NY State Senate Bill 2021-S3056A

Archive: Last Bill Status - In Senate Committee Higher Education Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Actions

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Date of Action	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 05, 2022	referred to higher education
Jun 10, 2021	committed to rules
May 19, 2021	advanced to third reading
May 12, 2021	2nd report cal.
May 11, 2021	1st report cal.1008
Apr 30, 2021	print number 3056a
Apr 30, 2021	amend and recommit to higher education
Jan 27, 2021	referred to higher education

Votes

- May 11, 2021 - Higher Education Committee Vote
  S3056A
  
  Aye
  
  9
  
  Nay
  
  1
  
  Aye with Reservations
  
  1
  
  Absent
  
  0
  
  Excused
  
  0
  
  Abstained
  
  0
  - - Higher Education Committee Vote: May 11, 2021
      
      aye (9)
      
      Boyle
      
      Cooney
      
      Gaughran
      
      Gounardes
      
      Griffo
      
      Jackson
      
      Oberacker
      
      Parker
      
      Rivera
      
      nay (1)
      
      Liu
      
      aye wr (1)
      
      Stavisky

Bill Amendments

Original

A (Active)

co-Sponsors

View additional co-sponsors

2021-S3056 - Details

See Assembly Version of this Bill:: A1535
Current Committee:: Senate Higher Education
Law Section:: Education Law
Laws Affected:: Amd §6902, Ed L; amd Part D §3, Chap 56 of 2014
Versions Introduced in 2019-2020 Legislative Session:: S8936, A10990

2021-S3056 - Summary

Makes certain provisions of the "nurse practitioners modernization act" permanent; eliminates certain administrative obligations.

2021-S3056 - Sponsor Memo

                                
 
BILL NUMBER: S3056

SPONSOR: RIVERA
 
TITLE OF BILL:

An act to amend the education law, in relation to the practice protocol
for nurse practitioners; and to amend part D of chapter 56 of the laws
of 2014, amending the education law relating to enacting the "nurse
practitioners modernization act", in relation to the effectiveness ther-
eof

 
PURPOSE OR GENERAL IDEA OF BILL:

Makes the Nurse Practitioner Modernization Act ("NPMA") (Part D of Chap-
ter 56 of the Laws of 2014) permanent and eliminates certain administra-
tive obligations that create barriers to accessing healthcare, consist-
ent with the 2018 New York State Education Department ("SED") and
Department of Health ("DOH") report issued pursuant to that Chapter.

 
SUMMARY OF SPECIFIC PROVISIONS:

Section 1 amends Education Law § 6902(3)(a) to clarify that NPs who have
practiced for less than 3,600 hours still need to maintain a written
practice agreement ('WPA"), but allows those NPs to enter into WPAs with
either a physician or an experienced NP who is practicing without a
collaborative agreement; and eliminates the obligation that junior NPs
file written practice protocols ("WPPs"), consistent with the SED recom-
mendation in the 2018 report.

Section 2 amends Education Law § 6902(3)(b) to clarify that experienced
NPs are not required to maintain WPAs or any other collaborative
arrangements.

Section 3 amends chapter 56 of the laws of 2014 Part D to eliminate the
sunset date for NPMA.

Section 4 sets the effective date.

 
JUSTIFICATION:

In order to increase access to health care services and eliminate arti-
ficial boundaries to consumer care, as part of the 2014 budget, the
State adopted the Nurse Practitioner Modernization Act. The NPMA, among
other things: (i) eliminated the requirement that NPs with at least
3,600 hours of practice maintain a WPA or WPPs, provided that the expe-
rienced NP maintains a collaborative relationship with one or more
licensed physicians qualified to collaborate in specialty involved, or a
hospital; and (ii) required that the SED issue a report, in consultation
with DOH, regarding the law's implementation, and offer recommendations
regarding the law.

The joint SED-DOH report released in late November 2018 summarized the
law, described how it was implemented by SED, and included several
"Findings and Recommendations":

* SED stated that there is no "evidence that the Act had an adverse
impact on the quality of care rendered by NPs or the number of NPs prac-
ticing in" NYS.  Accordingly, SED proposed amending Education Law §
6902(3Xa)(iv) to eliminate the current requirement that NPs "file . ..
practice protocols," because " This provision was enacted in 1994 . . .
no longer serves an important government purpose."

