senate Bill S3289A

2011-2012 Legislative Session

Establishes the nurse practitioners modernization act

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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
Jun 13, 2012 print number 3289a
amend (t) and recommit to higher education
Jan 04, 2012 referred to higher education
Feb 15, 2011 referred to higher education

Bill Amendments

Original
A (Active)
Original
A (Active)

Co-Sponsors

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S3289 - Bill Details

See Assembly Version of this Bill:
A5308A
Current Committee:
Senate Higher Education
Law Section:
Education Law
Laws Affected:
Amd §6902, Ed L

S3289 - Bill Texts

view summary

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.

view sponsor 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.

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

                                  3289

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                            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.

Co-Sponsors

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S3289A (ACTIVE) - Bill Details

See Assembly Version of this Bill:
A5308A
Current Committee:
Senate Higher Education
Law Section:
Education Law
Laws Affected:
Amd §6902, Ed L

S3289A (ACTIVE) - Bill Texts

view summary

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.

view sponsor memo
BILL NUMBER:S3289A

TITLE OF BILL:

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

PURPOSE OR GENERAL IDEA OF BILL:

To limit 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 limit the
requirements for written collaboration agreements and practice
protocols between nurse practitioners (NPs) and physicians to NPs who
are practicing for less than 36 months and 3,600 hours with
exceptions for good cause approved by the Education Department. Under
the exceptions allowed, a collaborating physician may be substituted
by a collaborating NP who is past his or her written-collaboration
term and is qualified to collaborate in the specialty involved.

NPs who have passed the written-collaboration term successfully will
still be required to maintain "collaborative relationships" with
physicians or Article 28 hospitals with written guidelines covering
consultation and emergency referral plans. The written guidelines
must be filed with the department and failure to do so will
constitute misconduct.

The department will survey physicians and NPs on their experience with
the new requirements and report their findings and recommendations to
the legislature by September 1, 2016.

JUSTIFICATION:

Nurse Practitioners 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 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 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
2008: A.10829 - Referred to Higher Education Committee
2009-10: A.765-B - Referred to Higher Education Committee

FISCAL IMPLICATIONS:

Reduces administrative costs for the State Education Department.

EFFECTIVE DATE:

180 days after the date of enactment.

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

                                 3289--A

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                            February 15, 2011
                               ___________

Introduced  by  Sens. YOUNG, AVELLA, ESPAILLAT, MONTGOMERY, OPPENHEIMER,
  RITCHIE, ROBACH -- read twice and ordered printed, and when printed to
  be committed to the Committee on Higher Education  --  recommitted  to
  the  Committee  on  Higher Education in accordance with Senate Rule 6,
  sec. 8 -- committee discharged, bill  amended,  ordered  reprinted  as
  amended and recommitted to said committee

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:

  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) (I) The practice of registered professional nursing by a nurse
practitioner, certified under section six thousand nine hundred  ten  of
this  article  AND PRACTICING FOR FEWER THAN THIRTY-SIX MONTHS AND THREE
THOUSAND SIX HUNDRED HOURS, may include the  diagnosis  of  illness  and
physical  conditions  and  the performance of therapeutic and corrective
measures within a specialty area of practice, in  collaboration  with  a
licensed  physician  qualified to collaborate in the specialty involved,
provided such services are performed in accordance with a written  prac-
tice  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 practi-
tioner 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.   IN THE EVENT THAT  (I)  AN  EXISTING  WRITTEN  PRACTICE
AGREEMENT  WITH  A COLLABORATING PHYSICIAN TERMINATES AS A RESULT OF THE

