TO THOSE PERSONS LICENSED AS ALLIED HEALTH PROFESSIONALS UNDER  THIS
 CHAPTER  OR  THE EDUCATION LAW. SPECIFICALLY, PHYSICIAN ASSISTANTS SHALL
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD03727-01-9

 S. 907                              2
 
 NOT PERFORM THE PRACTICE OF RADIOLOGIC TECHNOLOGY  OR  THE  PRACTICE  OF
 OPTOMETRY  AS  THOSE  PRACTICES  ARE  DEFINED UNDER THIS CHAPTER AND THE
 EDUCATION LAW.
   § 3. Subdivisions 1 and 2 of section 2305 of the public health law, as
 amended  by  section 35 of part E of chapter 56 of the laws of 2013, are
 amended to read as follows:
   1. No person, other than a licensed physician OR A PHYSICIAN ASSISTANT
 UNDER THE SUPERVISION OF A LICENSED PHYSICIAN,  or,  in  a  hospital,  a
 staff  physician, shall diagnose, treat or prescribe for a person who is
 infected with a sexually transmitted disease, or who has been exposed to
 infection with a sexually transmitted disease, or  dispense  or  sell  a
 drug,  medicine  or  remedy  for  the treatment of such person except on
 prescription of a duly licensed physician OR A PHYSICIAN ASSISTANT UNDER
 THE SUPERVISION OF A LICENSED PHYSICIAN.
   2. A licensed physician OR A PHYSICIAN ASSISTANT UNDER THE SUPERVISION
 OF A LICENSED PHYSICIAN, or in a hospital, a staff physician, may  diag-
 nose,  treat or prescribe for a person under the age of twenty-one years
 without the consent or knowledge of the  parents  or  guardian  of  said
 person,  where  such  person  is  infected  with  a sexually transmitted
 disease, or has been exposed to infection with  a  sexually  transmitted
 disease.
   § 4. Subdivisions 1 and 2 of section 2308 of the public health law are
 amended to read as follows:
   1.  Every  physician  OR  PHYSICIAN ASSISTANT UNDER THE SUPERVISION OF
 SUCH PHYSICIAN attending pregnant women in the state shall in  the  case
 of  every  woman so attended take or cause to be taken a sample of blood
 of such woman at the time of first examination, and submit  such  sample
 to an approved laboratory for a standard serological test for syphilis.
   2.  Every  other person permitted by law to attend upon pregnant women
 in the state but not permitted by law to take blood tests, shall cause a
 sample of the blood of such pregnant woman to be  taken  promptly  by  a
 duly  licensed  physician OR A PHYSICIAN ASSISTANT UNDER THE SUPERVISION
 OF SUCH PHYSICIAN and submitted to an approved laboratory for a standard
 serological test for syphilis.
   § 5. Section 2498 of the public health law, as added by chapter 237 of
 the laws of 1990, is amended to read as follows:
   § 2498. Provision of summary by  physician.    The  summary  shall  be
 provided  by a physician, OR A PHYSICIAN ASSISTANT UNDER THE SUPERVISION
 OF SUCH PHYSICIAN, to each person under such  physician's  OR  PHYSICIAN
 ASSISTANT'S  care,  when  a hysterectomy is under consideration for that
 person.
   § 6. Subdivision 10 of section 2500-e of the  public  health  law,  as
 added by chapter 4 of the laws of 1990, is amended to read as follows:
   10.  If  any  licensed physician, PHYSICIAN ASSISTANT UNDER THE SUPER-
 VISION OF A LICENSED PHYSICIAN or nurse practitioner  certifies  that  a
 follow-up  dose  of  hepatitis B vaccine may be detrimental to a child's
 health, the requirements of this section  shall  be  inapplicable  until
 such  immunization  is found no longer to be detrimental to such child's
 health.
   § 7. Section 2502 of the public health law, as amended by chapter  884
 of the laws of 1972, is amended to read as follows:
   §  2502.  Report  of  certain  conditions. Any nurse-midwife, nurse or
 other person having the care of an infant within the age  of  two  weeks
 who  neglects or omits to report immediately to the health officer or to
 a legally qualified practitioner of medicine of the city, town or  place
 where  such  child is being cared for, the fact that one or both eyes of

