S1410

An Act concerning physician assistants and amending various parts of the statutory law.

Be It Enacted by the Senate and General Assembly of the State of New Jersey:

1. Section 7 of P.L. 1983, c.17 (C.9:17-44) is amended to read as follows:

7. a. If, under the supervision of a licensed physician, a physician [assistant] associate, or an advanced practice nurse, and with the consent of her spouse or partner in a civil union, a woman is inseminated artificially with semen donated by a man not her spouse or partner, the spouse or partner is treated in law as if the spouse or partner were the legal parent of a child thereby conceived. The consent of the spouse or partner shall be in writing and signed by both parties to the marriage or civil union. The physician, physician [assistant] associate, or advance practice nurse shall certify their signatures and the date of the insemination, upon forms provided by the Department of Health, and file the consent with the Department of Health, where it shall be kept confidential and in a sealed file. However, the physician's, physician [assistant's] associate’s, or advance practice nurse's failure to do so shall not affect the parent and child relationship of the spouse or partner. All papers and records pertaining to the insemination, whether part of the permanent record of a court or of a file held by the supervising physician, [physician's assistant] physician associate, or advance practice nurse or elsewhere, are subject to inspection only upon an order of the court for compelling reasons clearly and convincingly shown.

b. Unless the donor of semen and the woman have entered into a written contract to the contrary, the donor of semen provided to a licensed physician, physician [assistant] associate, or advance practice nurse for use in artificial insemination of a woman other than the spouse or partner in a civil union is treated in law as if the donor of semen were not the legal parent of a child thereby conceived and shall have no rights or duties stemming from the conception of a child.

c. This section shall not apply in a proceeding to determine parentage of a child born in connection with a gestational carrier agreement executed in accordance with the provisions of P.L.2018, c.18 (C.9:17-60 et al.).

(cf: P.L.2018, c.18, s.13)

2. Section 3 of P.L.2018, c.18 (C.9:17-62) is amended to read as follows:

3. Definitions.

As used in [this act] P.L.2018, c.18 (C.9:17-60 et seq.):

"Advanced practice nurse" means a person certified in accordance with the provisions of section 8 or 9 of P.L.1991, c.377 (C.45:11-47 or 45:11-48).

"Assisted reproductive technology" means procreative laboratory procedures involving human eggs or pre-embryos, including, but not limited to: in vitro fertilization; embryo transfer; gamete transfer; pronuclear stage transfer; and zygote transfer.

"Attorney" means a person licensed to practice law in New Jersey or another state or the District of Columbia.

"Certified nurse midwife" means a midwife licensed by the State Board of Medical Examiners as a certified nurse midwife pursuant to the provisions of P.L.1991, c.97 (C.45:10-17 et al.).

"Donor" means a person who contributes gametes for use in assisted reproduction. The term does not include an intended parent who contributes gametes to be used in assisted reproduction pursuant to a valid gestational carrier agreement.

"Fertilization" means the initial union of the sperm and the egg.

"Gamete" means sperm or egg.

"Gestational carrier" means a woman 21 years of age or older who agrees to become pregnant for an intended parent by assisted reproductive technology without the use of her own egg.

"Gestational carrier agreement" means the written contract between the gestational carrier and the intended parent, pursuant to which the intended parent agrees to become the legal parent of a child created through assisted reproductive technology and carried by the gestational carrier.

"Implantation" means when the fertilized egg adheres to the gestational carrier's uterine wall.

"Intended parent" means a person who enters into a gestational carrier agreement with a gestational carrier pursuant to section 6 of P.L.2018, c.18 (C.9:17-65), pursuant to which the person shall be the legal parent of the resulting child. The term shall include persons who are single, married, partners in a civil union or domestic partnership, and couples who are not married or in a civil union or domestic partnership. Any reference to an intended parent shall include both spouses or partners in a civil union or domestic partnership. This term shall include the intended mother, the intended father, the intended mother and intended father, the intended mother and intended mother, or the intended father and intended father.

"In vitro fertilization" means all medical and laboratory procedures that are required to effectuate the formation of a human embryo outside the human body.

"Medical evaluation" means an evaluation and consultation by a physician, a physician [assistant] associate, a certified nurse midwife, or an advanced practice nurse.

"Order of parentage" means a judgment determining parentage pursuant to the provisions of a gestational carrier agreement that satisfies P.L.2018, c.18 (C.9:17-60 et al.).

"Physician" means a person licensed to practice medicine in New Jersey pursuant to R.S.45:9-1 et seq. or licensed to practice in any one of the United States or its territories, or the District of Columbia.

"Physician [assistant] associate" means a health professional who meets the qualifications under P.L.1991, c.378 (C.45:9-27.10 et seq.) and holds a current, valid license issued pursuant to section 4 of P.L.1991, c.378 (C.45:9-27.13).

"Pre-embryo" is a fertilized egg prior to 14 days of development.

