The New York State Education Department (“SED”) issued a proposed rule to allow nurse practitioners (“NPs”) with 3,600 hours of experience to have collaborative agreements with hospitals, as opposed to individual physicians. We wrote about the amendment to the Education Law in April of this year. This first notice of proposed rulemaking appears to put SED on schedule to allow these new collaborative arrangements to be effective by January 1, 2015, as scheduled.
The form that the Department of Education refers to in the new regulations does not appear on the Office of the Professions website—at least not yet. The current form that nurse practitioners use to verify their collaboration agreements with individual physicians remains up, although it is dated 3/2009 and does not reflect the new provision for experienced NPs who may want to have collaborative agreements with hospitals.
The new rules (beginning at page 5) will appear at 8 N.Y.C.R.R. § 64.5(g) and 8 N.Y.C.R.R. § 29.14(a)(3). Section 64.5(g) outlines the collaborative relationship requirements, and is essentially identical to the language set out in the Nurse Practitioners Modernization Act, which added Subdivision 3 to Education Law § 6902. Section 29.14 adds failure to comply with the collaborative relationship requirements to the definition of unprofessional conduct in nursing.
The new element to the regulation is the definition section, which uses the definition of “hospital” set out in Public Health Law § 2801(1). As New York health lawyers and providers know, “hospital” is a much broader term under that statute than many think—it includes not just general hospitals but also nursing homes, diagnostic and treatment centers, and dental clinics. As a practical matter, if a nurse practitioner chooses to have a relationship with a hospital rather than an individual physician, the NP must be able to “communicate with a physician qualified to collaborate in the specialty area involved and who has privileges at such hospital . . . .” 8 Proposed N.Y.C.R.R. § 64.5(g)(1)(i). “Privileges” is not a defined term, so one might wonder whether this regulation would permit a nurse practitioner to have a collaborative agreement with a nursing home, so long as the nursing home had on staff a physician qualified to work with the NP in the NP’s area of practice.
SED is accepting comments on this regulation until October 25, 2014. Interested providers may contact the State Education Department with their commentary at firstname.lastname@example.org.