S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  9950--A
 
                           I N  A S S E M B L Y
 
                             February 27, 2018
                                ___________
 
 Introduced by M. of A. GOTTFRIED, BRAUNSTEIN, ENGLEBRIGHT, CAHILL, McDO-
   NALD,  D'URSO,  CROUCH,  THIELE, SEAWRIGHT, BUCHWALD, LIFTON, DICKENS,
   TAYLOR, JAFFEE, NIOU, LUPARDO, BARRON,  ZEBROWSKI,  NORRIS,  LAWRENCE,
   ERRIGO,  MONTESANO, BLAKE, ORTIZ, COOK, MOSLEY, LAVINE, GLICK, CRESPO,
   BICHOTTE, DE LA ROSA, GOODELL, RIVERA, FAHY -- Multi-Sponsored  by  --
   M.  of  A.  DAVILA,  GIGLIO,  HYNDMAN -- read once and referred to the
   Committee on Health -- reported and referred to the Committee on Codes
   -- committee discharged, bill amended, ordered  reprinted  as  amended
   and recommitted to said committee
 
 AN ACT to amend the public health law and the education law, in relation
   to hospital standing orders for the care of newborns
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. The public health law is amended by adding  a  new  section
 2803-v to read as follows:
   § 2803-V. STANDING ORDERS FOR NEWBORN CARE IN A HOSPITAL.  1. A HOSPI-
 TAL MAY ESTABLISH STANDING ORDERS FOR THE CARE OF NEWBORNS IN THE HOSPI-
 TAL  UNTIL  THE DISCHARGE OF THE NEWBORN FROM THE HOSPITAL FOLLOWING THE
 BIRTH, WHICH MAY AUTHORIZE AN ATTENDING NURSE TO  PROVIDE  SERVICES  AND
 CARE TO HEALTHY NEWBORNS.
   2. AS USED IN THIS SECTION, UNLESS THE CONTEXT CLEARLY REQUIRES OTHER-
 WISE:
   (A) "HOSPITAL" MEANS A HOSPITAL THAT ROUTINELY PROVIDES PERINATAL CARE
 TO NEWBORNS.
   (B)  "ATTENDING PRACTITIONER" MEANS THE PHYSICIAN, NURSE PRACTITIONER,
 PHYSICIAN ASSISTANT OR MIDWIFE, ACTING WITHIN HIS OR  HER  LAWFUL  SCOPE
 AND  TERMS  OF  PRACTICE,  ATTENDING  THE  BIRTH  OR POSTNATAL CARE OF A
 NEWBORN IN A HOSPITAL.
   (C) "ATTENDING NURSE" MEANS A REGISTERED NURSE ATTENDING THE POSTNATAL
 CARE OF A NEWBORN, ACTING WITHIN HIS OR HER LAWFUL SCOPE OF PRACTICE.
   (D) "STANDING ORDER" MEANS A NON-PATIENT SPECIFIC ORDER FOR  THE  CARE
 OF HEALTHY NEWBORNS IN THE HOSPITAL, ESTABLISHED UNDER THIS SECTION.
   3. A STANDING ORDER MAY BE IMPLEMENTED IN THE CASE OF ANY NEWBORN WHEN
 (A)  DIRECTED  BY THE ATTENDING PRACTITIONER, OR (B) IN THE ABSENCE OF A
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
              

                       [ ] is old law to be omitted.
                                                            LBD14792-02-8

