Assembly Bill A4846A

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

                                  4846

                       2013-2014 Regular Sessions

                          I N  A S S E M B L Y

                            February 11, 2013
                               ___________

Introduced  by  M.  of  A.  GOTTFRIED, GUNTHER, PAULIN, LIFTON, LUPARDO,
  ENGLEBRIGHT,  GABRYSZAK,  HOOPER,  JAFFEE,   SCARBOROUGH,   ROSENTHAL,
  CAHILL,  PRETLOW, ORTIZ, BENEDETTO, CASTRO, GIBSON, RUSSELL, BRINDISI,
  RIVERA -- Multi-Sponsored by -- M. of A.  ABINANTI, BOYLAND,  BRENNAN,
  CROUCH,    CUSICK,    GALEF,    HEVESI,   LAVINE,   LENTOL,   MILLMAN,
  PEOPLES-STOKES, PERRY -- read once and referred 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:

  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 AGREE-

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD06944-02-3
              

A. 4846                             2

MENT WITH A COLLABORATING  PHYSICIAN  TERMINATES  AS  A  RESULT  OF  THE
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.
  [(f)]  (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

A. 4846                             3

AND  PHYSICAL  CONDITIONS AND THE PERFORMANCE OF THERAPEUTIC AND CORREC-
TIVE 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.
  (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 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.

A. 4846                             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 SEVENTEEN.
  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, 2019 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.

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

                                 4846--B

                       2013-2014 Regular Sessions

                          I N  A S S E M B L Y

                            February 11, 2013
                               ___________

Introduced  by  M.  of  A.  GOTTFRIED, GUNTHER, PAULIN, LIFTON, LUPARDO,
  ENGLEBRIGHT, HOOPER, JAFFEE, SCARBOROUGH, ROSENTHAL, CAHILL,  PRETLOW,
  ORTIZ,  BENEDETTO,  RUSSELL, BRINDISI, RIVERA -- Multi-Sponsored by --
  M. of A.  ABINANTI, BOYLAND, BRENNAN, CROUCH, CUSICK,  GALEF,  HEVESI,
  LAVINE,  LENTOL,  MILLMAN,  PEOPLES-STOKES,  PERRY  --  read  once and
  referred to the Committee on Higher Education -- committee discharged,
  bill amended, ordered reprinted as amended  and  recommitted  to  said
  committee  --  recommitted  to  the  Committee  on Higher Education in
  accordance with Assembly Rule 3, sec. 2 -- committee discharged,  bill
  amended,  ordered reprinted as amended and recommitted to said commit-
  tee

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, 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 physician
qualified to  collaborate  in  the  specialty  involved,  provided  such
services  are  performed in accordance with a written practice agreement
and written practice protocols EXCEPT AS PERMITTED BY PARAGRAPH  (B)  OF
THIS SUBDIVISION.  The written practice agreement shall include explicit
provisions  for  the  resolution of any disagreement between the collab-
orating physician and the nurse practitioner regarding a matter of diag-

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD06944-06-4
              

A. 4846--B                          2

nosis or treatment that is within the scope of practice of both. To  the
extent  the practice agreement does not so provide, then the collaborat-
ing physician's diagnosis or treatment shall prevail.
  (II) IN THE EVENT THAT (A) AN EXISTING WRITTEN PRACTICE AGREEMENT WITH
A  COLLABORATING  PHYSICIAN TERMINATES AS A RESULT OF: THE COLLABORATING
PHYSICIAN MOVING, RETIRING, NO LONGER NEEDING THE SERVICES OF THE  NURSE
PRACTITIONER,  NO  LONGER  BEING  QUALIFIED  TO PRACTICE; OR THE WRITTEN
PRACTICE AGREEMENT TERMINATING DUE TO NO FAULT ON THE PART OF THE  NURSE
PRACTITIONER; AND (B) THE NURSE PRACTITIONER DEMONSTRATES THAT HE OR SHE
HAS MADE A GOOD FAITH EFFORT TO ENTER INTO A NEW WRITTEN PRACTICE AGREE-
MENT  WITH  A COLLABORATING PHYSICIAN AND HAS BEEN UNABLE TO DO SO, THEN
UPON APPROVAL BY THE DEPARTMENT, 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 PRACTI-
TIONER WHO HAS BEEN CERTIFIED UNDER SECTION SIX  THOUSAND  NINE  HUNDRED
TEN  OF  THIS ARTICLE, WHO HAS BEEN PRACTICING FOR MORE THAN THREE THOU-
SAND SIX HUNDRED HOURS AND  WHO  IS  QUALIFIED  TO  COLLABORATE  IN  THE
SPECIALTY  INVOLVED,  PROVIDED THAT SERVICES ARE PERFORMED IN ACCORDANCE
WITH A WRITTEN PRACTICE AGREEMENT AND WRITTEN 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)] (III) 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 EXCEPT  AS  PERMITTED
BY  PARAGRAPH  (B)  OF  THIS SUBDIVISION.   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] 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 [subdivision]
PARAGRAPH.
  [(c)] (IV) 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)] (V) The practice protocol shall reflect current accepted medical
and nursing practice, OR FOR COLLABORATING WITH  ANOTHER  NURSE  PRACTI-
TIONER  PURSUANT  TO  SUBPARAGRAPH  (II)  OF THIS PARAGRAPH, 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
establishing  the procedure for the review of protocols and the disposi-
tion of any issues arising from such review.
  [(e)] (VI) No physician  OR,  WHERE  APPLICABLE,  NURSE  PRACTITIONER,
shall  enter  into practice agreements with more than four nurse practi-
tioners who are not located on the same physical premises as the collab-
orating physician OR COLLABORATING NURSE PRACTITIONER.
  [(f)] (B) NOTWITHSTANDING SUBPARAGRAPH (I) OF PARAGRAPH  (A)  OF  THIS
SUBDIVISION,  A  NURSE  PRACTITIONER, CERTIFIED UNDER SECTION SIXTY-NINE