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD01405-04-2

S. 3289--A                          2

COLLABORATING PHYSICIAN MOVING, RETIRING, NO LONGER NEEDING THE SERVICES
OF THE NURSE PRACTITIONER, NO LONGER BEING QUALIFIED TO PRACTICE OR UPON
HIS OR HER DEATH AND THE NURSE PRACTITIONER IS UNABLE TO  ENTER  INTO  A
NEW  WRITTEN PRACTICE AGREEMENT WITH ANOTHER COLLABORATING PHYSICIAN; OR
IF (II) A NURSE PRACTITIONER OBTAINS APPROVAL BY THE DEPARTMENT BASED ON
A DEMONSTRATION TO THE DEPARTMENT  THAT  AN  EXISTING  WRITTEN  PRACTICE
AGREEMENT  WAS TERMINATED DUE TO NO FAULT ON THE PART OF THE NURSE PRAC-
TITIONER, AND THAT THE NURSE PRACTITIONER IS UNABLE TO ENTER INTO A  NEW
WRITTEN   PRACTICE  AGREEMENT  WITHIN  ANOTHER  COLLABORATING  PHYSICIAN
FOLLOWING A SHOWING OF GOOD FAITH EFFORT; THEN:  SUCH NURSE PRACTITIONER
MAY CONTINUE TO PRACTICE PURSUANT TO THIS PARAGRAPH WITHIN  A  SPECIALTY
AREA OF PRACTICE FOR A PERIOD OF UP TO SIX MONTHS, IN COLLABORATION WITH
A  NURSE  PRACTITIONER WHO HAS BEEN CERTIFIED UNDER SECTION SIX THOUSAND
NINE HUNDRED TEN OF THIS ARTICLE, WHO HAS BEEN PRACTICING FOR MORE  THAN
THIRTY-SIX MONTHS AND THREE THOUSAND SIX HUNDRED HOURS AND WHO IS QUALI-
FIED  TO  COLLABORATE  IN THE SPECIALTY INVOLVED, PROVIDED THAT SERVICES
ARE PERFORMED IN ACCORDANCE WITH A WRITTEN PRACTICE AGREEMENT AND  WRIT-
TEN  PRACTICE  PROTOCOLS;  SUCH  SIX MONTH TIME PERIOD FOR COLLABORATION
BETWEEN NURSE PRACTITIONERS MAY BE EXTENDED FOR A PERIOD OF TIME NOT  TO
EXCEED  AN ADDITIONAL SIX MONTHS UPON A SHOWING OF GOOD CAUSE SUBJECT TO
THE APPROVAL OF THE DEPARTMENT.
  [(b)] (II) Prescriptions for drugs, devices and immunizing agents  may
be  issued  by  a nurse practitioner, under this [subdivision] PARAGRAPH
and section six thousand nine hundred ten of this article, in accordance
with the practice agreement and practice protocols.  The  nurse  practi-
tioner  shall obtain a certificate from the department upon successfully
completing a program including an appropriate pharmacology component, or
its equivalent, as established by the commissioner's regulations,  prior
to  prescribing  under  this  [subdivision]  PARAGRAPH.  The certificate
issued under section six thousand nine hundred ten of this article shall
state whether the nurse practitioner has successfully completed  such  a
program  or equivalent and is authorized to prescribe under this [subdi-
vision] PARAGRAPH.
  [(c)] (III) Each practice agreement shall provide for patient  records
review  by the collaborating physician OR, WHERE APPLICABLE, THE COLLAB-
ORATING NURSE PRACTITIONER, in a timely fashion but  in  no  event  less
often  than  every three months. The names of the nurse practitioner and
the collaborating physician  OR,  WHERE  APPLICABLE,  THE  COLLABORATING
NURSE  PRACTITIONER  shall  be clearly posted in the practice setting of
the nurse practitioner.
  [(d)] (IV)  The  practice  protocol  shall  reflect  current  accepted
medical  and  nursing practice, OR WHERE APPLICABLE THE CURRENT ACCEPTED
NURSING PRACTICE.   The protocols shall be  filed  with  the  department
within  ninety  days  of  the  commencement  of  the practice and may be
updated periodically. The commissioner shall make regulations establish-
ing the procedure for the review of protocols and the disposition of any
issues arising from such review.
  [(e)] (V) No physician OR, WHERE APPLICABLE, NURSE PRACTITIONER, shall
enter into practice agreements with more than four  nurse  practitioners
who  are  not located on the same physical premises as the collaborating
physician OR COLLABORATING NURSE PRACTITIONER.
  (B) (I) THE PRACTICE OF REGISTERED PROFESSIONAL  NURSING  BY  A  NURSE
PRACTITIONER,  CERTIFIED  UNDER SECTION SIX THOUSAND NINE HUNDRED TEN OF
THIS ARTICLE AND PRACTICING FOR MORE THAN THIRTY-SIX  MONTHS  AND  THREE
THOUSAND  SIX  HUNDRED  HOURS,  MAY INCLUDE THE DIAGNOSIS OF ILLNESS AND