 S. 907                              3
 
 such infant are [inflammed] INFLAMED or reddened whenever such shall  be
 the  case,  or  who  applies  any remedy therefor without the advice, or
 except by the direction of such officer  or  physician  OR  A  PHYSICIAN
 ASSISTANT  UNDER THE SUPERVISION OF A PHYSICIAN is guilty of a misdemea-
 nor.
   § 8. Section 2503 of the public health law, as amended by chapter  485
 of the laws of 1978, is amended to read as follows:
   § 2503. Drug information to be furnished expectant mothers. The physi-
 cian,  A  PHYSICIAN  ASSISTANT  UNDER  THE SUPERVISION OF A PHYSICIAN or
 nurse-midwife to be in attendance at the birth of a child  shall  inform
 the  expectant  mother,  in advance of the birth, of the drugs that such
 physician, PHYSICIAN ASSISTANT UNDER THE SUPERVISION OF A  PHYSICIAN  or
 nurse-midwife  expects to employ during pregnancy and of the obstetrical
 and other drugs that  such  physician,  PHYSICIAN  ASSISTANT  UNDER  THE
 SUPERVISION  OF  A PHYSICIAN or nurse-midwife expects to employ at birth
 and of the possible effects of such drugs on the child and mother.
   § 9. Subdivision 4 of section 2504 of the public health law, as  added
 by  chapter  769 of the laws of 1972 and as renumbered by chapter 976 of
 the laws of 1984, is amended to read as follows:
   4. Medical, dental, health and hospital services may  be  rendered  to
 persons  of  any  age  without the consent of a parent or legal guardian
 when, in the physician's OR PHYSICIAN ASSISTANT'S UNDER THE  SUPERVISION
 OF  SUCH  PHYSICIAN  judgment  an  emergency exists and the person is in
 immediate need of medical attention and an  attempt  to  secure  consent
 would  result in delay of treatment which would increase the risk to the
 person's life or health.
   § 10. Subdivision 1 of section 2570  of  the  public  health  law,  as
 amended  by  chapter  495  of  the  laws  of 1955, is amended to read as
 follows:
   1. Every institution in this state, operated for the  express  purpose
 of receiving or caring for dependent, neglected or destitute children or
 juvenile  delinquents,  except  hospitals, shall have attached thereto a
 regular physician OR PHYSICIAN ASSISTANT  UNDER  THE  SUPERVISION  OF  A
 REGULAR  PHYSICIAN  of its selection duly licensed under the laws of the
 state and in good professional standing, whose name and address shall be
 kept posted conspicuously within such institution.
   § 11. Subdivision 1 of section 2573 of the public health law, as added
 by chapter 495 of the laws of 1955, is amended to read as follows:
   1. The administrative officer or person  in  charge  and  the  regular
 physician  OR  PHYSICIAN  ASSISTANT  UNDER  THE SUPERVISION OF A REGULAR
 PHYSICIAN of every institution caring for children referred to  in  this
 article  shall  make  such reports concerning the physical condition and
 health of the children and the environmental sanitation of the  institu-
 tion  as  may be required by the state health commissioner, local health
 officer or health commissioner having jurisdiction.
   § 12. Subdivision 14 of section 3001 of  the  public  health  law,  as
 amended  by  chapter  804  of  the  laws  of 1992, is amended to read as
 follows:
   14. "Qualified medical and health personnel" means physicians,  PHYSI-
 CIAN  ASSISTANTS,  registered professional nurses and advanced emergency
 medical technicians competent in the management  of  patients  requiring
 advanced life support care.
   §  13.  Subdivisions 4 and 5 of section 3602 of the public health law,
 as amended by chapter 376 of the laws of 2015, are amended  to  read  as
 follows:

 S. 907                              4
 
   4.  "Home  health  aide  services"  means  simple  health  care tasks,
 personal hygiene services, housekeeping tasks essential to the patient's
 health and other related supportive services.  Such  services  shall  be
 prescribed by a physician OR A PHYSICIAN ASSISTANT UNDER THE SUPERVISION
 OF  A  PHYSICIAN  in accordance with a plan of treatment for the patient
 and shall be under the supervision of a  registered  professional  nurse
 from a certified home health agency or, when appropriate, from a provid-
 er  of  a  long  term  home  health  care program and of the appropriate
 professional therapist from  such  agency  or  provider  when  the  aide
 carries  out  simple  procedures  as an extension of physical, speech or
 occupational therapy. Such services may also be prescribed or ordered by
 a nurse practitioner to the extent authorized by law and consistent with
 subdivision three of section six thousand nine hundred two of the educa-
 tion law and not prohibited by federal law or regulation.
   5. "Personal care services" means services  to  assist  with  personal
 hygiene,   dressing,  feeding  and  household  tasks  essential  to  the
 patient's health. Such services shall be prescribed by a physician OR  A
 PHYSICIAN  ASSISTANT  UNDER THE SUPERVISION OF A PHYSICIAN in accordance
 with a plan of home care supervised by a registered professional  nurse.
 Such  services may also be prescribed or ordered by a nurse practitioner
 to the extent authorized by law and consistent with subdivision three of
 section six thousand nine hundred two  of  the  education  law  and  not
 prohibited by federal law or regulations.
   §  14.  Subdivision  4  of  section  4141 of the public health law, as
 amended by chapter 153 of the laws  of  2011,  is  amended  to  read  as
 follows:
   4. (a) The medical certificate shall be made, dated, and signed by the
 physician,  THE  PHYSICIAN  ASSISTANT  ACTING UNDER THE SUPERVISION OF A
 PHYSICIAN, or nurse practitioner, if any,  last  in  attendance  on  the
 deceased.
   (b)  Indefinite terms, denoting only symptoms of disease or conditions
 resulting from disease, shall not be held sufficient.
   (c) Any certificate stating the cause of  death  in  terms  which  the
 commissioner declares indefinite shall be returned to the physician, THE
 PHYSICIAN  ASSISTANT  ACTING UNDER THE SUPERVISION OF A PHYSICIAN, nurse
 practitioner, or person making the medical  certificate  for  correction
 and more definite statement.  A CERTIFICATE CERTIFIED TO AND SIGNED BY A
 PHYSICIAN  ASSISTANT IN ACCORDANCE WITH THIS SECTION SHALL HAVE THE SAME
 FORCE AND EFFECT IN THE LAW AS A CERTIFICATE SIGNED BY A PHYSICIAN.
   (d) Where a death is caused by an opioid  overdose,  such  information
 shall be indicated, including any related information as the commission-
 er may require.
   §  15.  Section 4141-a of the public health law, as amended by chapter
 352 of the laws of 2013, is amended to read as follows:
   § 4141-a. Death certificate; duties of hospital administrator. When  a
 death occurs in a hospital, except in those cases where certificates are
 issued  by  coroners  or medical examiners, the person in charge of such
 hospital or his or her designated representative shall promptly  present
 the  certificate  to the physician, THE PHYSICIAN ASSISTANT ACTING UNDER
 THE SUPERVISION OF A PHYSICIAN, or nurse practitioner in attendance,  or
 a  physician,  PHYSICIAN  ASSISTANT  ACTING  UNDER  THE SUPERVISION OF A
 PHYSICIAN, or nurse practitioner acting in his or her behalf, who  shall
 promptly  certify to the facts of death, provide the medical information
 required by the certificate, sign the medical certificate of death,  and
 thereupon  return  such certificate to such person, so that the seventy-
 two hour registration time limit prescribed in section four thousand one

 S. 907                              5
 
 hundred forty of this title can be met; provided, however that  commenc-
 ing  on or after the implementation date under section forty-one hundred
 forty-eight of this title, information and signatures required  by  this
 section  shall be obtained and made in accordance with section forty-one
 hundred forty-eight of this title.    A  CERTIFICATE  CERTIFIED  TO  AND
 SIGNED  BY  A  PHYSICIAN ASSISTANT IN ACCORDANCE WITH THIS SECTION SHALL
 HAVE THE SAME FORCE AND EFFECT IN LAW  AS  A  CERTIFICATE  SIGNED  BY  A
 PHYSICIAN.
   §  16.  Subdivision  (b)  of section 4142 of the public health law, as
 amended by chapter 153 of the laws  of  2011,  is  amended  to  read  as
 follows:
   (b)  present  the  certificate  promptly  to  the attending physician,
 PHYSICIAN ASSISTANT UNDER THE SUPERVISION OF A PHYSICIAN, or nurse prac-
 titioner, who shall forthwith certify to the facts of death, provide the
 medical information required by the certificate  and  sign  the  medical
 certificate  of  death,  or  to the coroner or medical examiner in those
 cases where so required by this article or, when a  death  occurs  in  a
 hospital,  except in those cases where certificates are issued by coron-
 ers or medical examiners, to the person in charge of  such  hospital  or
 his  or  her  designated  representative,  who  shall obtain the medical
 certificate of death as prescribed in section four thousand one  hundred
 forty-one-a of this title;
   §  17. The section heading and subdivisions 2, 3 and 4 of section 4161
 of the public health law, the section heading and subdivisions 2  and  3
 as  amended  by  chapter  153  of  the laws of 2011 and subdivision 4 as
 amended by chapter 352 of the laws of  2013,  are  amended  to  read  as
 follows:
   Fetal  death  certificates;  form  and  content; physicians, PHYSICIAN
 ASSISTANTS, nurse practitioners, midwives, and hospital administrators.
   2. In each case where  a  physician,  PHYSICIAN  ASSISTANT  UNDER  THE
 SUPERVISION  OF  A PHYSICIAN, or nurse practitioner was in attendance at
 or after a fetal death, it is the  duty  of  such  physician,  PHYSICIAN
 ASSISTANT UNDER THE SUPERVISION OF A PHYSICIAN, or nurse practitioner to
 certify  to  the  birth  and  to  the  cause of death on the fetal death
 certificate. Where a nurse-midwife was in attendance at a fetal death it
 is the duty of such nurse-midwife to certify to the birth but, he or she
 shall not certify to the cause of death on the fetal death certificate.
   3. Fetal deaths occurring  without  the  attendance  of  a  physician,
 PHYSICIAN ASSISTANT UNDER THE SUPERVISION OF A PHYSICIAN, or nurse prac-
 titioner as provided in subdivision two of this section shall be treated
 as deaths without medical attendance, as provided in this article.
   4.  When  a  fetal  death  occurs in a hospital, except in those cases
 where certificates are issued by  coroners  or  medical  examiners,  the
 person  in  charge  of  such hospital or his or her designated represen-
 tative shall promptly present the certificate to the  physician,  PHYSI-
 CIAN  ASSISTANT  UNDER  THE SUPERVISION OF A PHYSICIAN, or nurse practi-
 tioner in attendance, or a  physician,  PHYSICIAN  ASSISTANT  UNDER  THE
 SUPERVISION  OF  A PHYSICIAN, or nurse practitioner acting in his or her
 behalf, who shall promptly certify to the facts of birth  and  of  fetal
 death, provide the medical information required by the certificate, sign
 the  medical  certificate  of birth and death, and thereupon return such
 certificate to such person, so that the  seventy-two  hour  registration
 time limit prescribed in section four thousand one hundred sixty of this
 title  can  be  met;  provided,  however that commencing on or after the
 implementation date under section forty-one hundred forty-eight of  this
 article,  information  and signatures required by this subdivision shall