The DOH added that it is "notable that to date, as indicated in the
report, there is no indication of adverse impact on quality of care or
the number of practicing NPs and no increase in the number of misconduct
proceedings. DOH believes that this is reflective of the positive impact
of the law, which is also evident in the significant body of data that
has been collected by the Center for Health Workforce Studies under the
authority of the law." Thus, DOH proposed: (i) Eliminating the SED
"Collaborative Relationships Attestation Form" through statute, and
instead require that "NPs . .  continue maintaining documentation in
support of collaborative relationships at their practice locations and
make this information available to the SED upon request;" and (ii)
Making the NPMA permanent "so that the original intent of the law in
promoting access to care can continue to be realized."

On March 23, 2020, the Governor went a step further and outright waived
any requirements for NPs regarding written practice agreements or colla-
borative relationships in light of the COVID pandemic.  Specifically,
Executive Order 202.10 suspended Education Law 6902(3) "and any associ-
ated regulations . . . to the extent necessary to permit an NP to
provide medical services appropriate to their education, training and
experience, without a WPA, or collaborative relationship with a physi-
cian." Since then, it has become clearer that these administrative
requirements do not have any effect on patient outcomes.

This legislation accounts for the DOH and SED recommendations, as well
as the findings from the findings by the Center for Health Workforce
Studies, and makes the NPMA permanent and further modernized, to ensure
that New York's consumers may continue to access quality care from nurse
practitioners.

 
PRIOR LEGISLATIVE HISTORY:

2019-2020: S8936/A10990 Gottfried

 
FISCAL IMPLICATIONS:

This bill would have no fiscal impact on the State or local governments.

 
EFFECTIVE DATE:
Immediately.

2021-S3056 - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   3056
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                             January 27, 2021
                                ___________
 
 Introduced  by  Sen.  RIVERA -- 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 the practice  protocol
   for nurse practitioners; and to amend part D of chapter 56 of the laws
   of  2014,  amending  the education law relating to enacting the "nurse
   practitioners modernization act", in  relation  to  the  effectiveness
   thereof
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Subparagraphs (i) and (iv) of paragraph (a) of  subdivision
 3  of section 6902 of the education law, as amended by section 2 of part
 D of chapter 56 of the laws of 2014, is amended to read as follows:
   (i) The practice of registered professional nursing by a nurse practi-
 tioner, certified under section six thousand nine hundred  ten  of  this
 article,  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
 OR NURSE PRACTITIONER PRACTICING  PURSUANT  TO  PARAGRAPH  (B)  OF  THIS
 SUBDIVISION,   qualified  to  collaborate  in  the  specialty  involved,
 provided such services are performed in accordance with a written  prac-
 tice  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 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.
   (iv) The practice protocol shall reflect current accepted medical  and
 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 estab-

