Assembly Bill A10218A

                                BILL NUMBER:A10218

TITLE  OF  BILL:    An  act  to  amend the education law, in relation to
authorizing nurse practitioners to perform functions in conjunction with
diagnosing an illness

PURPOSE OR GENERAL IDEA OF BILL: To clarify that nurse practitioners may
perform various functions in conjunction with clinical  services  within
their scope of practice.

SUMMARY OF SPECIFIC PROVISIONS: Adds a new paragraph (h) to section 6902
of  the  Education  Law to clarify that a nurse practitioner may perform
any function in conjunction with a diagnosis or treatment that is within
the nurse practitioner's scope of practice, where a  statute  authorizes
or  directs  a  physician  to  perform that function, unless the statute
expressly states otherwise or unless the statutory  or  medical  context
requires  otherwise.  For example, a nurse practitioner could fill out a
form certifying to a diagnosis, or issue an order.  This  section  shall
not be construed to increase or decrease the lawful scope of practice of
a nurse practitioner.

JUSTIFICATION: Under existing law, nurse practitioners are able to diag-
nose  illness  and  physical  conditions,  and  perform  therapeutic and
corrective measures within a specialty area of practice.  Yet  they  are
not  authorized  by  some  statutes to perform many functions related to
their lawful practice. Following are examples of why this legislation is
              

needed.

Nurse practitioners are frequently the caregivers in attendance  when  a
patient  passes  away. With their extensive training and expertise, they
are fully qualified under their existing  scope  of  practice  to  issue
death certificates.

Under current law, the attending physician must obtain the contemporane-
ous  consent  of  a  patient with decisional capacity prior to issuing a
DNR. The decision by an individual about whether  to  withhold  resusci-
tation  is a deeply personal one. It should be contemplated in consulta-
tion with a person's primary care provider, which in many instances is a
nurse practitioner.  Because  current  law  only  allows  physicians  to
execute  a  DNR,  many patients are deprived of the ability to make this
decision in collaboration with  their  primary  care  provider  if  such
provider  is  a  nurse practitioner.   Patients should not be limited to
establishing a DNR for themselves with a physician with  whom  they  may
have had little or no direct contact.

Many  children have a pediatric nurse practitioner as their primary care
provider. Nurse practitioners have the training, skill, and  familiarity
necessary to recognize and certify pediatric patients who are at risk of
detrimental  health  effects  from  vaccines.  In the interest of common
sense and efficiency, nurse practitioners should be recognized as  capa-
ble of making such certification when necessary.

PRIOR LEGISLATIVE HISTORY: new bill

FISCAL IMPLICATIONS: none

EFFECTIVE DATE: immediately