Excludes services of attendants in certain residential care centers for community residences and family care homes; repealer

Title of bill

An act to repeal paragraph b of subdivision 1 of section 6908 of the education law, relating to the practice of nursing at institutions under the jurisdiction of the department of mental hygiene

Purpose

The purpose of this bill is to improve the quality of care provided in facilities operated or licensed by the Office of Mental Health (OMH) and the Office of Mental Retardation and Developmental Disabilities (OMRDD).

Summary

This bill amends Section 6908(1)(b) of the Education Law to eliminate the exemption in the education law which allows attendants in facilities subject to the jurisdiction of OMH and OMRDD to perform certain nursing functions if adequate nursing supervision is provided by removing the exemption as it relates to psychiatric centers, developmental centers and community residences licensed or operated by OMRDD as Intermediate Care Facilities.

Justification

The exemption clause allows attendants in "institutions under the jurisdiction of the Offices of OMH and OMRDD to practice nursing "if adequate nursing and medical supervision is provided." This provision is unique and specific to these institutions. In no other agency - public or private - is permission granted to unlicensed personnel for functions that are otherwise the responsibility of licensed personnel.

This clause was included within the Nurse Practice Act in 1938. During that era, treatment for the institutionalized mentally ill or retarded patient, focused almost exclusively on the custodial aspects of health care. Since that time, radical changes have occurred in the nature, scope and philosophy of care of the mentally ill and retarded. Mental health services are far more complex, and there is now an acute awareness of the client's right to sound developmental and therapeutic services.

Similarly, nursing practice has advanced significantly since 1938. This evolution is reflected in Section 6902 of Article 139 of the Education Law of New York as amended in 1972. Within this section, the practice of nursing is defined in part as "diagnosing and treating human responses to actual or potential health problems through such services as casefinding, health teaching, health counseling and provision of care supportive to or restorative of life and well-being."

In light of these changes, grave concern exists over trends within OMH and OMRDD toward delegation to mental health attendants of authority, and functions of responsibilities far beyond their level of initial and ongoing preparation. Examples of these include such crucial professional responsibilities as administration of medication, assessment, and interpretation of responses to illness which indicate a need for complex and immediate therapeutic action. It is not uncommon for therapy aides to be assigned full and direct responsibility for the health, treatment and well-being of large numbers of clients during evening and night hours of duty.

Legislative history

S.2730 of 2007-08; S.3163/A.15 of 2005-06; S.2637 of 2003-04, S.1830/A.7284 of 2001-02.

Fiscal implications

Possible increased cost to the State due to increased licensed nursing services in those facilities being removed from present exemption.

Effective date

This act shall take effect two years after enactment.