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

                                                            LBD00598-01-1

 S. 3056                             2

 lishing the procedure for the review of protocols and the disposition of
 any issues arising from such review.]
   §  2.  Paragraph (b) of subdivision 3 of section 6902 of the education
 law, as added by section 2 of part D of chapter 56 of the laws of  2014,
 is amended to read as follows:
   (b) Notwithstanding subparagraph (i) of paragraph (a) of this subdivi-
 sion,  a  nurse practitioner, certified under section sixty-nine hundred
 ten of this article and practicing for  more  than  three  thousand  six
 hundred  hours  [may  comply  with  this paragraph in lieu of complying]
 SHALL NOT BE REQUIRED TO COMPLY with the requirements of  paragraph  (a)
 of  this subdivision relating to collaboration with a physician, a writ-
 ten practice agreement and written practice protocols[. A nurse  practi-
 tioner  complying with this paragraph shall have collaborative relation-
 ships 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 qualified to collaborate in the specialty involved and having
 privileges  at such institution. As evidence that the nurse practitioner
 maintains collaborative  relationships,  the  nurse  practitioner  shall
 complete  and  maintain  a form, created by the department, to which the
 nurse practitioner  shall  attest,  that  describes  such  collaborative
 relationships.  For purposes of this paragraph, "collaborative relation-
 ships" shall mean that the nurse practitioner shall communicate, whether
 in person, by telephone or through written (including electronic) means,
 with a licensed physician qualified  to  collaborate  in  the  specialty
 involved  or,  in  the  case  of a hospital, communicate with a licensed
 physician qualified to collaborate in the specialty involved and  having
 privileges at such hospital, for the purposes of exchanging information,
 as  needed,  in  order to provide comprehensive patient care and to make
 referrals as necessary. Such form shall also reflect the  nurse  practi-
 tioner's  acknowledgement  that  if  reasonable  efforts  to resolve any
 dispute that may arise with the collaborating physician or, in the  case
 of  a collaboration with a hospital, with a licensed physician qualified
 to collaborate in the specialty involved and having privileges  at  such
 hospital,  about a patient's care are not successful, the recommendation
 of the physician shall prevail. Such form shall be updated as needed and
 may be subject to review by the department. The nurse practitioner shall
 maintain documentation that supports such  collaborative  relationships.
 Failure  to  comply  with  the requirements found in this paragraph by a
 nurse practitioner who is not complying with such  provisions  of  para-
 graph  (a) of this subdivision, shall be subject to professional miscon-
 duct provisions as set forth in  article  one  hundred  thirty  of  this
 title].
   §  3.  Section 3 of part D of chapter 56 of the laws of 2014, amending
 the education law relating to enacting the "nurse practitioners  modern-
 ization act", is amended to read as follows:
   § 3. This act shall take effect on the first of January after it shall
 have  become  a law [and shall expire June 30 of the sixth year after it
 shall have become a law, when upon such date the provisions of this  act
 shall  be deemed repealed]; 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 is
 authorized and directed to be made  and  completed  on  or  before  such
 effective date.
   § 4. This act shall take effect immediately.

co-Sponsors

View additional co-sponsors

2021-S3056A (ACTIVE) - Details

See Assembly Version of this Bill:: A1535
Current Committee:: Senate Higher Education
Law Section:: Education Law
Laws Affected:: Amd §6902, Ed L; amd Part D §3, Chap 56 of 2014
Versions Introduced in 2019-2020 Legislative Session:: S8936, A10990

2021-S3056A (ACTIVE) - Summary

Makes certain provisions of the "nurse practitioners modernization act" permanent; eliminates certain administrative obligations.

2021-S3056A (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S3056A

SPONSOR: RIVERA
 
TITLE OF BILL:

An act to amend the education law, in relation to the practice protocol
for nurse practitioners; and to amend part D of chapter 56 of the laws
of 2014, amending the education law relating to enacting the "nurse
practitioners modernization act", in relation to the effectiveness ther-
eof

 
PURPOSE OR GENERAL IDEA OF BILL:

Makes the Nurse Practitioner Modernization Act ("NPMA") (Part D of Chap-
ter 56 of the Laws of 2014) permanent and eliminates certain administra-
tive obligations that create barriers to accessing healthcare, consist-
ent with the 2018 New York State Education Department ("SED") and
Department of Health ("DOH") report issued pursuant to that Chapter.

 
SUMMARY OF SPECIFIC PROVISIONS:

Section 1 amends Education Law § 6902(3)(a) to clarify that NPs who have

practiced for less than 3,600 hours still need to maintain a written
practice agreement ('WPA"), but allows those NPs to enter into WPAs with
either a physician or an experienced NP who is practicing without a
collaborative agreement; and eliminates the obligation that junior NPs
file written practice protocols ("WPPs"), consistent with the SED recom-
mendation in the 2018 report.

Section 2 amends Education Law § 6902(3)(b) to clarify that experienced
NPs are not required to maintain WPAs or any other collaborative
arrangements.

Section 3 amends chapter 56 of the laws of 2014 Part D to eliminate the
sunset date for NPMA.

Section 4 sets the effective date.

