S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  1535--A
 
                        2021-2022 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 11, 2021
                                ___________
 
 Introduced  by  M.  of  A.  GOTTFRIED,  LUPARDO, PAULIN, FORREST, REYES,
   STIRPE, THIELE, BARRON, GRIFFIN, SIMON, SEAWRIGHT, MONTESANO, M. MILL-
   ER -- read once and referred to the Committee on Higher  Education  --
   committee  discharged,  bill amended, ordered reprinted as amended and
   recommitted to said committee

 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.
                                                            LBD00598-03-1
              

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   (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

 A. 1535--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.