THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

INTRODUCED BY GIBBONS, BRIGGS, CALTAGIRONE, CARROLL, COHEN, FABRIZIO, FARRY, FREEMAN, GALLOWAY, HARKINS, HORNAMAN, JOSEPHS, KORTZ, MURPHY, MURT, PYLE, SANTONI AND STURLA, JUNE 2, 2011

REFERRED TO COMMITTEE ON PROFESSIONAL LICENSURE, JUNE 2, 2011  

AN ACT

Amending the act of May 22, 1951 (P.L.317, No.69), entitled, as

amended, "An act relating to the practice of professional

nursing; providing for the licensing of nurses and for the

revocation and suspension of such licenses, subject to

appeal, and for their reinstatement; providing for the

renewal of such licenses; regulating nursing in general;

prescribing penalties and repealing certain laws," further

providing for definitions and providing for psychiatric

mental health clinical nurse specialist.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1.  Section 2 of the act of May 22, 1951 (P.L.317,

No.69), known as The Professional Nursing Law, is amended by

adding clauses to read:

Section 2.  Definitions.--When used in this act, the

following words and phrases shall have the following meanings

unless the context provides otherwise:

* * *

(16)  "Consultation" means interaction between a psychiatric

mental health clinical nurse specialist (PMHCNS) and another

member of the health care team for the purpose of transmitting

or obtaining information, advice or referral.

(17)  "Mental health diagnoses" means the use of advanced

professional nursing knowledge and skills in the identification

of and discrimination between physical and psychological signs

and symptoms, selecting those disorders from the most recent

version of the Diagnostic & Statistical Manual of Mental

Disorders that best reflect the signs and symptoms that are

afflicting the individual being evaluated to arrive at a

conclusion for which advanced nursing care is indicated or

referral to appropriate medical or community resources is

required.

(18)  "Psychiatric mental health clinical nurse specialist

(PMHCNS)" means a registered nurse licensed in this Commonwealth

who is certified as a clinical nurse specialist under this act

and authorized or certified by the State Board of Nursing as a

psychiatric mental health clinical nurse specialist.

Section 2.  Section 8.6 of the act, added July 20, 2007

(P.L.320, No.49), is amended to read:

Section 8.6.  Scope of Practice for Clinical Nurse Specialist

and for Psychiatric Mental Health Clinical Nurse Specialist.--

(a)  Nothing in this act shall permit a clinical nurse

specialist to engage in the practice of medicine or surgery as

defined in the act of December 20, 1985 (P.L.457, No.112), known

as the "Medical Practice Act of 1985"; perform acts of medical

diagnosis; or prescribe medical therapeutic or corrective

measures. The restrictions in this subsection apply to both

physical and mental disorders.

(b)  Nothing in this act shall be construed to limit or

prohibit a clinical nurse specialist from engaging in those

activities which normally constitute the practice of nursing,

including a nursing diagnosis, as defined in section 2.

(c)  A psychiatric mental health clinical nurse specialist

(PMHCNS) while functioning in the expanded role as a clinical

nurse specialist (CNS) shall practice within the scope of

practice of the particular clinical specialty area in which the

nurse is certified by the board.

(d)  In addition to existing authority prescribed in

subsections (a) and (b), a PMHCNS shall have the authority to do

all of the following:

(1)  Establish a mental health diagnosis.

(2)  Evaluate psychobiological interventions.

(3)  Provide individual psychotherapy.

(4)  Provide group psychotherapy.

(5)  Provide marital or couple psychotherapy.

(6)  Provide any therapy which purpose is to:

(i)  Effect change in the client in an attempt to alleviate

emotional disturbances.

(ii)  Reverse or change maladaptive behavior.

(iii)  Facilitate personality growth and development.

(7)  Provide consultation to health care providers and to

others:

(i)  Influence the plans of care for clients.

(ii)  Enhance the abilities of others to provide behavioral,

psychiatric and mental health care.

(iii)  Effect change in systems.

(8)  Provide behavioral rehabilitation care.

(9)  Utilize advanced practice skills to independently

provide:

(i)  Case management including behavioral rehabilitation at

home care.

(ii)  Health teaching, health promotion, health prevention

and aid to the client in developing healthy patterns of living.

(10)  Perform mental disability assessments.

(11)  Develop and manage programs to meet the mental health

needs of a population or to target a population at risk for

developing mental health problems.

(12)  Provide clinical supervision to other PMHCNS and other

registered nurses.

(13)  Provide crisis intervention and make referrals as

appropriate.

Section 3.  This act shall take effect in 60 days.