senate Bill S324

2011-2012 Legislative Session

Allows certified nurse practitioners to practice without collaboration of a licensed physician

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Archive: Last Bill Status - In Committee


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor

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Actions

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Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Mar 12, 2012 committee discharged and committed to rules
Feb 21, 2012 notice of committee consideration - requested
Jan 04, 2012 referred to higher education
Jan 05, 2011 referred to higher education

Co-Sponsors

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S324 - Bill Details

Current Committee:
Law Section:
Education Law
Laws Affected:
Amd §6902, add §6911, Ed L
Versions Introduced in 2009-2010 Legislative Session:
S2948B

S324 - Bill Texts

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Allows the practice of registered professional nursing by a certified nurse practitioner to include diagnosis and performance without collaboration of a licensed physician.

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BILL NUMBER:S324

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, and provide
coverage for nurse practitioner services.

SUMMARY OF SPECIFIC PROVISIONS:
Section 1 of the bill amends the nurse practice act in Education Law
to delete the requirements for a collaboration agreement and practice
protocols between nurse practitioners and physicians.
Section 2 establishes a nurse practitioner
advisory panel, appointed by the Regents.

Sections 4, 5, 6, and 7 mandate that major medical, comprehensive-type
insurance benefits, as well as managed care policies, extend coverage
to nurse practitioners, including those working in independent
settings.

JUSTIFICATION:
Nurse practitioners (NPs) practice in a variety of primary and
specialty care settings including ambulatory, acute, long term 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 advance
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 written
practice agreement which can be as narrow or as broad as the MD is
willing. Elsewhere, NP's 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:
2008: Referred to and died in Higher Education Committee;
2009-10: Referred to and died in Higher Education Committee.

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

EFFECTIVE DATE:


Immediately, with provisions.

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                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                   324

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                               (PREFILED)

                             January 5, 2011
                               ___________

Introduced by Sens. MONTGOMERY, HASSELL-THOMPSON, HUNTLEY, KLEIN, OPPEN-
  HEIMER, PERKINS -- 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.  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.
                                                           LBD01405-01-1

S. 324                              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 2. The education law is amended by adding a new section 6911 to read
as follows:
  S 6911. NURSE PRACTITIONER ADVISORY PANEL. A NINE MEMBER NURSE PRACTI-
TIONER ADVISORY PANEL SHALL BE APPOINTED BY  THE  BOARD  OF  REGENTS  ON
RECOMMENDATION  OF  THE  COMMISSIONER  FOR  THE PURPOSE OF ASSISTING THE
BOARD OF REGENTS, THE BOARD FOR NURSING, AND THE COMMISSIONER ON MATTERS
RELATED TO THE PRACTICE OF REGISTERED NURSING AS A  NURSE  PRACTITIONER.
THE PANEL SHALL BE COMPOSED OF AT LEAST SIX LICENSED AND CERTIFIED NURSE
PRACTITIONERS,  AND  AT  LEAST  TWO  PERSONS  TO REPRESENT CONSUMERS AND
PATIENT GROUPS.
  S 3. This act shall take effect immediately; provided,  however,  that
section  one  of this act shall take effect on the one hundred eightieth
day after it shall have become a law; and provided, further, that effec-
tive immediately, 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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