 S. 907                              6
 
 be obtained and  made  in  accordance  with  section  forty-one  hundred
 forty-eight of this article.
   §  18.  The  section  heading and subdivision 1 of section 4171 of the
 public health law, as amended by chapter 153 of the laws  of  2011,  are
 amended to read as follows:
   Records; duties of physicians, PHYSICIAN ASSISTANTS, nurse practition-
 ers, and others to furnish information.
   1.  Physicians, PHYSICIAN ASSISTANTS UNDER THE SUPERVISION OF A PHYSI-
 CIAN, nurse practitioners, nurse-midwives, funeral directors,  undertak-
 ers and informants, and all other persons having knowledge of the facts,
 are  hereby required to supply, upon a form provided by the commissioner
 or upon the original certificate, such information as they  may  possess
 regarding any birth or death upon demand of the commissioner, in person,
 by mail, or through the registrar.
   §  19.  Subdivisions  1,  3 and 5 of section 4175 of the public health
 law, as amended by chapter 153 of the laws of 2011, are amended to  read
 as follows:
   1.  If,  at any time after the birth, or within one year of the death,
 of any person within the state, a certified copy of the official  record
 of  said  birth or death, with the information required to be registered
 by this article, is necessary  for  legal,  judicial,  or  other  proper
 purposes,  and, after search by the commissioner or his or her represen-
 tatives, it appears that no such certificate of birth or death was  made
 and filed as provided by this article, then the commissioner shall imme-
 diately require the physician, PHYSICIAN ASSISTANT UNDER THE SUPERVISION
 OF  A  PHYSICIAN,  nurse  practitioner,  or  nurse-midwife who, being in
 attendance upon a birth, failed or neglected to file a certificate ther-
 eof, or the funeral director, undertaker, or other  person  who,  having
 charge  of  the  interment  or removal of the body of a deceased person,
 failed or neglected to file the certificate of death, if he  or  she  is
 living, to obtain and file at once with the local registrar such certif-
 icate in as complete form as the lapse of time will permit.
   3.  If  the  physician, PHYSICIAN ASSISTANT UNDER THE SUPERVISION OF A
 PHYSICIAN,  nurse  practitioner,  nurse-midwife,  funeral  director,  or
 undertaker  responsible for the report is deceased or cannot be located,
 then the person making application for the certified copy of the  record
 may  file  such  certificate of birth or death together with such state-
 ments subscribed and affirmed by the persons making them as  true  under
 the  penalties  of  perjury  and  other evidence as the commissioner may
 require.
   5. The delinquent physician, PHYSICIAN ASSISTANT UNDER THE SUPERVISION
 OF A PHYSICIAN, nurse  practitioner,  nurse-midwife,  funeral  director,
 undertaker,  or other person may, in the discretion of the commissioner,
 be prosecuted as required by this article, without bar from the  statute
 of  limitations,  if  he  or  she neglects or fails to file promptly the
 certificate required by this section.
   § 20. Subdivision 1 of section 6540 of the education law,  as  amended
 by chapter 48 of the laws of 2012, is amended to read as follows:
   1.  Physician  assistant.    The  term  "physician  assistant" means a
 [person] DEPENDENT PRACTITIONER  WORKING  UNDER  THE  SUPERVISION  OF  A
 LICENSED  PHYSICIAN RESPONSIBLE FOR THE ACTIONS OF THE PHYSICIAN ASSIST-
 ANT AND who is licensed as a physician assistant pursuant to this  arti-
 cle.
   §  21.  Subdivisions  1 and 7 of section 6542 of the education law, as
 amended by chapter 48 of the laws  of  2012,  are  amended  to  read  as
 follows:

