Bill Text: NJ A4271 | 2024-2025 | Regular Session | Introduced
Bill Title: Expands scope of practice of pediatricians and advanced practice nurses with respect to pediatric behavioral and developmental health care.
Spectrum: Partisan Bill (Democrat 3-0)
Status: (Introduced) 2024-05-02 - Introduced, Referred to Assembly Health Committee [A4271 Detail]
Download: New_Jersey-2024-A4271-Introduced.html
Sponsored by:
Assemblyman STERLEY S. STANLEY
District 18 (Middlesex)
Assemblyman DAN HUTCHISON
District 4 (Atlantic, Camden and Gloucester)
SYNOPSIS
Expands scope of practice of pediatricians and advanced practice nurses with respect to pediatric behavioral and developmental health care.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning pediatric behavioral and developmental health care, amending P.L.1991, c.377, and supplementing Title 45 of the Revised Statutes.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. (New section) A pediatrician, who does not specialize in pediatric behavioral or developmental health care, shall be permitted to provide behavioral or developmental health care to children with low-acuity, behavioral or developmental conditions, including, but not limited to, anxiety or stress, as determined by the State Board of Medical Examiners.
2. Section 10 of P.L.1991, c.377 (C.45:11-49) is amended to read as follows:
10. a. In addition to all other tasks which a registered professional nurse may, by law, perform, an advanced practice nurse may manage preventive care services and diagnose and manage deviations from wellness and long-term illnesses, consistent with the needs of the patient and within the scope of practice of the advanced practice nurse, by:
(1) initiating laboratory and other diagnostic tests;
(2) prescribing or ordering medications and devices, as authorized by subsections b. and c. of this section; and
(3) prescribing or ordering treatments, including referrals to other licensed health care professionals, and performing specific procedures in accordance with the provisions of this subsection.
b. An advanced practice nurse may order medications and devices in the inpatient setting, subject to the following conditions:
(1) the collaborating physician and advanced practice nurse shall address in the joint protocols whether prior consultation with the collaborating physician is required to initiate an order for a controlled dangerous substance;
(2) the order is written in accordance with standing orders or joint protocols developed in agreement between a collaborating physician and the advanced practice nurse, or pursuant to the specific direction of a physician;
(3) the advanced practice nurse authorizes the order by signing the nurse's own name, printing the name and certification number, and printing the collaborating physician's name;
(4) the physician is present or readily available through electronic communications;
(5) the charts and records of the patients treated by the advanced practice nurse are reviewed by the collaborating physician and the advanced practice nurse within the period of time specified by rules adopted by the Commissioner of Health pursuant to section 13 of P.L.1991, c.377 (C.45:11-52);
(6) the joint protocols developed by the collaborating physician and the advanced practice nurse are reviewed, updated, and signed at least annually by both parties; and
(7) the advanced practice nurse has completed six contact hours of continuing professional education in pharmacology related to controlled substances, including pharmacologic therapy, addiction prevention and management, and issues concerning prescription opioid drugs, including responsible prescribing practices, alternatives to opioids for managing and treating pain, and the risks and signs of opioid abuse, addiction, and diversion, in accordance with regulations adopted by the New Jersey Board of Nursing. The six contact hours shall be in addition to New Jersey Board of Nursing pharmacology education requirements for advanced practice nurses related to initial certification and recertification of an advanced practice nurse as set forth in N.J.A.C.13:37-7.2.