S. 3289--A                          3

PHYSICAL CONDITIONS AND THE PERFORMANCE OF  THERAPEUTIC  AND  CORRECTIVE
MEASURES WITHIN A SPECIALTY AREA OF PRACTICE.
  (II)  PRESCRIPTIONS  FOR  DRUGS,  DEVICES AND IMMUNIZING AGENTS MAY BE
ISSUED BY A NURSE PRACTITIONER, UNDER THIS  PARAGRAPH  AND  SECTION  SIX
THOUSAND  NINE HUNDRED TEN OF THIS ARTICLE. 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 PARAGRAPH; PROVIDED THAT ANY CERTIFICATE ISSUED
PURSUANT TO SUBPARAGRAPH (II) OF PARAGRAPH (A) OF THIS SUBDIVISION SHALL
ALSO SATISFY THE REQUIREMENTS OF THIS  SUBPARAGRAPH.    THE  CERTIFICATE
ISSUED UNDER SECTION SIX THOUSAND NINE HUNDRED TEN OF THIS ARTICLE SHALL
STATE  WHETHER  THE NURSE PRACTITIONER HAS SUCCESSFULLY COMPLETED SUCH A
PROGRAM OR EQUIVALENT AND IS AUTHORIZED TO PRESCRIBE  UNDER  THIS  PARA-
GRAPH.
  (III)  A NURSE PRACTITIONER, CERTIFIED UNDER SECTION SIX THOUSAND NINE
HUNDRED TEN OF THIS ARTICLE AND  PRACTICING  FOR  MORE  THAN  THIRTY-SIX
MONTHS AND THREE THOUSAND SIX HUNDRED HOURS, SHALL EITHER HAVE A WRITTEN
PRACTICE AGREEMENT AND WRITTEN PRACTICE PROTOCOLS WITH A LICENSED PHYSI-
CIAN  IN  CONFORMITY WITH THE REQUIREMENTS SET FORTH IN PARAGRAPH (A) OF
THIS SUBDIVISION OR SHALL HAVE COLLABORATIVE RELATIONSHIPS WITH  ONE  OR
MORE  LICENSED  PHYSICIANS  QUALIFIED  TO  COLLABORATE  IN THE SPECIALTY
INVOLVED OR A HOSPITAL,  LICENSED  UNDER  ARTICLE  TWENTY-EIGHT  OF  THE
PUBLIC  HEALTH  LAW,  THAT PROVIDES SERVICES THROUGH LICENSED PHYSICIANS
HAVING PRIVILEGES AT SUCH INSTITUTION AND QUALIFIED  TO  COLLABORATE  IN
THE  SPECIALTY  INVOLVED.  SUCH COLLABORATIVE RELATIONSHIP SHALL INCLUDE
WRITTEN GUIDELINES FOR PRACTICE THAT PROVIDE FOR THE CRITERIA TO BE USED
REGARDING CONSULTATION, INCLUDING METHODS AND FREQUENCY OF HOW CONSULTA-
TION SHALL BE PROVIDED, COLLABORATIVE MANAGEMENT AND REFERRAL, INCLUDING
EMERGENCY REFERRAL PLANS, TO ADDRESS THE  HEALTH  STATUS  AND  RISKS  OF
PATIENTS.  DOCUMENTATION  OF  SUCH  COLLABORATIVE RELATIONSHIPS SHALL BE
MAINTAINED BY THE NURSE PRACTITIONER AND THE  NURSE  PRACTITIONER  SHALL
MAKE INFORMATION ABOUT SUCH COLLABORATIVE RELATIONSHIPS AVAILABLE TO HIS
OR  HER  PATIENTS UPON REQUEST.  FAILURE TO COMPLY WITH THE REQUIREMENTS
FOUND IN THIS SUBPARAGRAPH SHALL BE SUBJECT TO  PROFESSIONAL  MISCONDUCT
PROVISIONS AS SET FORTH IN ARTICLE ONE HUNDRED THIRTY OF THIS TITLE.
  (IV)  THE  WRITTEN  GUIDELINES  FOR  PRACTICE  SHALL  REFLECT  CURRENT
ACCEPTED MEDICAL AND NURSING  PRACTICE  AND  SHALL  BE  FILED  WITH  THE
DEPARTMENT,  ALONG WITH AN ATTESTATION BY THE NURSE PRACTITIONER IDENTI-
FYING THE PHYSICIAN, PHYSICIANS, OR HOSPITAL THAT HAVE AGREED TO PARTIC-
IPATE IN THE COLLABORATIVE RELATIONSHIP PURSUANT TO SUCH WRITTEN  GUIDE-
LINES, WITHIN NINETY DAYS OF THE COMMENCEMENT OF THE PRACTICE AND MAY BE
UPDATED PERIODICALLY. THE COMMISSIONER SHALL MAKE REGULATIONS ESTABLISH-
ING THE PROCEDURES FOR THE REVIEW OF WRITTEN GUIDELINES AND THE DISPOSI-
TION OF ANY ISSUES ARISING FROM SUCH REVIEW.
  [(f)]  (C)  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  certification,  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. 3289--A                          4

