A.5308 (Gottfried) S.3289 (Young)

BACKGROUND:
• Nurse practitioners (“NPs”) have been practicing since 1965, and gained legal scope of practice in New York State in 1988. NPs are licensed, certified, and regulated by the State Education Department.

• NPs are Registered Nurses who have completed advanced education and training in the diagnoses, management and treatment of health problems.

• Like physicians, NPs are qualified to provide comprehensive and coordinated care and provide a broad array of diagnostic and therapeutic services. NPs are well equipped to meet the primary healthcare needs of our populations.

• Nurse practitioners are highly trained and experienced, individuals who exercise independent judgment, and collaborate with multiple specialists and healthcare practitioners everyday, just like physicians and other healthcare providers. 

QUALITY:

• An October 2010 report by the Robert Wood Johnson Foundation Institute of Medicine (“IOM”) recommends nurses should be able to “fulfill their potential as primary care providers to the full extent of their education and training” and that “restrictions on scope of practice…undermine the nursing professions’ ability to provide and improve both general and advanced care.” This report dispels the myth that NP quality of care is inferior to any other health care provider as do numerous other studies.

• Competency in practice is determined by education, training and professional judgment. Statutory collaboration requiring a written Collaborative Practice Agreement (CPA) is not a substitute for any of these things.

 

ACCESS & COST:

• The Affordable Care Act (“ACA”) adds millions to the rolls of insured at a time when there is a shortage of primary care providers. ACA recognized the value of nurse practitioners and established a special career path for them to be primary care providers in federally qualified health centers (“FQHCs”).

• NPs provide access to both urban and rural populations and are often the only primary care providers to Medicaid recipients in many those areas. They provide care to high volume patients in the government programs (Medicaid Managed Care, Child Health Plus and Family Health Plus).

• There are currently approximately 15,000 NP’s in NY providing millions of patient visits to New Yorkers, in every health care setting. (Hospitals, nursing homes, clinics, private practice, etc.)

• New York needs to ensure that there is greater access to primary care, and NPs can help fill this role.

• Where scope of practice overlaps between NPs and physicians, patients should not be forced to choose the most expensive alternative.

• Studies show that NPs provide care at least as well as physicians in many clearly defined areas of medicine and nursing for less money. The average salary of an NP has been recently reported at approximately one half that of a primary care physician.

• NPs are required, however, to collaborate with a physician and to have written evidence of this collaboration which represents an unnecessary cost and barrier to patient care.

• NPs in CPAs are often forced to pay the collaborating physician to perform the mandated chart reviews under current law. This can add up to thousands of dollars per year and results in waste, inefficiency and uncessary overhead.

 

WHAT DOES THIS BILL DO?

• The Modernization Act eliminates the current statutory requirement mandating that the NPs have a written practice agreement with a physician.

• It helps NY meet the challenges of building a healthcare workforce with size and skills needed to meet future demands of our state’s patient population.

• 17 other states allow nurse practitioners to practice with complete autonomy.

• Chapter 238 of the Laws of 2010 eliminated a similar mandate for midwives in New York.