 A. 9950--A                          2
 
 SPECIFIC DIRECTION BY THE ATTENDING PRACTITIONER,  THE  ATTENDING  NURSE
 DETERMINES,  IN  HIS OR HER PROFESSIONAL JUDGMENT, THAT IMPLEMENTING THE
 STANDING ORDER FOR THE NEWBORN IS CLINICALLY APPROPRIATE AND  CONSISTENT
 WITH  THE  STANDING  ORDER, THE HOSPITAL'S POLICIES AND APPLICABLE REGU-
 LATIONS. THE STANDING ORDER SHALL NOT BE IMPLEMENTED IN A SPECIFIC SITU-
 ATION WHERE THE HOSPITAL'S POLICIES, THE STANDING ORDER,  OR  APPLICABLE
 REGULATIONS PROVIDE OTHERWISE.
   4.  (A)  A STANDING ORDER SHALL PROVIDE FOR THE CIRCUMSTANCES IN WHICH
 THE CONDITION OR CHANGE IN CONDITION OF THE  NEWBORN  OR  THE  NEWBORN'S
 MOTHER,  OR  OTHER CIRCUMSTANCES RELATING TO PROVIDING SERVICES AND CARE
 TO THE NEWBORN, REQUIRE DEPARTURE FROM THE TERMS OF THE STANDING ORDER.
   (B) WHERE AN ATTENDING NURSE IMPLEMENTING  A  STANDING  ORDER  BECOMES
 AWARE  OF  CIRCUMSTANCES  THAT,  IN  HIS  OR  HER PROFESSIONAL JUDGMENT,
 REASONABLY INDICATE A NEED TO DEPART FROM  THE  TERMS  OF  THE  STANDING
 ORDER,  HE  OR  SHE  SHALL SO ADVISE THE ATTENDING PRACTITIONER. IN SUCH
 CIRCUMSTANCES, IF THE ATTENDING NURSE DETERMINES, IN HIS OR HER  PROFES-
 SIONAL  JUDGMENT, THAT THE HEALTH OF THE NEWBORN REQUIRES DEPARTING FROM
 THE STANDING ORDER PRIOR TO RECEIVING DIRECTION FROM THE ATTENDING PRAC-
 TITIONER, THE ATTENDING NURSE MAY DO SO,  CONSISTENT  WITH  HIS  OR  HER
 LAWFUL  SCOPE  OF PRACTICE, THE HOSPITAL'S POLICIES AND APPLICABLE REGU-
 LATIONS.
   (C) THE STANDING ORDER SHALL PROVIDE, INCLUDING THE TIMES AND  MANNER,
 THAT  AN  ATTENDING PRACTITIONER SHALL REVIEW AND ACKNOWLEDGE IN WRITING
 THE SERVICES AND CARE PROVIDED TO THE NEWBORN UNDER THE  STANDING  ORDER
 AND THE CONDITION OF THE NEWBORN.
   5.  (A)  A  STANDING  ORDER  MAY PROVIDE FOR CIRCUMSTANCES IN WHICH IT
 SHALL NOT BE IMPLEMENTED, OR IMPLEMENTED ONLY AT THE ORDER OF AN ATTEND-
 ING PRACTITIONER, WHICH MAY INCLUDE BUT NOT BE LIMITED TO:
   (I) LACK OF OR INADEQUATE PRENATAL CARE;
   (II) A BIRTH NOT ATTENDED BY AN ATTENDING PRACTITIONER;
   (III) A BIRTH NOT OCCURRING IN A HOSPITAL; OR
   (IV) A PREMATURE OR LOW BIRTH WEIGHT BIRTH.
   (B) A STANDING ORDER SHALL BE DATED, TIMED, AND AUTHENTICATED PROMPTLY
 IN THE PATIENT'S MEDICAL RECORD BY THE ATTENDING PRACTITIONER ACTING  IN
 ACCORDANCE  WITH  LAW,  INCLUDING SCOPE-OF-PRACTICE LAWS, HOSPITAL POLI-
 CIES, AND MEDICAL STAFF BYLAWS, RULES AND REGULATIONS.
   6. A STANDING ORDER MAY BE IMPLEMENTED ONLY IF THE IMPLEMENTING HOSPI-
 TAL:
   (A) ESTABLISHES THAT THE ORDER HAS BEEN REVIEWED AND APPROVED  BY  THE
 HOSPITAL'S MEDICAL STAFF AND NURSING AND PHARMACY LEADERSHIP;
   (B)  DEMONSTRATES  THAT THE ORDER IS CONSISTENT WITH NATIONALLY RECOG-
 NIZED EVIDENCE-BASED GUIDELINES; AND
   (C) ENSURES THAT THE PERIODIC AND  REGULAR  REVIEW  OF  THE  ORDER  IS
 CONDUCTED BY THE HOSPITAL'S MEDICAL STAFF AND NURSING AND PHARMACY LEAD-
 ERSHIP TO DETERMINE THE CONTINUING USEFULNESS AND SAFETY OF THE ORDER.
   7.  A STANDING ORDER IS A MEDICAL REGIMEN; IT SHALL BE CONSISTENT WITH
 THE LAWFUL SCOPE OF PRACTICE OF A REGISTERED NURSE.
   8. THE COMMISSIONER MAY MAKE REGULATIONS GOVERNING THE  TERMS,  PROCE-
 DURES AND IMPLEMENTATION OF STANDING ORDERS.
   §  2.  Section  6909  of  the education law is amended by adding a new
 subdivision 9 to read as follows:
   9. A REGISTERED PROFESSIONAL NURSE MAY EXECUTE A  STANDING  ORDER  FOR
 NEWBORN  CARE  IN  A  HOSPITAL  ESTABLISHED  UNDER  SECTION TWENTY-EIGHT
 HUNDRED THREE-V OF THE PUBLIC HEALTH LAW, AS PROVIDED IN  THAT  SECTION.
 THE COMMISSIONER MAY MAKE REGULATIONS RELATING TO IMPLEMENTATION OF THIS
 SUBDIVISION.