  (E) THE DEPARTMENT SHALL REVIEW THE COMPONENTS COMMONLY FOUND  IN  THE
WRITTEN GUIDELINES FOR PRACTICE FILED WITH THE DEPARTMENT AND SHALL ALSO
ESTABLISH A SURVEY FORM, WHICH SHALL BE MADE AVAILABLE TO PHYSICIANS AND
NURSE  PRACTITIONERS LICENSED IN THE STATE, IN ORDER TO SOLICIT COMMENTS
REGARDING  THE  PRACTICAL IMPLEMENTATION AND FUNCTIONALITY OF COLLABORA-
TIVE AGREEMENTS BETWEEN NURSE PRACTITIONERS AND COLLABORATIVE  RELATION-
SHIPS  BETWEEN  A  NURSE  PRACTITIONER AND A PHYSICIAN AND THE IMPACT OF
SUCH AGREEMENTS AND  RELATIONSHIPS  TO  THE  PROVISION  OF  HEALTH  CARE
SERVICES  WITHIN  THE  STATE. THE COMMISSIONER, IN CONSULTATION WITH THE
COMMISSIONER OF HEALTH, SHALL ISSUE A REPORT THAT SUMMARIZES THE  COMPO-
NENTS  COMMONLY  FOUND  IN  THE  WRITTEN GUIDELINES FOR PRACTICE AND THE
COMMENTS RECEIVED RELATING TO COLLABORATIVE AGREEMENTS AND COLLABORATIVE
RELATIONSHIPS ALONG WITH INFORMATION THAT INCLUDES, BUT IS  NOT  LIMITED
TO:  THE NUMBER OF NURSE PRACTITIONERS PRACTICING FOR FEWER THAN THIRTY-
SIX MONTHS AND THREE THOUSAND SIX HUNDRED HOURS THAT  PRACTICE  PURSUANT
TO A COLLABORATIVE AGREEMENT WITH A PHYSICIAN; THE NUMBER OF NURSE PRAC-
TITIONERS PRACTICING FOR FEWER THAN THIRTY-SIX MONTHS AND THREE THOUSAND
SIX  HUNDRED  HOURS  THAT PRACTICE PURSUANT TO A COLLABORATIVE AGREEMENT
WITH A NURSE PRACTITIONER FOR SIX MONTHS AND THE NUMBER OF  THESE  NURSE
PRACTITIONERS  THAT  EXTEND  A COLLABORATIVE AGREEMENT FOR AN ADDITIONAL
SIX MONTHS UPON A SHOWING OF GOOD CAUSE SUBJECT TO THE APPROVAL  OF  THE
DEPARTMENT;  THE  NUMBER OF NURSE PRACTITIONERS PRACTICING FOR MORE THAN
THIRTY-SIX MONTHS AND THREE THOUSAND SIX  HUNDRED  HOURS  THAT  PRACTICE
PURSUANT  TO A COLLABORATIVE RELATIONSHIP WITH A PHYSICIAN; OTHER INFOR-
MATION THE DEPARTMENT DEEMS RELEVANT, INCLUDING BUT NOT LIMITED TO,  ANY
RECOMMENDATIONS  FOR THE CONTINUATION OR AMENDMENTS TO THE PROVISIONS OF
THIS SECTION  RELATING  TO  COLLABORATIVE  AGREEMENTS  OR  COLLABORATIVE
RELATIONSHIPS.  THE  COMMISSIONER SHALL SUBMIT THIS REPORT TO THE GOVER-
NOR, THE SPEAKER OF THE ASSEMBLY, THE TEMPORARY PRESIDENT OF THE SENATE,
AND THE CHAIRS OF THE ASSEMBLY AND SENATE HIGHER EDUCATION COMMITTEES BY
SEPTEMBER FIRST, TWO THOUSAND SIXTEEN.
  S 3. This act shall take effect on the one hundred eightieth day after
it shall have become a law and shall expire June 30, 2018 when upon such
date the provisions of this act  shall  be  deemed  repealed;  provided,
however,  that  effective  immediately,  the  addition, amendment and/or
repeal of any rule or regulation necessary  for  the  implementation  of
this act on its effective date is authorized and directed to be made and
completed on or before such effective date.

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