"Pre-embryo transfer" means all medical and laboratory procedures that are necessary to effectuate the transfer of a pre-embryo into the uterine cavity.

"Psychological evaluation" means an evaluation and consultation by a clinical social worker, psychotherapist, or psychiatrist licensed by the State of New Jersey or licensed to practice in any one of the United States or its territories, or the District of Columbia.

"Reasonable expenses" means medical, hospital, counseling or other similar expenses incurred in connection with the gestational carrier agreement, reasonable attorney fees and costs for legal services in connection with the gestational carrier agreement, and the reasonable living expenses of the gestational carrier during her pregnancy including payments for reasonable food, clothing, medical expenses, shelter, and religious, psychological, vocational, or similar counseling services during the period of the pregnancy and during the period of postpartum recovery. These payments may be made directly to the gestational carrier or on the gestational carrier's behalf to the supplier of the goods or services pursuant to the gestational carrier agreement.

(cf: P.L.2018, c.18, s.3)

3. Section 6 of P.L.2018, c.18 (C.9:17-65) is amended to read as follows:

6. Requirements for a Gestational Carrier Agreement.

a. A gestational carrier agreement shall satisfy the following requirements:

(1) It is in writing and executed by the gestational carrier, her spouse or partner in a civil union or domestic partnership, if any, and each intended parent. If the intended parent is married or in a domestic partnership or civil union at the time the intended parent enters the agreement, both spouses or partners shall meet the requirements of subsection b. of section 5 of P.L.2018, c.18 (C.9:17-64) and shall be required to enter into the agreement as intended parents. If the intended parent is not married or in a civil union or domestic partnership, no other person shall be deemed a legal parent of the child unless that person meets the requirements of subsection b. of section 5 of P.L.2018, c.18 (C.9:17-64) and duly executes the agreement;

(2) It is executed after the required medical and psychological screenings of the gestational carrier and the psychological screening of the intended parent, but prior to the commencement of any other necessary medical procedures in furtherance of the implantation of the pre-embryo; and

(3) The gestational carrier and her spouse or partner, if any, and the intended parent shall have been represented by separate attorneys in all matters relating to the gestational carrier agreement and each attorney provides an affidavit of such representation.

b. A gestational carrier agreement shall provide:

(1) Express terms that the gestational carrier shall:

(a) Undergo pre-embryo transfer and attempt to carry and give birth to the child;

(b) Surrender custody of the child to the intended parent immediately upon the child's birth; and

(c) Have the right to medical care for the pregnancy, labor, delivery, and postpartum recovery provided by a physician, physician [assistant] associate, advance practice nurse, or certified nurse midwife of her choice, after she notifies, in writing, the intended parent of her choice;

(2) An express term that, if the gestational carrier is married or in a civil union or domestic partnership, the spouse or partner agrees to the obligations imposed on the gestational carrier pursuant to the terms of the gestational carrier agreement and to surrender custody of the child to the intended parent immediately upon the child's birth; and

(3) Express terms that the intended parent shall:

(a) Accept custody of the child immediately upon the child's birth; and

(b) Assume sole responsibility for the support of the child immediately upon the child's birth.

c. A gestational carrier agreement shall be presumed enforceable if:

(1) It satisfies the contractual requirements set forth in subsection a. of this section; and

(2) It contains at a minimum each of the terms set forth in subsection b. of this section.

In addition, an enforceable gestational carrier agreement shall include a provision setting forth the financial responsibilities of the parties and shall include a provision that the intended parent shall pay the gestational carrier's reasonable expenses, as defined herein, unless expressly waived, in whole or in part, in writing by the gestational carrier.

d. In the event that any of the requirements of this section are not met, a court of competent jurisdiction shall determine parentage based on the parties' intent.

(cf: P.L.2018, c.18, s.6)

4. Section 1 of P.L.1968, c.230 (C.9:17A-4) is amended to read as follows:

1. a. (1) The consent to the provision of medical or surgical care or services or a forensic sexual assault examination by a hospital or public clinic, or consent to the performance of medical or surgical care or services or a forensic sexual assault examination by a health care professional, when executed by a minor who is or believes that he or she may have a sexually transmitted infection, or who is at least 13 years of age and is or believes that he or she may be infected with the human immunodeficiency virus or have acquired immune deficiency syndrome, or by a minor who, in the judgment of the treating health care professional, appears to have been sexually assaulted, shall be valid and binding as if the minor had achieved the age of majority. Any such consent shall not be subject to later disaffirmance by reason of minority. In the case of a minor who appears to have been sexually assaulted, the minor's parents or guardian shall be notified immediately, unless the treating healthcare professional believes that it is in the best interests of the patient not to do so. Inability of the treating health care professional, hospital, or clinic to locate or notify the parents or guardian shall not preclude the provision of any emergency or medical or surgical care to the minor or the performance of a forensic sexual assault examination on the minor.

