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                                 SENATE AMENDED
        PRIOR PRINTER'S NOS. 1548, 1986, 2019         PRINTER'S NO. 2176

THE GENERAL ASSEMBLY OF PENNSYLVANIA


HOUSE BILL

No. 1253 Session of 2007


        INTRODUCED BY SOLOBAY, SEIP, BELFANTI, CAPPELLI, CREIGHTON,
           DALEY, EACHUS, FREEMAN, GEIST, GRUCELA, JOSEPHS, KIRKLAND,
           MURT, PETRONE, SAYLOR, SIPTROTH, KULA, EVERETT, GIBBONS,
           KORTZ, PALLONE, JAMES, THOMAS, CALTAGIRONE AND PASHINSKI,
           MAY 10, 2007

        SENATOR TOMLINSON, CONSUMER PROTECTION AND PROFESSIONAL
           LICENSURE, IN SENATE, AS AMENDED, JUNE 30, 2007

                                     AN ACT

     1  Amending the act of May 22, 1951 (P.L.317, No.69), entitled, as
     2     amended, "An act relating to the practice of professional
     3     nursing; providing for the licensing of nurses and for the
     4     revocation and suspension of such licenses, subject to
     5     appeal, and for their reinstatement; providing for the
     6     renewal of such licenses; regulating nursing in general;
     7     prescribing penalties and repealing certain laws," further
     8     providing for scope of practice for certified registered
     9     nurse practitioners; and providing for professional
    10     liability.

    11     The General Assembly of the Commonwealth of Pennsylvania
    12  hereby enacts as follows:
    13     Section 1.  Section 8.2 of the act of May 22, 1951 (P.L.317,
    14  No.69), known as The Professional Nursing Law, added December 9,
    15  2002 (P.L.1567, No.206), is amended to read:
    16     Section 8.2.  Scope of Practice for Certified Registered
    17  Nurse Practitioners.--(a)  A certified registered nurse
    18  practitioner while functioning in the expanded role as a
    19  professional nurse shall practice within the scope of practice


     1  of the particular clinical specialty area in which the nurse is
     2  certified by the board.
     3     (b)  A certified registered nurse practitioner may perform
     4  acts of medical diagnosis in collaboration with a physician and
     5  in accordance with regulations promulgated by the board.
     6     (c)  [A] Except as provided in subsection (c.1), a certified
     7  registered nurse practitioner may prescribe medical therapeutic
     8  or corrective measures if the nurse is acting in accordance with
     9  the provisions of section 8.3.
    10     (c.1)  Except as limited by subsection (c.2), and in addition
    11  to existing authority, a certified registered nurse practitioner
    12  shall have authority to do all of the following, provided that
    13  the certified nurse practitioner is acting within the scope of
    14  the certified registered nurse practitioner's collaborative or
    15  written agreement with a physician and the certified registered
    16  nurse practitioner's specialty certification:
    17     (1)  Order home health and hospice care.
    18     (2)  Order durable medical equipment.
    19     (3)  Issue oral orders to the extent permitted by the health
    20  care facilities' by-laws, rules, regulations or administrative
    21  policies and guidelines.
    22     (4)  Make physical therapy and dietitian referrals.
    23     (5)  Order respiratory or occupational therapy.                <--
    24     (5)  MAKE RESPIRATORY AND OCCUPATIONAL THERAPY REFERRALS.      <--
    25     (6)  Perform disability assessments for the program providing
    26  Temporary Assistance to Needy Families (TANF).
    27     (7)  Issue home bound schooling certifications.
    28     (8)  Perform and sign THE initial assessment of methadone      <--
    29  treatment evaluations, provided that any order for methadone
    30  treatment shall be made only by a physician.
    20070H1253B2176                  - 2 -     

     1     (c.2)  Nothing in this section shall be construed to:
     2     (1)  Supersede the authority of the Department of Health and
     3  the Department of Public Welfare to regulate the types of health
     4  care professionals who are eligible for medical staff membership
     5  or clinical privileges.
     6     (2)  Restrict the authority of a health care facility to
     7  determine the scope of practice and supervision or other
     8  oversight requirements for health care professionals practicing
     9  within the facility.
    10     (d)  Nothing in this section shall be construed to limit or
    11  prohibit a certified registered nurse practitioner from engaging
    12  in those activities which normally constitute the practice of
    13  nursing as defined in section 2.
    14     Section 2.  The act is amended by adding a section to read:
    15     Section 8.5.  Professional Liability.--A certified registered
    16  nurse practitioner practicing in this Commonwealth shall
    17  maintain a level of professional liability coverage as required
    18  for a nonparticipating health care provider under the act of
    19  March 20, 2002 (P.L.154, No.13), known as the "Medical Care
    20  Availability and Reduction of Error (Mcare) Act," but shall not
    21  be eligible to participate in the Medical Care Availability and
    22  Reduction of Error (Mcare) Fund.
    23     Section 3.  The State Board of Nursing, the Department of
    24  Public Welfare, the State Board of Medicine and the Department
    25  of Health shall promulgate regulations to implement the
    26  amendment or addition of sections 8.2 and 8.5 of the act within
    27  18 months of the effective date of this section.
    28     Section 4.  The following acts are repealed insofar as they
    29  are inconsistent with the amendment of section 8.2 of the act
    30  and the addition of section 8.5 of the act:
    20070H1253B2176                  - 3 -     

     1         (1)  Section 3.1 3.1(B) of the act.                        <--
     2         (2)  Section 9 9(D) of the act of October 10, 1975         <--
     3     (P.L.383, No.110), known as the Physical Therapy Practice
     4     Act.
     5         (3)  Section 14 of the act of June 15, 1982 (P.L.502,
     6     No.140), known as the Occupational Therapy Practice Act.
     7         (4)  Section 13.1(d) of the act of December 20, 1985
     8     (P.L.457, No.112), known as the Medical Practice Act of 1985.
     9     Section 5.  This act shall take effect in 60 days.














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