NY State Senate Bill 2023-S9038

Current 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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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Apr 11, 2024	referred to higher education

2023-S9038 (ACTIVE) - Details

See Assembly Version of this Bill:: A8378
Current Committee:: Senate Higher Education
Law Section:: Education Law
Laws Affected:: Amd §§6542, 902 & 6810, Ed L; amd §§3701, 3702, 3703 & 3302, Pub Health L

2023-S9038 (ACTIVE) - Summary

Modifies physician assistant standards in the state of New York by allowing physician assistants to practice without supervision if they have practiced for more than eight thousand hours or completed a program approved by the department of education and department of health, as well as, expanding where physician assistants can practice and their ability to treat patients; requires the department of education and department of health to develop rules and regulations for such new standards.

2023-S9038 (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S9038

SPONSOR: MAY
 
TITLE OF BILL:

An act to amend the education law and the public health law, in relation
to amending physician assistant practice standards

 
PURPOSE OR GENERAL IDEA OF BILL:

To authorize physician assistants to practice without the supervision of
a physician under certain circumstances.

 
SUMMARY OF SPECIFIC PROVISIONS:

Section 1 amends § 6542 of the education law by adding language to
describe the circumstances when a physician assistant is authorized to
practice without the supervision of a physician. The circumstances are:
when the physician assistant has practiced for more than 8,000 hours and
is practicing in primary care or is employed by a health system or
hospital and the health system or hospital determines the physician
assistant meets the qualification of the medical staff bylaws and gives

the physician assistant privileges; and where a physician assistant has
completed a program approved by the department of health in consultation
with the commissioner of education, when such services are performed
within the scope of such program and specifies that where supervision is
required it shall be continuous but not be construed as necessarily
requiring the physical presence of the supervising physician at the time
and place where such services are performed.

Section one adds physician assistants to the professionals who may
prescribe and order a patient specific order or non-patient specific
regimen to a licensed pharmacist or registered professional nurse for
specific tasks and tests.

§ 2 of the bill amends subdivision 1 of § 2701 of the public health law
to say that regulations defining and restricting the duties of physician
assistants should be consistent with § 6542 of the education law as
amended in section one.

§ 3 of the bill amends subdivisions 1 and 3 of § 3702 of the public
health law to add durable medical equipment to what a physician assist-
ant may order for inpatient medical orders and on prescriptions for
controlled substances adds language reflecting new language in S 6542 of
the education law as amended in section one.

§ 4 of the bill amends § 3703 of the public health law to add language
making the section consistent with new language in § 6542 of the educa-
tion law as amended in section one.

§ 5 of the bill amends paragraph a of subdivision 2 of § 902 of the
education law to authorize a physician assistant to perform the duties
of the director of school health services.

§ 6 of the bill amends subdivision 5 of § 6810 of the education law by
striking "doctor's" and replacing with "prescriber's" name for
prescription records.


§ 7 of the bill amends subdivision 27 of § 3302 of the public health law
to add physician assistants to the list of practitioners permitted to
dispense, administer or conduct research with respect to a controlled
substance.

§ 8 is the effective date.

 
JUSTIFICATION:

In the fifty years since New York State established the profession and
practice of physician assistant, the enabling statutory language has had
few, if any, amendments while the health care delivery system has
changed considerably. Stagnation.in the statutory language has caused
confusion and created barriers to access to care. PAs must undergo a
rigorous course of medical education and training and are authorized to
practice in virtually any medical field doctors are trained in.

They develop competencies working with physicians and in a team-based
care environment. Unfortunately, language in the current statutory
framework, like the word "supervisory," is frequently misinterpreted to
impose limitations on, or erect barriers to, physician assistants' prac-
tice.

During the COVID-19 pandemic, the Governor explicitly waived any "super-
visory" requirements for physician assistants, recognizing that
increased flexibility to allow greater access to care was imperative
during the public health crisis. Multiple hospital systems and physician
practices across the state have benefitted from the elimination of
barriers to care - not to mention all persons in New York State. This
bill would make permanent some of the changes permitted during the
pandemic while recognizing the changes that have occurred over the past
fifty years to the state's health care delivery system.

 
PRIOR LEGISLATIVE HISTORY:

New bill.

 
FISCAL IMPLICATION:

Savings to be determined.

 
EFFECTIVE DATE:
120 days after it shall have become a law.