 S. 907                              7

   1.  Notwithstanding  any other provision of law, a physician assistant
 may perform medical services, but only when under the supervision  of  a
 physician  and  only when such acts and duties as are assigned to him or
 her are within the scope of practice of such supervising physician.  THE
 SUPERVISING  PHYSICIAN  MAY  DELEGATE  TO  THE  PHYSICIAN  ASSISTANT ANY
 MEDICAL PROCEDURES OR TASKS FOR WHICH THE PHYSICIAN ASSISTANT IS  APPRO-
 PRIATELY  TRAINED AND QUALIFIED TO PERFORM AND THAT ARE PERFORMED WITHIN
 THE NORMAL SCOPE OF THE PHYSICIAN'S PRACTICE.
   7. Nothing in this article, or in article thirty-seven of  the  public
 health  law,  shall  be  construed  to authorize physician assistants to
 perform those specific functions and duties  specifically  delegated  by
 law  to  those persons licensed as allied health professionals under the
 public health law or this  [chapter]  TITLE.    SPECIFICALLY,  PHYSICIAN
 ASSISTANTS  SHALL  NOT  PERFORM THE PRACTICE OF RADIOLOGIC TECHNOLOGY OR
 THE PRACTICE OF OPTOMETRY AS  THOSE  PRACTICES  ARE  DEFINED  UNDER  THE
 PUBLIC HEALTH LAW AND THIS TITLE.
   §  22.  The education law is amended by adding a new section 6545-a to
 read as follows:
   § 6545-A. STATUTORY CONSTRUCTION.  A PHYSICIAN ASSISTANT  MAY  PERFORM
 ANY FUNCTION, WITH APPROPRIATE PHYSICIAN SUPERVISION, IN ANY HEALTH CARE
 SETTING, THAT A STATUTE AUTHORIZES OR DIRECTS A PHYSICIAN TO PERFORM AND
 THAT IS WITHIN THE NORMAL PRACTICE OF THAT PHYSICIAN, EXCEPT THOSE FUNC-
 TIONS  AUTHORIZED  OR  DIRECTED  BY  AND  IN ARTICLE THIRTY-THREE OF THE
 PUBLIC HEALTH LAW, UNLESS  THE  STATUTE  AUTHORIZING  OR  DIRECTING  THE
 PHYSICIAN  TO PERFORM SUCH FUNCTION OR FUNCTIONS EXPRESSLY STATES OTHER-
 WISE.
   § 23. Subdivision c of section 6731 of the education law,  as  amended
 by chapter 389 of the laws of 2007, is amended to read as follows:
   c.  Such  treatment shall be rendered pursuant to a referral which may
 be directive as to  treatment  by  a  licensed  physician,  A  PHYSICIAN
 ASSISTANT UNDER THE SUPERVISION OF A LICENSED PHYSICIAN, dentist, podia-
 trist, nurse practitioner or licensed midwife, each acting within his or
 her  lawful  scope  of practice, and in accordance with their diagnosis,
 except as provided in subdivision d of this section.
   § 24. Subdivision c of section 6741 of the education law, as added  by
 chapter 618 of the laws of 1980, is amended to read as follows:
   c.  Nothing  in this article is intended to affect the overall medical
 direction by a licensed physician OR A  PHYSICIAN  ASSISTANT  UNDER  THE
 SUPERVISION OF A LICENSED PHYSICIAN, of a physical therapist assistant.
   §  25. Subdivision 3 of section 6807 of the education law, as added by
 chapter 573 of the laws of 1999, is amended to read as follows:
   3. A pharmacist may dispense drugs and devices to a registered profes-
 sional nurse, and a registered professional nurse may possess and admin-
 ister, drugs and devices, pursuant to  a  non-patient  specific  regimen
 prescribed  or  ordered  by  a licensed physician, A PHYSICIAN ASSISTANT
 UNDER THE SUPERVISION OF A LICENSED PHYSICIAN or certified nurse practi-
 tioner, pursuant to regulations promulgated by the commissioner and  the
 public health law.
   §  26. Subdivision 5 of section 6909 of the education law, as added by
 chapter 573 of the laws of 1999, is amended to read as follows:
   5. A registered professional nurse may execute a non-patient  specific
 regimen  prescribed  or  ordered  by  a  licensed physician, A PHYSICIAN
 ASSISTANT UNDER THE SUPERVISION OF A  LICENSED  PHYSICIAN  or  certified
 nurse  practitioner,  pursuant to regulations promulgated by the commis-
 sioner.

