I live in NY so this bill is very interesting to me as I will be starting a PMHNP program this summer. I was reading headlines stating that NP's now have independent practice. I have read through the article and it states that the APRN has to have an agreement even after the 36 months with a physician. What am I missing? How is this independent practice?
"A NURSE PRACTITIONER, CERTIFIED UNDER SECTION SIX THOUSAND NINE
HUNDRED TEN OF THIS ARTICLE AND PRACTICING FOR MORE THAN THIRTY-SIX
MONTHS AND THREE THOUSAND SIX HUNDRED HOURS, SHALL EITHER HAVE A WRITTEN
PRACTICE AGREEMENT AND WRITTEN PRACTICE PROTOCOLS WITH A LICENSED PHYSI-
CIAN IN CONFORMITY WITH THE REQUIREMENTS SET FORTH IN PARAGRAPH (A) OF
THIS SUBDIVISION OR SHALL HAVE COLLABORATIVE RELATIONSHIPS 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
HAVING PRIVILEGES AT SUCH INSTITUTION AND QUALIFIED TO COLLABORATE IN
THE SPECIALTY INVOLVED. SUCH COLLABORATIVE RELATIONSHIP SHALL INCLUDE
WRITTEN GUIDELINES FOR PRACTICE THAT PROVIDE FOR THE CRITERIA TO BE USED
REGARDING CONSULTATION, INCLUDING METHODS AND FREQUENCY OF HOW CONSULTA-
TION SHALL BE PROVIDED, COLLABORATIVE MANAGEMENT AND REFERRAL, INCLUDING
EMERGENCY REFERRAL PLANS, TO ADDRESS THE HEALTH STATUS AND RISKS OF
Nursetim.....Having had children, I understand the concept. I also understand what independent practice means. My question was why is the NYS act being referred to as independent practice when there is still a collaborative agreement needed with a physician.
Barnstormin' - In certain situations in non-independent practice states NPs have had to pay physicians, I don't believe that will be the case in NY after this statue goes into effect. I'm basing this on Juan's earlier posts in this thread.
While this statue certainly is not the model I would hope for, from all indications I have seen it is a step forward. The question I have is, is it enough of a step forward? Apparently the Nurse Practitioner Association of New York thinks so, as the link Juan put in his post indicates they are happy with the new law and consider it progress.
I agree with BlueDevil, as NPs I believe now is the time for us to fight for full independence in every state. I think there is sufficient data from those states that have had independent practice for many years to make our case now. If new NPs must be supervised, than they should be supervised by other NPs, not someone from another profession. After that, they should be able to practice without restriction as long as they are practicing within their scope of practice.
Insurance companies and healthcare organizations should not be able to exclude APRN care, again it should be treated in the same manner as care from any other provider. Even in a state like NM which has had independent practice for a very long time, my preceptors tell me stories of roadblocks they have run into that have limited their ability to properly care for their patients, it is time to remove these roadblocks.
Barnstormin' PMHNP
349 Posts
Nursetim.....Having had children, I understand the concept. I also understand what independent practice means. My question was why is the NYS act being referred to as independent practice when there is still a collaborative agreement needed with a physician.