Advanced Directive and Defibrillator Bills Among Priorities
For The Nurse Practitioner Association New York State
Nurse Practitioners Will Go To Albany To Urge Passage
of Important Patient-Centered Legislation
Nurse practitioners from across New York State will be in Albany for their annual Capital Day on Tuesday, April 25, 2017, to lobby for important legislation that has far-reaching impact on patients and families in the state. The number one issue on the Association’s agenda is S.1869 (Hannon), advanced directive legislation that authorizes nurse practitioners to execute orders not to resuscitate and other orders pertaining to life-sustaining treatment. Known as the DNR Bill, it would amend the Public Health Law to add “attending nurse practitioner” to the list of health care providers with whom patients and families can consult as they contemplate end of life decisions.
“Decisions regarding life-sustaining treatment or other orders not to resuscitate are deeply personal ones. Patients should be able to contemplate such decisions in consultation with their primary care provider which, in many instances, is a nurse practitioner,” says Stephen Ferrara, DNP, FNP, FAANP, Associate Dean of Clinical Affairs at Columbia University School of Nursing and Executive Director of the Nurse Practitioner Association of New York State.
He adds, “There are approximately 18,000 licensed nurse practitioners in New York State, many of whom are primary healthcare providers for patients. As a result, they may be more familiar with the wishes of those patients and their family members. Patients should not be denied the right to choose to include their primary care provider, who may be a nurse practitioner, in these end of life decisions.”
The Nurse Practitioner Association New York State (NPA) also points out that including nurse practitioners among those providers authorized to execute orders not to resuscitate and orders pertaining to life-sustaining treatments will lead to successful conversations between healthcare providers and patients, enabling those patients to make clear choices regarding advanced directives. Enacting this legislation is consistent with the recently adopted federal policy. In January 2016, Medicare began reimbursing for advance care planning as a separate service provided by health care practitioners – including nurse practitioners, physicians, and others.
The DNR Bill previously passed both houses of the New York State Legislature. At the time, the legislation was supported by the State Education Department (“SED”), which noted that in situations where a nurse practitioner is serving as the primary care provider for a patient, the nurse practitioner “may better understand the patient’s medical concerns surrounding cardiopulmonary resuscitation and may be better suited to facilitate discussions relating to the patient’s condition and risks associated with such resuscitation with the patient or the patient's family. Moreover, the nurse practitioner may be better suited to assess the appropriateness of such an order given the patient's condition.” Ultimately, however, the bill was vetoed by then-Governor Paterson. The legislation has since been revised to address the concerns raised in 2010, and the updated bill, sponsored by Senate Health Committee Chair, Kemp Hannon (R-Nassau), passed the Senate in 2016. At the time, the Assembly did not act on the companion legislation sponsored by Assembly Health Committee Chair, Dick Gottfried (D-Manhattan). Senator Hannon’s bill was reintroduced in January 2017, and Assemblyman Gottfried will again be sponsoring the companion legislation.
The Nurse Practitioner Association’s Capital Day agenda will also include seeking support for legislation authorizing nurse practitioners to be included among health care professionals who may enter into agreements to enable certain individuals and entities to make automatic defibrillators (“AEDs”) available. Defibrillators can be lifesavers during medical emergencies and increasing public access has been critically important for cardiac emergencies. Current law, however, restricts these individuals and entities from accessing the important equipment unless the individual or entity enters into an agreement with a physician or hospital. Dr. Ferrara, who is himself a certified nurse practitioner, says, “There is simply no reason why other qualified health care professionals, such as nurse practitioners, should be limited in their ability to enter into these collaborative agreements with persons and entities that wish to increase access to AEDs.”
David Dempsey, DNP, FNP, President of the Nurse Practitioner Association New York State, says, “We are grateful that over the years our legislators have acknowledged the education, skills and vital role that nurse practitioners have in providing health care to patients in New York State. We look forward to visiting with our state representatives on April 25, and continuing to work with them to expand health care options for all New Yorkers.”
The Nurse Practitioner Association New York State
Nurse Practitioners (NPs) are registered nurses who have completed advanced education, at a Master’s or Doctorate level, plus additional preparation. These professionals are authorized to independently diagnose illness and physical conditions, perform therapeutic and corrective measures, order tests, prescribe medications, devices and immunizing agents, and refer patients to other health care providers. The Nurse Practitioner Association New York State (NPA), the only statewide professional association of nurse practitioners, promotes high standards of healthcare delivery through the empowerment of Nurse Practitioners and the profession throughout New York State.