Authorizes physicians and certified nurse practitioners to prescribe and order the administering for tests for tuberculosis

BILL NUMBER:S3304

Title of bill

An act to amend the education law, in relation to authorizing physicians and certified nurse practitioners to prescribe and order the administering of tests for tuberculosis

Purpose

To allow registered nurses to administer tests for tuberculosis under a non-patient specific order issued by a physician or nurse practitioner

Summary of provisions

Section one amends Education Law § 6527(6)(c) to remove the reference to purified protein derivative (PPD) tests, and to instead authorize administration of all tests for tuberculosis under a non-specific order issued by a nurse practitioner.

Section two amends Education Law § 6909(4)(c) to remove the reference to purified protein derivative (PPD) tests, and to instead authorize administration of all tests for tuberculosis under a non-specific order issued by a physician.

Section three provides that this act shall take effect 90 days after enactment.

Justification

Tuberculosis is a deadly, but preventable disease more common in other parts of the world. Screening is an important accepted measure for preventing resurgence, especially at a time of increased resistance. With New York's strong history as a port of entry, screening recent arrivals from high risk areas should be conducted in an efficient manner in order to prevent the spread of this deadly disease. Large institutions, such as universities, often see hundreds of people in need of screening at the start of a semester. Similarly, seasonal influxes of workers due to industry needs (tourism, recreational. agricultural work) can also require fast and efficient screening to effectuate positive health outcomes for immigrants and the domestic population in New York.

Presently, the law allows a registered nurse to screen patients for tuberculosis using a purified protein derivative, or PPD, skin test without a doctor writing a prescription for that specific patient, or a "patient-specific order." While there are blood tests available for the same purpose, registered nurses are prohibited from administering this type of test without a patient specific order. This blood test is often more desirable for several reasons. First, the current skin test requires a second follow-up visit to the doctor's office, causing inefficiencies and inconvenience for the patient. Secondly, the blood test produces fewer false positives. The skin test reacts to a common (though not fully effective) tuberculosis vaccine used abroad, so individuals that have had this vaccination will typically show a positive result under the skin test. In order to confirm this

diagnosis, patients must have a chest x-ray performed. Fewer false positives would lead to fewer expensive chest x-rays.

This bill will lead to a more efficient patient experience and create better health outcomes by allowing physicians or nurse practitioners to empower registered nurses, under their supervision, to administer any tuberculosis screening test to a patient without the need for a patient specific prescription.

Legislative history

New bill.

Fiscal implications

None.

Effective date

90 days after enactment