2023-S9038 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   9038
 
                             I N  S E N A T E
 
                              April 11, 2024
                                ___________
 
 Introduced  by  Sen.  MAY  --  read  twice and ordered printed, and when
   printed to be committed to the Committee on Higher Education
 
 AN ACT to amend the education law and the public health law, in relation
   to amending physician assistant practice standards
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section 1. Section 6542 of the education law, as amended by chapter 48
 of  the  laws  of  2012, subdivisions 3 and 5 as amended by section 1 of
 part T of chapter 57 of the laws of 2013, is amended to read as follows:
   § 6542. Performance of medical services. 1. Notwithstanding any  other
 provision  of  law,  a physician assistant may perform medical services,
 but only when under the supervision of a physician and  only  when  such
 acts  and  duties  as are assigned to him or her are within the scope of
 practice of such supervising physician  UNLESS  OTHERWISE  PERMITTED  BY
 THIS SECTION.
   2.  [Supervision  shall  be  continuous  but shall not be construed as
 necessarily requiring the physical presence of the supervising physician
 at the time and place where such services  are  performed]  A  PHYSICIAN
 ASSISTANT  MAY PRACTICE WITHOUT THE SUPERVISION OF A PHYSICIAN UNDER THE
 FOLLOWING CIRCUMSTANCES:
   (A) WHERE THE PHYSICIAN ASSISTANT, LICENSED UNDER  SECTION  SIXTY-FIVE
 HUNDRED  FORTY-ONE  OF  THIS  ARTICLE  HAS PRACTICED FOR MORE THAN EIGHT
 THOUSAND HOURS; AND
   (I) IS PRACTICING IN PRIMARY CARE. FOR THE PURPOSES OF THIS PARAGRAPH,
 "PRIMARY CARE" SHALL MEAN NON-SURGICAL CARE IN  THE  FIELDS  OF  GENERAL
 PEDIATRICS,  GENERAL ADULT MEDICINE, GENERAL GERIATRIC MEDICINE, GENERAL
 INTERNAL MEDICINE, OBSTETRICS AND GYNECOLOGY, FAMILY MEDICINE,  OR  SUCH
 OTHER RELATED AREAS AS DETERMINED BY THE COMMISSIONER OF HEALTH; OR
   (II)  IS  EMPLOYED  BY  A  HEALTH SYSTEM OR HOSPITAL ESTABLISHED UNDER
 ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW, AND THE HEALTH SYSTEM  OR
 HOSPITAL  DETERMINES THE PHYSICIAN ASSISTANT MEETS THE QUALIFICATIONS OF
 THE MEDICAL STAFF BYLAWS AND THE HEALTH SYSTEM  OR  HOSPITAL  GIVES  THE
 PHYSICIAN ASSISTANT PRIVILEGES; AND
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD13627-01-3