(2) As used in this subsection, "health care professional" means a physician, physician [assistant] associate, nurse, or other health care professional whose professional practice is regulated pursuant to Title 45 of the Revised Statutes.

b. When a minor believes that he or she is adversely affected by a substance use disorder involving drugs or is a person with a substance use disorder involving drugs as defined in section 2 of P.L.1970, c.226 (C.24:21-2) or is adversely affected by an alcohol use disorder or is a person with an alcohol use disorder as defined in section 2 of P.L.1975, c.305 (C.26:2B-8), the minor's consent to treatment under the supervision of a physician licensed to practice medicine, or an individual licensed or certified to provide treatment for an alcohol use disorder, or in a facility licensed by the State to provide for the treatment of an alcohol use disorder, shall be valid and binding as if the minor had achieved the age of majority. Any such consent shall not be subject to later disaffirmance by reason of minority. Treatment for an alcohol use disorder or a substance use disorder involving drugs that is consented to by a minor shall be considered confidential information between the physician, the treatment provider, or the treatment facility, as appropriate, and the patient, and neither the minor nor the minor's physician, treatment provider, or treatment facility, as appropriate, shall be required to report such treatment when it is the result of voluntary consent, except as may otherwise be required by law.

When a minor who is sixteen years of age or older believes that he or she is in need of behavioral health care services for the treatment of mental illness or emotional disorders, the minor's consent to temporary outpatient treatment, excluding the use or administration of medication, under the supervision of a physician licensed to practice medicine, an advanced practice nurse, or an individual licensed to provide professional counseling under Title 45 of the Revised Statutes, including, but not limited to, a psychiatrist, licensed practicing psychologist, certified social worker, licensed clinical social worker, licensed social worker, licensed marriage and family therapist, certified psychoanalyst, or licensed psychologist, or in an outpatient health care facility licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.), shall be valid and binding as if the minor had achieved the age of majority. Any such consent shall not be subject to later disaffirmance by reason of minority. Treatment for behavioral health care services for mental illness or emotional disorders that is consented to by a minor shall be considered confidential information between the physician, the individual licensed to provide professional counseling, the advanced practice nurse, or the health care facility, as appropriate, and the patient, and neither the minor nor the minor's physician, professional counselor, nurse, or outpatient health care facility, as appropriate, shall be required to report such treatment when it is the result of voluntary consent.

The consent of no other person or persons, including but not limited to, a spouse, parent, custodian, or guardian, shall be necessary in order to authorize a minor to receive such hospital services, facility, or clinical care or services, medical or surgical care or services, or counseling services from a physician licensed to practice medicine, an individual licensed or certified to provide treatment for an alcohol use disorder, an advanced practice nurse, or an individual licensed to provide professional counseling under Title 45 of the Revised Statutes, as appropriate, except that behavioral health care services for the treatment of mental illness or emotional disorders shall be limited to temporary outpatient services only.

(cf: P.L.2017, c.131, s.7)

5. Section 3 of P.L.2013, c.71 (C.18A:40-41d) is amended to read as follows:

3. a. The Commissioners of Education and Health, in consultation with the New Jersey Chapter of the American Academy of Pediatrics, the New Jersey Academy of Family Physicians, the American Heart Association, and the New Jersey Chapter of the American College of Cardiology, shall develop, by the 2013-2014 school year, a Student-Athlete Cardiac Screening professional development module to increase the assessment skills of those health care practitioners who perform student-athlete physical examinations and screenings. The module shall include, but need not be limited to, the following:

(1) how to complete and review a detailed medical history with an emphasis on cardiovascular family history and personal reports of symptoms;

(2) identifying symptoms of sudden cardiac arrest that may require follow up with a cardiologist;

(3) recognizing normal structural changes of the athletic heart;

(4) recognizing prodromal symptoms that precede sudden cardiac arrest;

(5) performing the cardiovascular physical examination;

(6) reviewing the major etiologies of sudden unexplained cardiac death with an emphasis on structural abnormalities and acquired conditions; and

(7) when to refer a student to a cardiologist for further assessment.

b. The module developed pursuant to subsection a. of this section and the pamphlet developed pursuant to section 1 of P.L.2007, c.125 (C.18A:40-41) shall be posted on the websites of the Department of Education, the American Academy of Pediatrics, the New Jersey Academy of Family Physicians, the American Heart Association, the American College of Cardiology, the Athletic Trainers' Society of New Jersey, the State Board of Medical Examiners, the New Jersey State Board of Nursing, and the New Jersey State Society of Physician Assistants, or any successor organization thereof.

c. A physician, advanced practice nurse, or physician [assistant] associate who performs a student-athlete's annual physical examination prior to the student's participation in a school-sponsored interscholastic or intramural athletic team or squad as required pursuant to subsection a. of section 2 of P.L.2013, c.71 (C.18A:40-41.7) shall complete the Student-Athlete Cardiac Screening professional development module developed pursuant to subsection a. of this section. Upon performing a physical examination required by subsection a. of section 2 of P.L.2013, c.71 (C.18A:40-41.7), the physician, advanced practice nurse, or physician [assistant] associate shall sign the certification statement on the Preparticipation Physical Evaluation form required pursuant to subsection a. of section 2 of P.L.2013, c.71 (C.18A:40-41.7) attesting to the completion of the module. The board of education of a public school district and the governing board or chief school administrator of a nonpublic school shall retain the original signed statement to attest to the qualification of the health care practitioner to perform the physical examination required by subsection a. of section 2 of P.L.2013, c.71 (C.18A:40-41.7).