 S. 907                              8
 
   § 27. Section 6957 of the education law, as amended by chapter 328  of
 the laws of 1992, is amended to read as follows:
   § 6957. Exempt persons.  Nothing in this article shall be construed to
 affect,  prevent  or in any manner expand or limit any duty or responsi-
 bility of a licensed physician OR A PHYSICIAN ASSISTANT UNDER THE SUPER-
 VISION OF A LICENSED PHYSICIAN, from practicing midwifery or  affect  or
 prevent  a  medical  student,  PHYSICIAN  ASSISTANT STUDENT or midwifery
 student in clinical practice under the supervision of a licensed  physi-
 cian  or  board  certified obstetrician/gynecologist or licensed midwife
 practicing [pursuant to the provisions of  section  twenty-five  hundred
 sixty  of  the public health law] in pursuance of an educational program
 registered by the department from engaging in such practice.
   § 28. Section 7901 of the education law, as amended by chapter 460  of
 the laws of 2011, is amended to read as follows:
   § 7901. Definition.  The  practice  of  the profession of occupational
 therapy is defined as the functional evaluation of the client, the plan-
 ning and utilization of a program of purposeful activities, the develop-
 ment and utilization of a treatment program,  and/or  consultation  with
 the  client,  family,  caregiver  or  organization  in order to restore,
 develop  or  maintain  adaptive  skills,  and/or  performance  abilities
 designed  to  achieve maximal physical, cognitive and mental functioning
 of the client associated with his or her activities of daily living  and
 daily  life  tasks.  A  treatment  program designed to restore function,
 shall be rendered on the prescription or referral of a physician, PHYSI-
 CIAN ASSISTANT UNDER THE SUPERVISION  OF  A  LICENSED  PHYSICIAN,  nurse
 practitioner  or  other  health  care  provider acting within his or her
 scope of practice pursuant to this title. However, nothing contained  in
 this  article  shall  be  construed  to permit any licensee hereunder to
 practice medicine or psychology, including psychotherapy or to otherwise
 expand such licensee's scope of practice beyond what  is  authorized  by
 this chapter.
   §  29.  Subdivision  7 of section 461-c of the social services law, as
 amended by chapter 168 of the laws  of  2011,  is  amended  to  read  as
 follows:
   7.  (a)  At the time of the admission to an adult care facility, other
 than a shelter for adults, a resident shall submit  to  the  facility  a
 written  report from a physician, a physician assistant UNDER THE SUPER-
 VISION OF A LICENSED PHYSICIAN, or a nurse  practitioner,  which  report
 shall state:
   (i) that the physician, physician assistant UNDER THE SUPERVISION OF A
 LICENSED  PHYSICIAN,  or  nurse practitioner has physically examined the
 resident within one month and the date of such examination;
   (ii) that the resident is not in need of acute or long term medical or
 nursing care which would require placement in a hospital or  residential
 health care facility; and
   (iii)  that  the  resident  is  not  otherwise  medically  or mentally
 unsuited for care in the facility.
   (b) For the purpose of creating an accessible and available record and
 assuring that a resident is properly placed  in  such  a  facility,  the
 report shall also contain the resident's significant medical history and
 current  conditions,  the prescribed medication regimen, and recommenda-
 tions for diet, the assistance needed in the activities of daily  living
 and  where  appropriate,  recommendations  for  exercise, recreation and
 frequency of medical examinations.
   (c) Such resident shall thereafter  be  examined  by  a  physician,  a
 physician  assistant UNDER THE SUPERVISION OF A LICENSED PHYSICIAN, or a