 S. 9038                             2
 
   (B)  WHERE  A  PHYSICIAN  ASSISTANT  LICENSED UNDER SECTION SIXTY-FIVE
 HUNDRED FORTY-ONE OF THIS ARTICLE HAS COMPLETED A  PROGRAM  APPROVED  BY
 THE DEPARTMENT OF HEALTH, IN CONSULTATION WITH THE DEPARTMENT, WHEN SUCH
 SERVICES ARE PERFORMED WITHIN THE SCOPE OF SUCH PROGRAM.
   3.  [No  physician  shall employ or supervise more than four physician
 assistants in his or her private practice] WHERE SUPERVISION IS REQUIRED
 BY THIS SECTION, IT SHALL BE CONTINUOUS BUT SHALL NOT  BE  CONSTRUED  AS
 NECESSARILY REQUIRING THE PHYSICAL PRESENCE OF THE SUPERVISING PHYSICIAN
 AT THE TIME AND PLACE WHERE SUCH SERVICES ARE PERFORMED.
   4.  Nothing  in  this article shall prohibit a hospital from employing
 physician assistants provided they [work  under  the  supervision  of  a
 physician  designated  by the hospital and not beyond the scope of prac-
 tice of such physician. The numerical limitation of subdivision three of
 this section shall not apply to services performed in a  hospital]  MEET
 THE  QUALIFICATIONS OF THE MEDICAL STAFF BYLAWS AND ARE GIVEN PRIVILEGES
 AND OTHERWISE MEET THE REQUIREMENTS OF THIS SECTION.
   5. [Notwithstanding any other provision of this article, nothing shall
 prohibit a physician employed by or rendering services to the department
 of corrections and community supervision under contract from supervising
 no more than six physician assistants in his or  her  practice  for  the
 department of corrections and community supervision] A PHYSICIAN ASSIST-
 ANT  SHALL BE AUTHORIZED TO PRESCRIBE, DISPENSE, ORDER, OR PROCURE ITEMS
 TO COMMENCE OR COMPLETE A COURSE OF THERAPY.
   6. [Notwithstanding any other  provision  of  law,  a  trainee  in  an
 approved  program  may  perform  medical services when such services are
 performed within the scope of such program] (A)  A  PHYSICIAN  ASSISTANT
 MAY PRESCRIBE AND ORDER A PATIENT SPECIFIC ORDER OR NON-PATIENT SPECIFIC
 REGIMEN  TO  A  LICENSED  PHARMACIST  OR  REGISTERED PROFESSIONAL NURSE,
 PURSUANT TO REGULATIONS PROMULGATED BY THE COMMISSIONER OF  HEALTH,  AND
 CONSISTENT WITH THE PUBLIC HEALTH LAW, FOR:
   (I) ADMINISTERING IMMUNIZATIONS;
   (II) THE EMERGENCY TREATMENT OF ANAPHYLAXIS;
   (III)  ADMINISTERING  PURIFIED  PROTEIN  DERIVED  (PPD) TESTS OR OTHER
 TESTS TO DETECT OR SCREEN FOR TUBERCULOSIS INFECTIONS;
   (IV) ADMINISTERING TESTS TO DETERMINE THE PRESENCE OF THE HUMAN  IMMU-
 NODEFICIENCY VIRUS;
   (V)  ADMINISTERING  TESTS TO DETERMINE THE PRESENCE OF THE HEPATITIS C
 VIRUS;
   (VI) THE URGENT OR EMERGENCY TREATMENT OF OPIOID RELATED  OVERDOSE  OR
 SUSPECTED OPIOID RELATED OVERDOSE;
   (VII)  SCREENING  OF PERSONS AT INCREASED RISK OF SYPHILIS, GONORRHEA,
 AND CHLAMYDIA;
   (VIII) ADMINISTERING ELECTROCARDIOGRAM TESTS TO DETECT SIGNS AND SYMP-
 TOMS OF ACUTE CORONARY SYNDROME;
   (IX) ADMINISTERING POINT-OF-CARE BLOOD GLUCOSE TESTS TO EVALUATE ACUTE
 MENTAL STATUS CHANGES IN PERSONS WITH SUSPECTED HYPOGLYCEMIA;
   (X) ADMINISTERING TESTS AND INTRAVENOUS LINES  TO  PERSONS  THAT  MEET
 SEVERE SEPSIS AND SEPTIC SHOCK CRITERIA; AND
   (XI) ADMINISTERING TESTS TO DETERMINE PREGNANCY.
   (B)  NOTHING IN THIS SUBDIVISION SHALL AUTHORIZE UNLICENSED PERSONS TO
 ADMINISTER IMMUNIZATIONS, VACCINES, OR OTHER DRUGS.
   7. WHERE A  PHYSICIAN  ASSISTANT  LICENSED  UNDER  SECTION  SIXTY-FIVE
 HUNDRED  FORTY-ONE  OF  THIS ARTICLE HAS COMPLETED A PROGRAM APPROVED BY
 THE DEPARTMENT OF HEALTH, IN CONSULTATION WITH THE DEPARTMENT, WHEN SUCH
 SERVICES ARE PERFORMED WITHIN THE SCOPE OF SUCH PROGRAM.
 S. 9038                             3
 