A. 4846--B                          3

HUNDRED TEN OF THIS ARTICLE AND PRACTICING FOR MORE THAN THREE  THOUSAND
SIX  HUNDRED  HOURS  MAY COMPLY WITH THIS PARAGRAPH IN LIEU OF COMPLYING
WITH THE REQUIREMENTS OF PARAGRAPH (A) OF THIS SUBDIVISION  RELATING  TO
COLLABORATION WITH A PHYSICIAN, A WRITTEN PRACTICE AGREEMENT AND WRITTEN
PRACTICE  PROTOCOLS.  A NURSE PRACTITIONER COMPLYING WITH THIS PARAGRAPH
SHALL HAVE COLLABORATIVE RELATIONSHIPS WITH ONE OR MORE LICENSED  PHYSI-
CIANS  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 QUALIFIED TO COLLABORATE
IN THE SPECIALTY INVOLVED AND HAVING PRIVILEGES AT SUCH INSTITUTION.  AS
EVIDENCE  THAT  THE NURSE PRACTITIONER MAINTAINS COLLABORATIVE RELATION-
SHIPS, THE NURSE  PRACTITIONER  SHALL  COMPLETE  AND  MAINTAIN  A  FORM,
CREATED BY THE DEPARTMENT, WHICH THE NURSE PRACTITIONER SHALL ATTEST TO,
THAT  IDENTIFIES WRITTEN PRACTICE PROTOCOLS AND THE METHODS BY WHICH THE
NURSE PRACTITIONER WILL COLLABORATE SUCH AS: THE  CRITERIA  TO  BE  USED
REGARDING CONSULTATION, INCLUDING METHODS AND FREQUENCY OF HOW CONSULTA-
TION SHALL BE PROVIDED; COLLABORATIVE MANAGEMENT AND REFERRAL; AND EMER-
GENCY  REFERRAL  PLANS. SUCH FORMS SHALL BE UPDATED AS NEEDED AND MAY BE
SUBJECT TO REVIEW BY THE DEPARTMENT. THE NURSE PRACTITIONER  SHALL  MAKE
INFORMATION CONTAINED IN THIS FORM AVAILABLE TO HIS OR HER PATIENTS UPON
REQUEST. FAILURE TO COMPLY WITH THE REQUIREMENTS FOUND IN THIS PARAGRAPH
BY  A  NURSE  PRACTITIONER  WHO IS NOT COMPLYING WITH SUCH PROVISIONS OF
PARAGRAPH (A) OF THIS SUBDIVISION,  SHALL  BE  SUBJECT  TO  PROFESSIONAL
MISCONDUCT PROVISIONS AS SET FORTH IN ARTICLE ONE HUNDRED THIRTY OF THIS
TITLE.
  (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 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.
  (E) THE COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER OF HEALTH,
SHALL ISSUE A REPORT ON THE IMPLEMENTATION OF  THE  PROVISIONS  OF  THIS
SECTION,  ALONG  WITH  INFORMATION THAT INCLUDES, BUT IS NOT LIMITED TO:
THE NUMBER OF NURSE PRACTITIONERS PRACTICING FOR FEWER THAN THREE  THOU-
SAND  SIX  HUNDRED  HOURS  THAT  PRACTICE PURSUANT TO A WRITTEN PRACTICE
AGREEMENT WITH A PHYSICIAN; THE NUMBER OF NURSE PRACTITIONERS THAT PRAC-
TICE PURSUANT TO A WRITTEN PRACTICE AGREEMENT WITH A NURSE  PRACTITIONER
FOR SIX MONTHS AND THE NUMBER OF THESE NURSE PRACTITIONERS THAT EXTEND A
WRITTEN  PRACTICE  AGREEMENT FOR AN ADDITIONAL SIX MONTHS UPON A SHOWING
OF GOOD CAUSE SUBJECT TO THE APPROVAL OF THE DEPARTMENT; THE  NUMBER  OF
NURSE  PRACTITIONERS  THAT  PRACTICE PURSUANT TO COLLABORATIVE RELATION-
SHIPS WITH PHYSICIANS; AND OTHER INFORMATION THE DEPARTMENT DEEMS  RELE-
VANT,  INCLUDING BUT NOT LIMITED TO, ANY RECOMMENDATIONS FOR THE CONTIN-
UATION OF OR AMENDMENTS TO THE PROVISIONS OF THIS  SECTION  RELATING  TO
WRITTEN  PRACTICE AGREEMENTS OR COLLABORATIVE RELATIONSHIPS. THE COMMIS-
SIONER SHALL SUBMIT THIS REPORT TO THE  GOVERNOR,  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 EIGHTEEN.
  S  3.  This act shall take effect on the first day of January after it
shall have become a law and shall expire June 30 of the sixth year after

A. 4846--B                          4

it shall have become a law, when upon such date the provisions  of  this
act  shall  be  deemed repealed; provided, however, that effective imme-
diately, 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.