 S. 907                              9
 
 nurse practitioner, at least annually and shall submit an annual written
 report in conformity with the provisions of this subdivision.
   (d)  Following  a  resident's stay in a hospital or residential health
 care facility, upon return to the adult care facility,  the  adult  care
 facility  shall not be required to obtain the report in paragraph (a) of
 this  subdivision,  and  instead  shall  obtain  a  statement  from  the
 discharging facility which shall:
   (i)  state that the resident is appropriate to return to the facility;
 and
   (ii) include the reason for the resident's stay, the treatment plan to
 be followed, and any new or changed orders, including medications.
   The statement shall be completed by a physician, a physician assistant
 UNDER THE SUPERVISION OF A LICENSED PHYSICIAN, or a nurse practitioner.
   (e) Nothing required in this section shall require the use of an iden-
 tical form in adult care  facilities  and  assisted  living  residences,
 either upon admission or return.
   §  30. Paragraphs (a), (b) and (c) of subdivision 1 of section 13-b of
 the workers' compensation law, as amended by chapter 473 of the laws  of
 2000, are amended to read as follows:
   (a)  Any  physician  licensed to practice medicine in the state of New
 York OR A PHYSICIAN ASSISTANT UNDER THE DIRECT  SUPERVISION  OF  SUCH  A
 LICENSED  PHYSICIAN may render emergency medical care under this chapter
 without authorization by the chair under this section; and
   (b) A licensed physician who is a  member  of  a  constituted  medical
 staff  of  any hospital OR A PHYSICIAN ASSISTANT UNDER THE DIRECT SUPER-
 VISION OF SUCH A LICENSED PHYSICIAN, may render medical care under  this
 chapter  while  an  injured employee remains a patient in such hospital;
 and
   (c) CONSISTENT WITH ARTICLE THIRTY-SEVEN OF THE PUBLIC HEALTH LAW  AND
 ARTICLE  ONE HUNDRED THIRTY-ONE-B OF THE EDUCATION LAW, MEDICAL CARE MAY
 BE RENDERED BY A PHYSICIAN ASSISTANT UNDER THE DIRECT SUPERVISION  OF  A
 LICENSED AUTHORIZED PHYSICIAN. Under the active and personal supervision
 of  an authorized physician medical care may be rendered by a registered
 nurse or other person trained in  laboratory  or  diagnostic  techniques
 within  the  scope  of such person's specialized training and qualifica-
 tions.  This  supervision  shall  be  evidenced  by  signed  records  of
 instructions for treatment and signed records of the patient's condition
 and progress. Reports of such treatment and supervision shall be made by
 such physician to the chair on such forms and at such times as the chair
 may require.
   §  31.  Paragraph (d) of subdivision 3 of section 13-c of the workers'
 compensation law, as added by chapter 828 of the laws of 1975,  subpara-
 graph  (ii) as amended and subparagraph (iii) as added by chapter 803 of
 the laws of 1983, and subparagraph (iv) as added and subparagraph (v) as
 renumbered by chapter 649 of the laws of 1985, is  amended  to  read  as
 follows:
   (d) (i) A physician rendering medical care at a medical center author-
 ized,  OR  A  PHYSICIAN ASSISTANT UNDER THE DIRECT SUPERVISION OF SUCH A
 PHYSICIAN, hereunder must be authorized to render such care pursuant  to
 this  chapter  and  he OR SHE shall limit his OR HER professional activ-
 ities hereunder to such medical care as his OR HER experience and train-
 ing qualify him OR HER to render.
   (ii) When para-medical, laboratory or X-ray services or other  medical
 care  is  required  it  shall be rendered, under the active and personal
 supervision of an authorized physician, by a registered nurse  or  other
 person  trained  in laboratory or diagnostic techniques within the scope

 S. 907                             10

 of such person's specialized training and  qualifications.  This  super-
 vision  shall  be evidenced by signed records of instructions for treat-
 ment and signed records of the patient's condition and progress. Reports
 of such treatment and supervision shall be made by such physician to the
 chairman on such forms and at such times as the chairman may require.
   (iii) When physical therapy care is required it shall be rendered by a
 duly  licensed  physical therapist upon the referral which may be direc-
 tive as to treatment of an  authorized  physician,  PHYSICIAN  ASSISTANT
 UNDER  THE DIRECT SUPERVISION OF SUCH PHYSICIAN or podiatrist within the
 scope of such physical therapist's specialized training  and  qualifica-
 tions as defined in article one hundred thirty-six of the education law.
 Reports  of  such treatment and records of instruction for treatment, if
 any, shall be maintained by the physical therapist and referring profes-
 sional and submitted to the chairman on such forms and at such times  as
 the chairman may require.
   (iv)  When  occupational therapy care is required it shall be rendered
 by a duly  licensed  and  registered  occupational  therapist  upon  the
 prescription or referral of an authorized physician OR PHYSICIAN ASSIST-
 ANT  UNDER  THE DIRECT SUPERVISION OF SUCH PHYSICIAN within the scope of
 such occupational therapist's specialized training and qualifications as
 defined in article one hundred fifty-six of the education  law.  Reports
 of  such  treatment  and  records  of instruction for treatment, if any,
 shall be maintained by the occupational therapist and referring  profes-
 sional  and submitted to the chairman on such forms and at such times as
 the chairman may require.
   (v) The physician rendering the medical care  hereunder  shall  be  in
 charge  of  the  care unless, in his OR HER judgment, it is necessary to
 refer the case to a specially trained  and  qualified  physician,  which
 physician  shall then assume complete responsibility for and supervision
 of any further medical care rendered.
   § 32. Subdivisions (d), (e) and (f) of section  33.04  of  the  mental
 hygiene  law,  subdivisions  (d)  and (f) as added by chapter 779 of the
 laws of 1977, such section as renumbered and subdivision (e) as  amended
 by chapter 334 of the laws of 1980, are amended to read as follows:
   (d)  Restraint  shall be effected only by written order of a physician
 OR A PHYSICIAN ASSISTANT UNDER THE SUPERVISION OF SUCH PHYSICIAN after a
 personal examination of the patient except in an emergency situation, as
 provided by subdivision (e) of this section. The order shall  set  forth
 the  facts  justifying the restraint and shall specify the nature of the
 restraint and any conditions for maintaining the restraint.   The  order
 shall  also  set forth the time of expiration of the authorization, with
 such order to apply for a period of no more than four  hours,  provided,
 however,  that any such order imposing restraint after nine o'clock p.m.
 may extend until nine o'clock a.m. of the next day.   A full  record  of
 restraint,  including  all signed orders of physicians, shall be kept in
 the patient's file and shall be  subject  to  inspection  by  authorized
 persons.
   (e)  If an emergency situation exists in which the patient is engaging
 in activity that presents an immediate danger  to  himself,  HERSELF  or
 others and a physician OR A PHYSICIAN ASSISTANT UNDER THE SUPERVISION OF
 SUCH  PHYSICIAN  is not immediately available, restraint may be effected
 only to the extent  necessary  to  prevent  the  patient  from  injuring
 himself or others at the direction of the senior member of the staff who
 is present.  The senior staff member shall cause a physician OR A PHYSI-
 CIAN ASSISTANT UNDER THE SUPERVISION OF SUCH PHYSICIAN to be immediately
 summoned and shall record the time of the call and the person contacted.