(cf: P.L.2013, c.71, s.3)

6. Section 2 of P.L.2013, c.71 (C.18A:40-41.7) is amended to read as follows:

2. a. The board of education of a public school district and the governing board or chief school administrator of a nonpublic school shall require that prior to the participation of any student enrolled in grades six to 12 on a school-sponsored interscholastic or intramural athletic team or squad, the student shall have a physical examination using the "Preparticipation Physical Evaluation" form developed jointly by the American Academy of Family Physicians, American Academy of Pediatrics, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine. The Preparticipation Physical Evaluation form shall include the History and Physical Examination components. The Preparticipation Physical Evaluation form shall also include a certification statement, to be signed by the licensed physician, advanced practice nurse, or physician [assistant] associate who performed the physical examination, attesting to the completion of the current professional development module developed pursuant to subsection a. of section 3 of P.L.2013, c.71 (C.18A:40-41d).

b. The physical examination required by subsection a. of this section shall be conducted within 365 days prior to the first day of official practice in an athletic season and shall be conducted by a licensed physician, advanced practice nurse, or physician [assistant] associate. Each student whose physical examination was completed more than 90 days prior to the first day of official practice in an athletic season shall provide a health history update questionnaire, completed and signed by the student's parent or guardian. The completed health history update questionnaire shall be reviewed by the school nurse and, if applicable, the school athletic trainer and shall include information as to whether, in the time period since the date of the student's last preparticipation physical examination, the student has:

(1) been advised by a licensed physician, advanced practice nurse, or physician [assistant] associate not to participate in a sport;

(2) sustained a concussion, been unconscious or lost memory from a blow to the head;

(3) broken a bone or sprained, strained, or dislocated any muscles or joints;

(4) fainted or blacked out;

(5) experienced chest pains, shortness of breath, or heart racing;

(6) had a recent history of fatigue and unusual tiredness;

(7) been hospitalized, visited an emergency room, or had a significant medical illness;

(8) started or stopped taking any over the counter or prescribed medications; or

(9) had a sudden death in the family, or whether any member of the student's family under the age of 50 has had a heart attack or heart trouble.

c. A board of education of a public school district and the governing board or chief school administrator of a nonpublic school shall not permit a student enrolled in grades six to 12 to participate on a school-sponsored interscholastic or intramural athletic team or squad unless the student has completed a Preparticipation Physical Evaluation form and, if applicable, a completed health history update questionnaire as required by subsections a. and b. of this section.

(cf: P.L.2013, c.71, s.2)

7. Section 3 of P.L.2013, c.211 (C.18A:61D-13) is amended to read as follows:

3. As used in [this act] P.L.2013, c.211 (C.18A:61D-11 et seq.):

"Institution of higher education" means a public or independent institution of higher education.

"Licensed campus medical professional" means a physician, physician [assistant] associate, advanced practice nurse, or registered nurse who is appropriately licensed by the State of New Jersey and is designated by an institution of higher education to oversee the institution's epinephrine administration and training program.

"Member of the campus community" means an individual who is a student, faculty, or staff member of an institution of higher education.

"Secretary" means the Secretary of Higher Education.

"Trained designee" means a member of the campus community trained by a licensed campus medical professional in the emergency administration of epinephrine via a pre-filled auto-injector mechanism.

(cf: P.L.2013, c.211, s.3)

8. Section 4 of P.L.2013, c.211 (C.18A:61D-14) is amended to read as follows:

4. a. An institution of higher education may develop a policy, in accordance with the guidelines established by the secretary pursuant to section 6 of P.L.2013, c.211 (C.18A:61D-16), for the emergency administration of epinephrine via a pre-filled auto-injector mechanism to a member of the campus community for anaphylaxis when a medical professional is not available. The policy shall:

(1) permit a trained designee, under the guidance of a licensed campus medical professional, to administer epinephrine via a pre-filled auto-injector mechanism to a member of the campus community for whom the designee is responsible, when the designee in good faith believes that the member of the campus community is having an anaphylactic reaction;

(2) permit a trained designee, when responsible for the safety of one or more members of the campus community, to carry in a secure but easily accessible location a supply of pre-filled epinephrine auto-injectors that is prescribed under a standing protocol from a licensed physician; and