 A. 9950--A                          3
 
   § 3. This act shall take effect on the one hundred twentieth day after
 it  shall have become a law.  Effective immediately, the commissioner of
 health and the commissioner of education may make regulations  and  take
 other actions reasonably necessary to implement this act on that date.

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  9950--B
 
                           I N  A S S E M B L Y
 
                             February 27, 2018
                                ___________
 
 Introduced by M. of A. GOTTFRIED, BRAUNSTEIN, ENGLEBRIGHT, CAHILL, McDO-
   NALD,  D'URSO,  CROUCH,  THIELE, SEAWRIGHT, BUCHWALD, LIFTON, DICKENS,
   TAYLOR, JAFFEE, NIOU, LUPARDO, BARRON,  ZEBROWSKI,  NORRIS,  LAWRENCE,
   ERRIGO,  MONTESANO, BLAKE, ORTIZ, COOK, MOSLEY, LAVINE, GLICK, CRESPO,
   BICHOTTE, DE LA ROSA, GOODELL, RIVERA, FAHY -- Multi-Sponsored  by  --
   M.  of  A.  DAVILA,  GIGLIO,  HYNDMAN -- read once and referred to the
   Committee on Health -- reported and referred to the Committee on Codes
   -- committee discharged, bill amended, ordered  reprinted  as  amended
   and  recommitted  to  said  committee  -- reported and referred to the
   Committee on  Rules  --  Rules  Committee  discharged,  bill  amended,
   ordered reprinted as amended and recommitted to the Committee on Rules
 
