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Relates to the practice protocol for nurse practitioners
(D, WF) 33rd Senate District
| 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 |
(R, C) 57th Senate District
(D) Senate District
(D, WF) 55th Senate District
(R, C, IP) Senate District
View additional co-sponsors
(D) 42nd Senate District
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
Makes certain provisions of the "nurse practitioners modernization act" permanent; eliminates certain administrative obligations.
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.
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.
(D) 36th Senate District
(R, C) 57th Senate District
(D) Senate District
(D, WF) 55th Senate District
View additional co-sponsors
(D, WF) 31st Senate District
(D, WF) 13th Senate District
(R, C, IP) Senate District
(D, WF) 18th Senate District
(D) 32nd Senate District
(D) 42nd Senate District
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
Makes certain provisions of the "nurse practitioners modernization act" permanent; eliminates certain administrative obligations.
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.
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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