(3) provide that the licensed campus medical professional shall have responsibility for: training designees on how to identify an anaphylactic reaction, how to identify the indications for when to use epinephrine, and how to administer epinephrine via a pre-filled auto-injector mechanism; and distributing prescribed pre-filled epinephrine auto-injectors to trained designees.

b. Each institution of higher education that develops a policy pursuant to subsection a. of this section shall designate a physician, physician [assistant] associate, advanced practice nurse, or registered nurse who is appropriately licensed by the State of New Jersey to serve as the licensed campus medical professional.

c. A licensed campus medical professional is authorized to:

(1) establish and administer a standardized training protocol for the emergency administration of epinephrine by trained designees;

(2) ensure that trained designees have satisfactorily completed the training protocol;

(3) obtain a supply of pre-filled epinephrine auto-injectors under a standing protocol from a licensed physician; and

(4) control distribution to trained designees of pre-filled epinephrine auto-injectors.

(cf: P.L.2013, c.211, s.4)

9. N.J.S.18A:71C-32 is amended to read as follows:

18A:71C-32. "Approved site" means a site located within a State designated underserved area or a health professional shortage area, or a clinic which is part of the extramural network of dental clinics established by the New Jersey Dental School of Rutgers, The State University, or a site that has been determined by the Higher Education Student Assistance Authority, in consultation with the Department of Health and Senior Services, to serve medically underserved populations according to criteria determined by the authority, including, but not limited to, the percentage of medically underserved patients served.

"Authority" means the Higher Education Student Assistance Authority.

"Eligible qualifying loan expenses" means the cumulative outstanding balance of student loans covering the cost of attendance at an undergraduate institution of medical, dental, or other primary care professional education at the time an applicant is selected for the program. Interest paid or due on qualifying loans that an applicant has taken out for use in paying the costs of undergraduate medical, dental, or other primary care professional education shall be considered eligible for reimbursement under the program. The authority may establish a limit on the total amount of qualifying loans which may be redeemed for participants under the program, provided that the total redemption of qualifying loans does not exceed $120,000, or the maximum amount authorized by the federal government, whichever is greater, either in State funds or the sum of federal, State, and other non-federal matching funds, pursuant to section 338I of the Public Health Service Act (42 U.S.C.s.254q-1), whichever is applicable.

"Executive director" means the executive director of the Higher Education Student Assistance Authority.

"Health professional shortage area" (HPSA) means an urban or rural area, a population group or a public or non-profit private medical or dental facility or other public facility which the Secretary of Health and Human Services determines has a health professional shortage pursuant to section 332 of the Public Health Service Act (42 U.S.C. s.254e).

"Primary care" means the practice of family medicine, general internal medicine, general pediatrics, general obstetrics, gynecology, pediatric dentistry, general dentistry, public health dentistry, and any other areas of medicine or dentistry which the Commissioner of Health and Senior Services may define as primary care. Primary care also includes the practice of a nurse-practitioner, certified nurse-midwife, and physician [assistant] associate.

"Primary care practitioner" means a State-licensed or certified health care professional who has obtained a degree in allopathic or osteopathic medicine, dentistry, or another primary care profession at an undergraduate institution of medical, dental, or other primary care professional education, as applicable.

"Program" means the Primary Care Practitioner Loan Redemption Program established pursuant to N.J.S.18A:71C-33.

"Program participant" means a primary care practitioner who contracts with the authority to engage in the clinical practice of primary care at an approved site in exchange for the redemption of eligible qualifying loan expenses provided under the program.

"Qualifying loan" means a government or commercial loan for the actual costs paid for tuition and reasonable education and living expenses relating to the obtaining of a degree in allopathic or osteopathic medicine, dentistry, or another primary care profession.

"State designated underserved area" means a geographic area in this State which has been ranked by the Commissioner of Health and Senior Services on the basis of health status and economic indicators as reflecting a medical or dental health professional shortage.

"Total and permanent disability" means a physical or mental disability that is expected to continue indefinitely or result in death and renders a participant in the program unable to perform that person's service obligation, as determined by the executive director or his designee.

"Undergraduate medical, dental, or other primary care professional education" means the period of time between entry into medical school, dental school, or other primary care professional training program and the award of a degree in allopathic or osteopathic medicine, dentistry, or another primary care profession, respectively.