 
JUSTIFICATION:

In order to increase access to health care services and eliminate arti-
ficial boundaries to consumer care, as part of the 2014 budget, the
State adopted the Nurse Practitioner Modernization Act. The NPMA, among
other things: (i) eliminated the requirement that NPs with at least
3,600 hours of practice maintain a WPA or WPPs, provided that the expe-
rienced NP maintains a collaborative relationship with one or more
licensed physicians qualified to collaborate in specialty involved, or a
hospital; and (ii) required that the SED issue a report, in consultation
with DOH, regarding the law's implementation, and offer recommendations
regarding the law.

The joint SED-DOH report released in late November 2018 summarized the
law, described how it was implemented by SED, and included several
"Findings and Recommendations":

* SED stated that there is no "evidence that the Act had an adverse
impact on the quality of care rendered by NPs or the number of NPs prac-
ticing in" NYS. Accordingly, SED proposed amending Education Law §
6902(3Xa)(iv) to eliminate the current requirement that NPs "file .
practice protocols," because " This provision was enacted in 1994.. .
no longer serves an important government purpose."

The DOH added that it is "notable that to date, as indicated in the
report, there is no indication of adverse impact on quality of care or
the number of practicing NPs and no increase in the number of misconduct
proceedings. DOH believes that this is reflective of the positive impact
of the law, which is also evident in the significant body of data that
has been collected by the Center for Health Workforce Studies under the
authority of the law." Thus, DOH proposed: (i) Eliminating the SED
"Collaborative Relationships Attestation Form" through statute, and
instead require that "NPs . .  continue maintaining documentation in
support of collaborative relationships at their practice locations and
make this information available to the SED upon request;" and (ii)
Making the NPMA permanent "so that the original intent of the law in
promoting access to care can continue to be realized."

On March 23, 2020, the Governor went a step further and outright waived
any requirements for NPs regarding written practice agreements or colla-
borative relationships in light of the COVID pandemic.  Specifically,
Executive Order 202.10 suspended Education Law 6902(3) "and any associ-
ated regulations .. . to the extent necessary to permit an NP to provide
medical services appropriate to their education, training and experi-
ence, without a WPA, or collaborative relationship with a physician."
Since then, it has become clearer that these administrative requirements
do not have any effect on patient outcomes.

This legislation accounts for the DOH and SED recommendations, as well
as the findings from the findings by the Center for Health Workforce
Studies, and makes the NPMA permanent and further modernized, to ensure
that New York's consumers may continue to access quality care from nurse
practitioners.

 
PRIOR LEGISLATIVE HISTORY:

2019-2020: S8936/A10990 Gottfried

 
FISCAL IMPLICATIONS:

This bill would have no fiscal impact on the State or local governments.

 
EFFECTIVE DATE:
Immediately.

2021-S3056A (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  3056--A
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                             January 27, 2021
                                ___________
 
 Introduced by Sens. RIVERA, BORRELLO, BROOKS, BROUK, RITCHIE, SKOUFIS --
   read  twice  and  ordered printed, and when printed to be committed to
   the Committee  on  Higher  Education  --  committee  discharged,  bill
   amended,  ordered reprinted as amended and recommitted to said commit-
   tee

 AN ACT to amend the education law, in relation to the practice  protocol
   for nurse practitioners; and to amend part D of chapter 56 of the laws
   of  2014,  amending  the education law relating to enacting the "nurse
   practitioners modernization act", in  relation  to  the  effectiveness
   thereof
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Subparagraphs (i) and (iv) of paragraph (a) of  subdivision
 3  of section 6902 of the education law, as amended by section 2 of part
 D of chapter 56 of the laws of 2014, are amended to read as follows:
   (i) The practice of registered professional nursing by a nurse practi-
 tioner, certified under section six thousand nine hundred  ten  of  this
 article,  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
 OR NURSE PRACTITIONER PRACTICING  PURSUANT  TO  PARAGRAPH  (B)  OF  THIS
 SUBDIVISION,   qualified  to  collaborate  in  the  specialty  involved,
 provided such services are performed in accordance with a written  prac-
 tice  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 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.