 AN ACT to amend the public health law and the education law, in relation
   to hospital standing orders for the care of newborns
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. The public health law is amended by adding  a  new  section
 2803-v to read as follows:
   § 2803-V. STANDING ORDERS FOR NEWBORN CARE IN A HOSPITAL.  1. A HOSPI-
 TAL MAY ESTABLISH STANDING ORDERS FOR THE CARE OF NEWBORNS IN THE HOSPI-
 TAL  UNTIL  THE DISCHARGE OF THE NEWBORN FROM THE HOSPITAL FOLLOWING THE
 BIRTH, WHICH MAY AUTHORIZE AN ATTENDING NURSE TO  PROVIDE  SERVICES  AND
 CARE TO HEALTHY NEWBORNS.
   2. AS USED IN THIS SECTION, UNLESS THE CONTEXT CLEARLY REQUIRES OTHER-
 WISE:
   (A) "HOSPITAL" MEANS A HOSPITAL THAT ROUTINELY PROVIDES PERINATAL CARE
 TO NEWBORNS.
   (B)  "ATTENDING PRACTITIONER" MEANS THE PHYSICIAN, NURSE PRACTITIONER,
 PHYSICIAN ASSISTANT OR MIDWIFE, ACTING WITHIN HIS OR  HER  LAWFUL  SCOPE
 AND  TERMS  OF  PRACTICE,  ATTENDING  THE  BIRTH  OR POSTNATAL CARE OF A
 NEWBORN IN A HOSPITAL.
   (C) "ATTENDING NURSE" MEANS A REGISTERED NURSE ATTENDING THE POSTNATAL
 CARE OF A NEWBORN, ACTING WITHIN HIS OR HER LAWFUL SCOPE OF PRACTICE.
   (D) "STANDING ORDER" MEANS A NON-PATIENT SPECIFIC ORDER FOR  THE  CARE
 OF HEALTHY NEWBORNS IN THE HOSPITAL, ESTABLISHED UNDER THIS SECTION.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
              

                       [ ] is old law to be omitted.
                                                            LBD14792-04-8