(cf: P.L.2012, c.45, s.99)

10. Section 3 of P.L.2009, c.307 (C.24:6I-3) is amended to read as follows:

3. As used in P.L.2009, c.307 (C.24:6I-1 et al.) and P.L.2015, c.158 (C.18A:40-12.22 et al.):

"Academic medical center" means (1) an entity located in New Jersey that, on the effective date of P.L.2019, c.153 (C.24:6I-5.1 et al.), has an addiction medicine faculty practice or is in the same health care system as another facility located in New Jersey that offers outpatient medical detoxification services or inpatient treatment services for substance use disorder; has a pain management faculty practice or a facility-based pain management service located in New Jersey; has graduate medical training programs accredited, or pending accreditation, by the Accreditation Council for Graduate Medical Education or the American Osteopathic Association in primary care and medical specialties; is the principal teaching affiliate of a medical school based in the State; and has the ability to conduct research related to medical cannabis. If the entity is part of a system of health care facilities, the entity shall not qualify as an academic medical center unless the health care system is principally located within the State; or

(2) an accredited school of osteopathic medicine that: is located in a state that shares a common border with this State; has an articulation agreement or similar memorandum of understanding, plus an agreement to establish and maintain an apprenticeship program in this State to train workers in the cannabis industry, which training would earn college credit, with any State college or university located in a county of the first class with a college of nursing or nursing degree program accredited by the Commission on Collegiate Nursing Education on the effective date of P.L.2021, c.16 (C.24:6I-31 et al.); and has an institutional review board that has, on the effective date of P.L.2021, c.16 (C.24:6I-31 et al.), previously approved a clinical research study in this State involving medical cannabis; and has the ability and will conduct all research and development in the county in which the partner State college or university is located.

"Adverse employment action" means refusing to hire or employ an individual, barring or discharging an individual from employment, requiring an individual to retire from employment, or discriminating against an individual in compensation or in any terms, conditions, or privileges of employment.

"Cannabis" has the meaning given to "marihuana" in section 2 of the "New Jersey Controlled Dangerous Substances Act," P.L.1970, c.226 (C.24:21-2).

"Clinical registrant" means an entity that has a written contractual relationship with an academic medical center in the region in which it has its principal place of business, which includes provisions whereby the parties will engage in clinical research related to the use of medical cannabis and the academic medical center or its affiliate will provide advice to the entity regarding patient health and safety, medical applications, and dispensing and managing controlled dangerous substances, among other areas.

"Commission" means the Cannabis Regulatory Commission established pursuant to section 31 of P.L.2019, c.153 (C.24:6I-24).

"Commissioner" means the Commissioner of Health.

"Common ownership or control" means:

(1) between two for-profit entities, the same individuals or entities own and control more than 50 percent of both entities;

(2) between a nonprofit entity and a for-profit entity, a majority of the directors, trustees, or members of the governing body of the nonprofit entity directly or indirectly own and control more than 50 percent of the for-profit entity; and

(3) between two nonprofit entities, the same directors, trustees, or governing body members comprise a majority of the voting directors, trustees, or governing body members of both nonprofits.

"Department" means the Department of Health.

"Designated caregiver" means a resident of the State who:

(1) is at least 18 years old;

(2) has agreed to assist with a registered qualifying patient's medical use of cannabis, is not currently serving as a designated caregiver for more than one other qualifying patient, and is not the qualifying patient's health care practitioner;

(3) subject to the provisions of paragraph (2) of subsection c. of section 4 of P.L.2009, c.307 (C.24:6I-4), has never been convicted of possession or sale of a controlled dangerous substance, unless such conviction occurred after the effective date of P.L.2009, c.307 (C.24:6I-1 et al.) and was for a violation of federal law related to possession or sale of cannabis that is authorized under P.L.2009, c.307 (C.24:6I-1 et al.) or P.L.2015, c.158 (C.18A:40-12.22 et al.);

(4) has registered with the commission pursuant to section 4 of P.L.2009, c.307 (C.24:6I-4), and, except in the case of a designated caregiver who is an immediate family member of the patient, has satisfied the criminal history record background check requirement of section 4 of P.L.2009, c.307 (C.24:6I-4); and

(5) has been designated as a designated caregiver by the patient when registering or renewing a registration with the commission or in other written notification to the commission.

"Dispense" means the furnishing of medical cannabis to a registered qualifying patient, designated caregiver, or institutional caregiver by a medical cannabis dispensary or clinical registrant pursuant to written instructions issued by a health care practitioner pursuant to the requirements of P.L.2009, c.307 (C.24:6I-1 et al.). The term shall include the act of furnishing medical cannabis to a medical cannabis handler for delivery to a registered qualifying patient, designated caregiver, or institutional caregiver, consistent with the requirements of subsection i. of section 27 of P.L.2019, c.153 (C.24:6I-20).

"Health care facility" means a general acute care hospital, nursing home, long term care facility, hospice care facility, group home, facility that provides services to persons with developmental disabilities, behavioral health care facility, or rehabilitation center.

"Health care practitioner" means a physician, advanced practice nurse, or physician [assistant] associate licensed or certified pursuant to Title 45 of the Revised Statutes who:

(1) possesses active registrations to prescribe controlled dangerous substances issued by the United States Drug Enforcement Administration and the Division of Consumer Affairs in the Department of Law and Public Safety;

(2) is the health care practitioner responsible for the ongoing treatment of a patient's qualifying medical condition, the symptoms of that condition, or the symptoms associated with the treatment of that condition, provided, however, that the ongoing treatment shall not be limited to the provision of authorization for a patient to use medical cannabis or consultation solely for that purpose; and

(3) if the patient is a minor, is a pediatric specialist.