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD00598-02-1

 S. 3056--A                          2
 
   (iv) The practice protocol shall reflect current accepted medical  and
 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.
   §  2.  Paragraph (b) of subdivision 3 of section 6902 of the education
 law, as added by section 2 of part D of chapter 56 of the laws of  2014,
 is amended to read as follows:
   (b) Notwithstanding subparagraph (i) of paragraph (a) of this subdivi-
 sion,  a  nurse practitioner, certified under section sixty-nine hundred
 ten of this article and practicing for  more  than  three  thousand  six
 hundred  hours  [may  comply  with  this paragraph in lieu of complying]
 SHALL NOT BE REQUIRED TO COMPLY with the requirements of  paragraph  (a)
 of  this subdivision relating to collaboration with a physician OR NURSE
 PRACTITIONER, a written practice agreement and written  practice  proto-
 cols[.  A  nurse  practitioner  complying with this paragraph shall have
 collaborative relationships with one or more licensed physicians  quali-
 fied  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, to which the nurse practitioner shall attest,
 that  describes  such  collaborative relationships. For purposes of this
 paragraph, "collaborative relationships" shall mean that the nurse prac-
 titioner shall communicate, whether in person, by telephone  or  through
 written  (including  electronic) means, with a licensed physician quali-
 fied to collaborate in the specialty involved  or,  in  the  case  of  a
 hospital, communicate with a licensed physician qualified to collaborate
 in  the  specialty  involved and having privileges at such hospital, for
 the purposes of exchanging information, as needed, in order  to  provide
 comprehensive patient care and to make referrals as necessary. Such form
 shall  also  reflect  the  nurse  practitioner's acknowledgement that if
 reasonable efforts to resolve  any  dispute  that  may  arise  with  the
 collaborating physician or, in the case of a collaboration with a hospi-
 tal, with a licensed physician qualified to collaborate in the specialty
 involved  and having privileges at such hospital, about a patient's care
 are not successful, the recommendation of the physician  shall  prevail.
 Such form shall be updated as needed and may be subject to review by the
 department.  The  nurse  practitioner  shall maintain documentation that
 supports such collaborative relationships. 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].
   § 3. Section 3 of part D of chapter 56 of the laws of  2014,  amending
 the  education law relating to enacting the "nurse practitioners modern-
 ization act", as amended by section 10 of part S of chapter  57  of  the
 laws of 2021, is amended to read as follows:
   § 3. This act shall take effect on the first of January after it shall
 have become a law [and shall expire June 30 of the seventh year after it
 shall  have become a law, when upon such date the provisions of this act
 shall be deemed repealed]; provided, however, that effective  immediate-
 ly,  the  addition,  amendment  and/or  repeal of any rule or regulation

 S. 3056--A                          3
 
 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.
   § 4. This act shall take effect immediately.

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Senate Bill S3056A

Sponsored By

Archive: Last Bill Status - In Senate Committee Higher Education Committee

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Votes

May 11, 2021 - Higher Education Committee Vote

Higher Education Committee Vote: May 11, 2021

Bill Amendments

co-Sponsors

2021-S3056 - Details

2021-S3056 - Summary

2021-S3056 - Sponsor Memo

2021-S3056 - Bill Text download pdf

co-Sponsors

2021-S3056A (ACTIVE) - Details

2021-S3056A (ACTIVE) - Summary

2021-S3056A (ACTIVE) - Sponsor Memo

2021-S3056A (ACTIVE) - Bill Text download pdf

Comments

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Senate Bill S3056A

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Sponsored By

Archive: Last Bill Status - In Senate Committee Higher Education Committee

Actions

Votes

Bill Amendments

co-Sponsors

2021-S3056 - Details

2021-S3056 - Summary

2021-S3056 - Sponsor Memo

2021-S3056 - Bill Text download pdf

co-Sponsors

2021-S3056A (ACTIVE) - Details

2021-S3056A (ACTIVE) - Summary

2021-S3056A (ACTIVE) - Sponsor Memo

2021-S3056A (ACTIVE) - Bill Text download pdf

Comments