   8. Nothing in this article, or in article thirty-seven of  the  public
 health  law,  shall  be  construed  to authorize physician assistants to
 perform those specific functions and duties  specifically  delegated  by
 law  to  those persons licensed as allied health professionals under the
 public health law or this chapter.
   §  2.  Subdivision  1  of  section  3701  of the public health law, as
 amended by chapter 48 of the  laws  of  2012,  is  amended  to  read  as
 follows:
   1.  to  promulgate  regulations  defining  and  restricting the duties
 [which may be assigned to] OF physician assistants [by their supervising
 physician, the degree of supervision required and the  manner  in  which
 such duties may be performed] CONSISTENT WITH SECTION SIXTY-FIVE HUNDRED
 FORTY-TWO OF THE EDUCATION LAW;
   § 3. Subdivisions 1 and 3 of section 3702 of the public health law, as
 amended  by  chapter  48  of  the  laws  of 2012, are amended to read as
 follows:
   1. Inpatient medical orders. A licensed physician  assistant  employed
 or  extended  privileges  by  a  hospital  may, if permissible under the
 bylaws, rules and regulations of the  hospital,  write  medical  orders,
 including those for controlled substances AND DURABLE MEDICAL EQUIPMENT,
 for  inpatients  [under the care of the physician responsible for his or
 her supervision. Countersignature of such  orders  may  be  required  if
 deemed  necessary  and  appropriate  by the supervising physician or the
 hospital, but in no event shall countersignature be  required  prior  to
 execution].
   3.  Prescriptions  for  controlled  substances.  A  licensed physician
 assistant, in good faith and acting within his or her  lawful  scope  of
 practice,  and  to  the  extent  assigned  by  his  or  her  supervising
 physician, AS APPLICABLE PURSUANT TO SECTION SIXTY-FIVE  HUNDRED  FORTY-
 TWO OF THE EDUCATION LAW, may prescribe controlled substances as a prac-
 titioner  under  article thirty-three of this chapter, to patients under
 the care of such physician responsible for his or her  supervision.  The
 commissioner,  in  consultation  with the commissioner of education, may
 promulgate such regulations as are necessary to carry out  the  purposes
 of this section.
   §  4.  Section 3703 of the public health law, as amended by chapter 48
 of the laws of 2012, is amended to read as follows:
   § 3703. Statutory construction. A physician assistant may perform  any
 function in conjunction with a medical service lawfully performed by the
 physician  assistant, in any health care setting, that a statute author-
 izes or directs a physician to perform and that is  appropriate  to  the
 education,  training  and experience of the licensed physician assistant
 and within the ordinary practice of the supervising physician, AS APPLI-
 CABLE PURSUANT TO SECTION SIXTY-FIVE HUNDRED FORTY-TWO OF THE  EDUCATION
 LAW.  This  section  shall  not be construed to increase or decrease the
 lawful scope of practice of a physician assistant  under  the  education
 law.
   § 5. Paragraph a of subdivision 2 of section 902 of the education law,
 as  amended  by  chapter  376 of the laws of 2015, is amended to read as
 follows:
   a. The board of education, and the trustee or  board  of  trustees  of
 each  school district, shall employ, at a compensation to be agreed upon
 by the parties, a qualified physician, A PHYSICIAN ASSISTANT, or a nurse
 practitioner to the extent authorized by  the  nurse  practice  act  and
 consistent  with  subdivision three of section six thousand nine hundred
 two of this chapter, to perform the duties of  the  director  of  school
 S. 9038                             4
 
 health  services, including any duties conferred on the school physician
 or school medical inspector under any provision of law, to  perform  and
 coordinate the provision of health services in the public schools and to
 provide  health  appraisals  of students attending the public schools in
 the city or district. The physicians, PHYSICIANS  ASSISTANTS,  or  nurse
 practitioners  so employed shall be duly licensed pursuant to applicable
 law.
   § 6. Subdivision 5 of section 6810 of the education law, as  added  by
 chapter 881 of the laws of 1972, is amended to read as follows:
   5. Records of all prescriptions filled or refilled shall be maintained
 for  a period of at least five years and upon request made available for
 inspection and copying by  a  representative  of  the  department.  Such
 records   shall  indicate  date  of  filling  or  refilling,  [doctor's]
 PRESCRIBER'S name, patient's name and address and the name  or  initials
 of   the   pharmacist   who   prepared,  compounded,  or  dispensed  the
 prescription. Records of prescriptions for controlled  substances  shall
 be  maintained  pursuant  to requirements of article thirty-three of the
 public health law.
   § 7. Subdivision 27 of section 3302  of  the  public  health  law,  as
 amended  by  chapter  92  of  the  laws  of  2021, is amended to read as
 follows:
   27. "Practitioner" means:
   A physician, PHYSICIAN ASSISTANT, dentist,  podiatrist,  veterinarian,
 scientific  investigator, or other person licensed, or otherwise permit-
 ted to dispense, administer  or  conduct  research  with  respect  to  a
 controlled  substance  in the course of a licensed professional practice
 or research licensed pursuant to this  article.  Such  person  shall  be
 deemed  a "practitioner" only as to such substances, or conduct relating
 to such substances, as is permitted by [his] THEIR  license,  permit  or
 otherwise permitted by law.
   § 8. This act shall take effect on the one hundred twentieth day after
 it  shall  have  become  a law. Effective immediately, the department of
 education and the department of health  are  authorized  to  promulgate,
 amend and/or repeal any rule or regulation necessary for the implementa-
 tion of section one of this act on or before such effective date.

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Senate Bill S9038

Sponsored By

Current Bill Status - In Senate Committee Higher Education Committee

2023-S9038 (ACTIVE) - Details

2023-S9038 (ACTIVE) - Summary

2023-S9038 (ACTIVE) - Sponsor Memo

2023-S9038 (ACTIVE) - Bill Text download pdf

Comments

Senate Bill S9038

Share this bill

Sponsored By

Rachel May

Current Bill Status - In Senate Committee Higher Education Committee

2023-S9038 (ACTIVE) - Details

2023-S9038 (ACTIVE) - Summary

2023-S9038 (ACTIVE) - Sponsor Memo

2023-S9038 (ACTIVE) - Bill Text download pdf

Comments