"Immediate family" means the spouse, domestic partner, civil union partner, child, sibling, or parent of an individual, and shall include the siblings, parents, and children of the individual's spouse, domestic partner, or civil union partner, and the parents, spouses, domestic partners, or civil union partners of the individual's parents, siblings, and children.

"Institutional caregiver" means a resident of the State who:

(1) is at least 18 years old;

(2) is an employee of a health care facility;

(3) is authorized, within the scope of the individual's professional duties, to possess and administer controlled dangerous substances in connection with the care and treatment of patients and residents pursuant to applicable State and federal laws;

(4) is authorized by the health care facility employing the person to assist registered qualifying patients who are patients or residents of the facility with the medical use of cannabis, including, but not limited to, obtaining medical cannabis for registered qualifying patients and assisting registered qualifying patients with the administration of medical cannabis;

(5) subject to the provisions of paragraph (2) of subsection c. of section 4 of P.L.2009, c.307 (C.24:6I-4), has never been convicted of possession or sale of a controlled dangerous substance, unless such conviction occurred after the effective date of P.L.2009, c.307 (C.24:6I-1 et al.) and was for a violation of federal law related to possession or sale of cannabis that is authorized under P.L.2009, c.307 (C.24:6I-1 et al.) or P.L.2015, c.158 (C.18A:40-12.22 et al.); and

(6) has registered with the commission pursuant to section 4 of P.L.2009, c.307 (C.24:6I-4).

"Integrated curriculum" means an academic, clinical, or research program at an institution of higher education that is coordinated with a medical cannabis cultivator, medical cannabis manufacturer, or medical cannabis dispensary to apply theoretical principles, practical experience, or both involving the cultivation, manufacturing, dispensing, delivery, or medical use of cannabis to a specific area of study, including, but not limited to, agriculture, biology, business, chemistry, culinary studies, ecology, environmental studies, health care, horticulture, technology, or any other appropriate area of study or combined areas of study. Integrated curricula shall be subject to approval by the commission and the Office of the Secretary of Higher Education.

"Integrated curriculum permit" or "IC permit" means a permit issued to a medical cannabis cultivator, medical cannabis manufacturer, or medical cannabis dispensary that includes an integrated curriculum approved by the commission and the Office of the Secretary of Higher Education.

"Medical cannabis alternative treatment center" or "alternative treatment center" means an organization issued a permit, including a conditional permit, by the commission to operate as a medical cannabis cultivator, medical cannabis manufacturer, medical cannabis dispensary, or clinical registrant. This term shall include the organization's officers, directors, board members, and employees.

"Medical cannabis cultivator" means an organization holding a permit issued by the commission that authorizes the organization to: possess and cultivate cannabis and deliver, transfer, transport, distribute, supply, and sell medical cannabis and related supplies to other medical cannabis cultivators and to medical cannabis manufacturers, clinical registrants, and medical cannabis dispensaries, as well as to plant, cultivate, grow, and harvest medical cannabis for research purposes. A medical cannabis cultivator permit shall not authorize the permit holder to manufacture, produce, or otherwise create medical cannabis products, or to deliver, transfer, transport, distribute, supply, sell, or dispense medical cannabis, medical cannabis products, paraphernalia, or related supplies to qualifying patients, designated caregivers, or institutional caregivers.

"Medical cannabis dispensary" means an organization issued a permit by the commission that authorizes the organization to: purchase or obtain medical cannabis and related supplies from medical cannabis cultivators; purchase or obtain medical cannabis products and related supplies from medical cannabis manufacturers; purchase or obtain medical cannabis, medical cannabis products, and related supplies and paraphernalia from other medical cannabis dispensaries and from clinical registrants; deliver, transfer, transport, distribute, supply, and sell medical cannabis and medical cannabis products to other medical cannabis dispensaries; furnish medical cannabis, including medical cannabis products, to a medical cannabis handler for delivery to a registered qualifying patient, designated caregiver, or institutional caregiver consistent with the requirements of subsection i. of section 27 of P.L.2019, c.153 (C.24:6I-20); and possess, display, deliver, transfer, transport, distribute, supply, sell, and dispense medical cannabis, medical cannabis products, paraphernalia, and related supplies to qualifying patients, designated caregivers, and institutional caregivers. A medical cannabis dispensary permit shall not authorize the permit holder to cultivate medical cannabis, to produce, manufacture, or otherwise create medical cannabis products.

