Establishes the nurse practitioners modernization act

Summary of specific provisions

The bill amends the nurse practice act in Education law to limit the requirements for written collaboration agreements and practice protocols between nurse practitioners (NPs) and physicians to NPs who are practicing for less than 36 months and 3,600 hours with exceptions for good cause approved by the State Education Department (SED). Under the exceptions allowed, a collaborating physician may be substituted by a collaborating NP who is past his or her written-collaboration term and is qualified to collaborate in the specialty involved.

If a written practice agreement were to terminate because the collaborating physician moves, retires, or dies, and the nurse practitioner is unable to enter into a new written practice agreement with a physician, the nurse Practitioner may enter into one with an experienced nurse practitioner in order to continue to practice for up to six months. The six month period may be extended for up to another six months upon showing of good cause subject to the approval of SED.

NPs who have successfully practiced for more than 36 months and 3,600 hours shall not be required to have a written practice agreement with a physician. These NPs will, however, continue to collaborate with physicians or Article 28 hospitals, in addition to other healthcare providers. Additionally, these NPs will be required to complete and execute a form to be created by the State Education Department that will include, among other things, a summary of the NP's written practice protocols, the manner in which the NP will collaborate and refer with other providers. Although this form does not need to be filed with SED, it will be subject to review of the Department. Failure to comply with this requirement will be considered misconduct.

Finally, the bill will require the Commissioner of Education, in consultation with-the Commissioner of Health, to issue a report summarizing the implementation of this law, and any recommendations for further revisions to the NP's statute. The report shall be submitted to the legislature by September 1, 2018. The bill includes a sunset provision for these changes in June 2020.

Justification

Nurse Practitioners practice in a variety of primary and specialty care settings including ambulatory, acute, long term care, and primary care. Nurse practitioners are licensed and certified by the State Education Department to diagnose illness and physical conditions and perform therapeutic and corrective measures, order tests, prescribe medications, medical devices and immunizing agents and, when appropriate, refer patients to other health care providers, without direct supervision. In addition to their advance certification by the Nursing Board, many NPs are certified by national accrediting agencies in one or more practice specialty. Currently, New York requires a mandatory collaboration relationship between a NP and a MD.

That relationship is defined by a written practice agreement which can be as narrow or as broad as the MD is willing. Elsewhere, NPs practice with complete independence in 18 states (AK, AZ, CO, HI, ID, IA, ME, MD, MT, ND, NH, NM, OR, RI, UT, VT, WA, WY) and the District of Columbia. Given the education, training and advanced certification of NPs, statutorily mandated collaboration no longer serves a clinical purpose. Instead, mandatory collaboration and the written practice agreement serves as a barrier to practice and a disincentive to advanced certification, and it restricts access to primary health care for individuals and families in undeserved areas the state.

Prior legislative history

Similar to S.3289: referred to Higher Education in 2011 and 2012. A.5308-A passed the Assembly in 2012.

Fiscal implications

Reduces administrative costs for the State Education Department.

Effective date

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 it shall have become a law, 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.