 A. 9950--B                          2
 
   3. A STANDING ORDER MAY BE IMPLEMENTED IN THE CASE OF ANY NEWBORN WHEN
 (A)  DIRECTED  BY THE ATTENDING PRACTITIONER, OR (B) IN THE ABSENCE OF A
 SPECIFIC DIRECTION BY THE ATTENDING PRACTITIONER,  THE  ATTENDING  NURSE
 DETERMINES,  IN  HIS OR HER PROFESSIONAL JUDGMENT, THAT IMPLEMENTING THE
 STANDING  ORDER FOR THE NEWBORN IS CLINICALLY APPROPRIATE AND CONSISTENT
 WITH THE STANDING ORDER, THE HOSPITAL'S POLICIES  AND  APPLICABLE  REGU-
 LATIONS. THE STANDING ORDER SHALL NOT BE IMPLEMENTED IN A SPECIFIC SITU-
 ATION  WHERE  THE HOSPITAL'S POLICIES, THE STANDING ORDER, OR APPLICABLE
 REGULATIONS PROVIDE OTHERWISE.
   4. (A) A STANDING ORDER SHALL PROVIDE FOR THE CIRCUMSTANCES  IN  WHICH
 THE  CONDITION  OR  CHANGE  IN CONDITION OF THE NEWBORN OR THE NEWBORN'S
 MOTHER, OR OTHER CIRCUMSTANCES RELATING TO PROVIDING SERVICES  AND  CARE
 TO THE NEWBORN, REQUIRE DEPARTURE FROM THE TERMS OF THE STANDING ORDER.
   (B)  WHERE  AN  ATTENDING  NURSE IMPLEMENTING A STANDING ORDER BECOMES
 AWARE OF CIRCUMSTANCES  THAT,  IN  HIS  OR  HER  PROFESSIONAL  JUDGMENT,
 REASONABLY  INDICATE  A  NEED  TO  DEPART FROM THE TERMS OF THE STANDING
 ORDER, HE OR SHE SHALL SO ADVISE THE  ATTENDING  PRACTITIONER.  IN  SUCH
 CIRCUMSTANCES,  IF THE ATTENDING NURSE DETERMINES, IN HIS OR HER PROFES-
 SIONAL JUDGMENT, THAT THE HEALTH OF THE NEWBORN REQUIRES DEPARTING  FROM
 THE STANDING ORDER PRIOR TO RECEIVING DIRECTION FROM THE ATTENDING PRAC-
 TITIONER,  THE  ATTENDING  NURSE  MAY  DO SO, CONSISTENT WITH HIS OR HER
 LAWFUL SCOPE OF PRACTICE, THE HOSPITAL'S POLICIES AND  APPLICABLE  REGU-
 LATIONS.
   (C)  THE STANDING ORDER SHALL PROVIDE, INCLUDING THE TIMES AND MANNER,
 THAT AN ATTENDING PRACTITIONER SHALL REVIEW AND ACKNOWLEDGE  IN  WRITING
 THE  SERVICES  AND CARE PROVIDED TO THE NEWBORN UNDER THE STANDING ORDER
 AND THE CONDITION OF THE NEWBORN.
   5. (A) A STANDING ORDER MAY PROVIDE  FOR  CIRCUMSTANCES  IN  WHICH  IT
 SHALL NOT BE IMPLEMENTED, OR IMPLEMENTED ONLY AT THE ORDER OF AN ATTEND-
 ING PRACTITIONER, WHICH MAY INCLUDE BUT NOT BE LIMITED TO:
   (I) LACK OF OR INADEQUATE PRENATAL CARE;
   (II) A BIRTH NOT ATTENDED BY AN ATTENDING PRACTITIONER;
   (III) A BIRTH NOT OCCURRING IN A HOSPITAL; OR
   (IV) A PREMATURE OR LOW BIRTH WEIGHT BIRTH.
   (B) A STANDING ORDER SHALL BE DATED, TIMED, AND AUTHENTICATED PROMPTLY
 IN  THE PATIENT'S MEDICAL RECORD BY THE ATTENDING PRACTITIONER ACTING IN
 ACCORDANCE WITH LAW, INCLUDING SCOPE-OF-PRACTICE  LAWS,  HOSPITAL  POLI-
 CIES, AND MEDICAL STAFF BYLAWS, RULES AND REGULATIONS.
   6. A STANDING ORDER MAY BE IMPLEMENTED ONLY IF THE IMPLEMENTING HOSPI-
 TAL:
   (A)  ESTABLISHES  THAT THE ORDER HAS BEEN REVIEWED AND APPROVED BY THE
 HOSPITAL'S MEDICAL STAFF AND NURSING AND PHARMACY LEADERSHIP, AND SIGNED
 BY A PHYSICIAN AFFILIATED WITH THE HOSPITAL OR, IN THE CASE OF A MIDWIF-
 ERY BIRTH CENTER, BY A MIDWIFE AFFILIATED WITH THE HOSPITAL;
   (B) DEMONSTRATES THAT THE ORDER IS CONSISTENT WITH  NATIONALLY  RECOG-
 NIZED EVIDENCE-BASED GUIDELINES; AND
   (C)  ENSURES  THAT  THE  PERIODIC  AND  REGULAR REVIEW OF THE ORDER IS
 CONDUCTED BY THE HOSPITAL'S MEDICAL STAFF AND NURSING AND PHARMACY LEAD-
 ERSHIP TO DETERMINE THE CONTINUING USEFULNESS AND SAFETY OF THE ORDER.
   7. A STANDING ORDER IS A MEDICAL REGIMEN; IT SHALL BE CONSISTENT  WITH
 THE LAWFUL SCOPE OF PRACTICE OF A REGISTERED NURSE.
   8.  THE  COMMISSIONER MAY MAKE REGULATIONS GOVERNING THE TERMS, PROCE-
 DURES AND IMPLEMENTATION OF STANDING ORDERS.
   § 2. Section 6909 of the education law is  amended  by  adding  a  new
 subdivision 9 to read as follows:

 A. 9950--B                          3
 
   9.  A  REGISTERED  PROFESSIONAL NURSE MAY EXECUTE A STANDING ORDER FOR
 NEWBORN CARE  IN  A  HOSPITAL  ESTABLISHED  UNDER  SECTION  TWENTY-EIGHT
 HUNDRED  THREE-V  OF THE PUBLIC HEALTH LAW, AS PROVIDED IN THAT SECTION.
 THE COMMISSIONER MAY MAKE REGULATIONS RELATING TO IMPLEMENTATION OF THIS
 SUBDIVISION.
   § 3. This act shall take effect on the one hundred twentieth day after
 it  shall have become a law.  Effective immediately, the commissioner of
 health and the commissioner of education may make regulations  and  take
 other actions reasonably necessary to implement this act on that date.