c. An advanced practice nurse may prescribe medications and devices in all other medically appropriate settings, subject to the following conditions:
(1) the collaborating physician and advanced practice nurse shall address in the joint protocols whether prior consultation with the collaborating physician is required to initiate a prescription for a controlled dangerous substance;
(2) the prescription is written in accordance with standing orders or joint protocols developed in agreement between a collaborating physician and the advanced practice nurse, or pursuant to the specific direction of a physician;
(3) the advanced practice nurse writes the prescription on a New Jersey Prescription Blank pursuant to P.L.2003, c.280 (C.45:14-40 et seq.), signs the nurse's own name to the prescription and prints the nurse's name and certification number;
(4) the prescription is dated and includes the name of the patient and the name, address, and telephone number of the collaborating physician;
(5) the physician is present or readily available through electronic communications;
(6) the charts and records of the patients treated by the advanced practice nurse are periodically reviewed by the collaborating physician and the advanced practice nurse;
(7) the joint protocols developed by the collaborating physician and the advanced practice nurse are reviewed, updated, and signed at least annually by both parties; and
(8) the advanced practice nurse has completed six contact hours of continuing professional education in pharmacology related to controlled substances, including pharmacologic therapy, addiction prevention and management, and issues concerning prescription opioid drugs, including responsible prescribing practices, alternatives to opioids for managing and treating pain, and the risks and signs of opioid abuse, addiction, and diversion, in accordance with regulations adopted by the New Jersey Board of Nursing. The six contact hours shall be in addition to New Jersey Board of Nursing pharmacology education requirements for advanced practice nurses related to initial certification and recertification of an advanced practice nurse as set forth in N.J.A.C.13:37-7.2.
d. The joint protocols employed pursuant to subsections b. and c. of this section shall conform with standards adopted by the Director of the Division of Consumer Affairs pursuant to section 12 of P.L.1991, c.377 (C.45:11-51) or section 10 of P.L.1999, c.85 (C.45:11-49.2), as applicable.
e. (Deleted by amendment, P.L.2004, c.122.)
f. An attending advanced practice nurse may determine and certify the cause of death of the nurse's patient and execute the death certification pursuant to R.S.26:6-8 if no collaborating physician is available to do so and the nurse is the patient's primary caregiver.
g. An advanced practice nurse may authorize qualifying patients for the medical use of cannabis and issue written instructions for medical cannabis to registered qualifying patients, subject to the following conditions:
(1) the collaborating physician and advanced practice nurse shall address in the joint protocols whether prior consultation with the collaborating physician is required to authorize a qualifying patient for the medical use of cannabis or issue written instructions for medical cannabis;
(2) the authorization for the medical use of cannabis or issuance of written instructions for cannabis is in accordance with standing orders or joint protocols developed in agreement between a collaborating physician and the advanced practice nurse, or pursuant to the specific direction of a physician;
(3) the advanced practice nurse signs the nurse's own name to the authorization or written instruction and prints the nurse's name and certification number;
(4) the authorization or written instruction is dated and includes the name of the qualifying patient and the name, address, and telephone number of the collaborating physician;
(5) the physician is present or readily available through electronic communications;
(6) the charts and records of qualifying patients treated by the advanced practice nurse are periodically reviewed by the collaborating physician and the advanced practice nurse;
(7) the joint protocols developed by the collaborating physician and the advanced practice nurse are reviewed, updated, and signed at least annually by both parties; and
(8) the advanced practice nurse complies with the requirements for authorizing qualifying patients for the medical use of cannabis and for issuing written instructions for medical cannabis established pursuant to P.L.2009, c.307 (C.24:6I-1 et al.).
h. An advanced practice nurse, who does not specialize in pediatric behavioral or developmental health care, shall be permitted to provide behavioral or developmental health care to children with low-acuity, behavioral or developmental conditions, including, but not limited to, anxiety or stress, as determined by the New Jersey Board of Nursing.
(cf: P.L.2019, c.153, s.47)
3. (New section) The State Board of Medical Examiners and the New Jersey Board of Nursing shall each shall adopt rules and regulations, in accordance with the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), as are necessary to effectuate the provisions of this act.
4. This act shall take effect immediately.
STATEMENT
This bill expands the scope of practice of pediatricians and advanced practice nurses with respect to pediatric behavioral and developmental health care.
Under the bill, a pediatrician or advanced practice nurse, who does not specialize in pediatric behavioral or developmental health care, is to be permitted to provide behavioral or developmental health care to children with low-acuity, behavioral or developmental conditions, including, but not limited to, anxiety or stress, as determined by the State Board of Medical Examiners and New Jersey Board of Nursing.