 S. 907                             11
 
 Pending  the  arrival  of a physician OR A PHYSICIAN ASSISTANT UNDER THE
 SUPERVISION OF SUCH PHYSICIAN, the patient shall be kept under  constant
 supervision.  If  a  physician OR A PHYSICIAN ASSISTANT UNDER THE SUPER-
 VISION  OF SUCH PHYSICIAN does not arrive within thirty minutes of being
 summoned, the senior staff member shall record any  such  delay  in  the
 patient's  clinical  record  and  also place into the patient's clinical
 record a written description  of  the  facts  justifying  the  emergency
 restraint which shall specify the nature of the restraint and any condi-
 tions  for maintaining the restraint until the arrival of a physician OR
 A PHYSICIAN ASSISTANT UNDER  THE  SUPERVISION  OF  SUCH  PHYSICIAN,  the
 reasons  why  less  restrictive  forms of restraint were not used, and a
 description of the steps taken  to  assure  that  the  patient's  needs,
 comfort  and  safety were properly cared for. Such physician OR A PHYSI-
 CIAN ASSISTANT UNDER THE SUPERVISION OF SUCH PHYSICIAN  shall  place  in
 the clinical record an explanation for any such delay.
   (f) During the time that a patient is in restraint, he OR SHE shall be
 monitored to see that his OR HER physical needs, comfort, and safety are
 properly  cared  for.  An assessment of the patient's condition shall be
 made at least once every thirty minutes or at more frequent intervals as
 directed by a physician OR A PHYSICIAN ASSISTANT UNDER  THE  SUPERVISION
 OF  SUCH  PHYSICIAN.  The assessment shall be recorded and placed in the
 patient's file. A patient in restraint shall be released from  restraint
 at  least  every two hours, except when asleep. If at any time a patient
 upon being released from restraint makes no overt  gestures  that  would
 threaten serious harm or injury to himself, HERSELF or others, restraint
 shall  not  be  reimposed and a physician shall be immediately notified.
 Restraint shall not be reimposed in such situation unless in the  physi-
 cian's  OR  A PHYSICIAN ASSISTANT'S UNDER THE SUPERVISION OF SUCH PHYSI-
 CIAN professional judgment release would be harmful to  the  patient  or
 others.
   § 33. Paragraph e of subdivision 1 of section 406 of the general busi-
 ness  law,  as amended by chapter 376 of the laws of 2015, is amended to
 read as follows:
   e. Each application shall be accompanied by a certificate  of  a  duly
 licensed  physician, A PHYSICIAN ASSISTANT UNDER THE SUPERVISION OF SUCH
 A PHYSICIAN or nurse practitioner to the extent authorized  by  law  and
 consistent  with  subdivision three of section six thousand nine hundred
 two of the education law on a form prescribed by the secretary,  showing
 freedom  from  any  infectious or communicable disease which certificate
 shall have been issued within thirty days  prior  to  the  date  of  the
 filing of the application.
   § 34. This act shall take effect immediately.

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