"Medical cannabis manufacturer" means an organization issued a permit by the commission that authorizes the organization to: purchase or obtain medical cannabis and related supplies from a medical cannabis cultivator or a clinical registrant; purchase or obtain medical cannabis products from another medical cannabis manufacturer or a clinical registrant; produce, manufacture, or otherwise create medical cannabis products; and possess, deliver, transfer, transport, distribute, supply, and sell medical cannabis products and related supplies to other medical cannabis manufacturers and to medical cannabis dispensaries and clinical registrants. A medical cannabis manufacturer permit shall not authorize the permit holder to cultivate medical cannabis or to deliver, transfer, transport, distribute, supply, sell, or dispense medical cannabis, medical cannabis products, paraphernalia, or related supplies to registered qualifying patients, designated caregivers, or institutional caregivers.

"Medical use of cannabis" means the acquisition, possession, transport, or use of cannabis or paraphernalia by a registered qualifying patient as authorized by P.L.2009, c.307 (C.24:6I-1 et al.) and P.L.2015, c.158 (C.18A:40-12.22 et al.).

"Minor" means a person who is under 18 years of age and who has not been married or previously declared by a court or an administrative agency to be emancipated.

"Paraphernalia" has the meaning given in N.J.S.2C:36-1.

"Pediatric specialist" means a physician who is a board-certified pediatrician or pediatric specialist, or an advanced practice nurse or physician [assistant] associate who is certified as a pediatric specialist by an appropriate professional certification or licensing entity.

"Primary care" means the practice of family medicine, general internal medicine, general pediatrics, general obstetrics, or gynecology.

"Qualifying medical condition" means seizure disorder, including epilepsy; intractable skeletal muscular spasticity; post-traumatic stress disorder; glaucoma; positive status for human immunodeficiency virus; acquired immune deficiency syndrome; cancer; amyotrophic lateral sclerosis; multiple sclerosis; muscular dystrophy; inflammatory bowel disease, including Crohn's disease; terminal illness, if the patient has a prognosis of less than 12 months of life; anxiety; migraine; Tourette's syndrome; dysmenorrhea; chronic pain; opioid use disorder; or any other medical condition or its treatment that is approved by the commission.

"Qualifying patient" or "patient" means a resident of the State who has been authorized for the medical use of cannabis by a health care practitioner.

"Registration with the commission" means a person has met the qualification requirements for, and has been registered by the commission as, a registered qualifying patient, designated caregiver, or institutional caregiver. The commission shall establish appropriate means for health care practitioners, health care facilities, medical cannabis dispensaries, law enforcement, schools, facilities providing behavioral health services or services for persons with developmental disabilities, and other appropriate entities to verify an individual's status as a registrant with the commission.

"Significantly involved person" means a person or entity who holds at least a five percent investment interest in an entity issued, or applying for a permit to operate as, a medical cannabis cultivator, medical cannabis manufacturer, medical cannabis dispensary, or clinical registrant, or who is a decision making member of a group that holds at least a 20 percent investment interest in an entity issued, or applying for a permit to operate as, a medical cannabis cultivator, medical cannabis manufacturer, medical cannabis dispensary, or clinical registrant, in which no member of that group holds more than a five percent interest in the total group investment interest, and the person or entity makes controlling decisions regarding the operations of the entity issued, or applying for a permit to operate as, a medical cannabis cultivator, medical cannabis manufacturer, medical cannabis dispensary, or clinical registrant.

"Terminally ill" means having an illness or condition with a prognosis of less than 12 months of life.

"Usable cannabis" means the dried leaves and flowers of cannabis, and any mixture or preparation thereof, and does not include the seeds, stems, stalks, or roots of the plant.

(cf: P.L.2021, c.16, s.4)

11. Section 3 of P.L.2013, c.46 (C.24:6J-3) is amended as follows:

3. As used in [this act] P.L.2013, c.46 (C.24:6J-1 et al.):

"Commissioner" means the Commissioner of Human Services.

"Drug overdose" means an acute condition including, but not limited to, physical illness, coma, mania, hysteria, diminished consciousness, respiratory depression, or death resulting from the consumption or use of a controlled dangerous substance or another substance with which a controlled dangerous substance was combined and that a layperson would reasonably believe to require medical assistance.

"Emergency medical response entity" means an organization, company, governmental entity, community-based program, or healthcare system that provides pre-hospital emergency medical services and assistance. "Emergency medical response entity" includes, but is not limited to, a first aid, rescue and ambulance squad or other basic life support (BLS) ambulance provider; a mobile intensive care provider or other advanced life support (ALS) ambulance provider; an air medical service provider; or a fire-fighting company or organization, which squad, provider, company, or organization is qualified to send paid or volunteer emergency medical responders to the scene of an emergency.

"Emergency medical responder" means a person, other than a health care practitioner, who is employed on a paid or volunteer basis in the area of emergency response, including, but not limited to, an emergency medical technician, a mobile intensive care paramedic, or a fire fighter, acting in that person's professional capacity.

"Health care practitioner" means any individual who is licensed or certified to provide health care services pursuant to Title 45 of the Revised Statutes.

"Institution of higher education" means any public or private university, college, technical college or community college located in New Jersey.

"Law enforcement agency" means a department, division, bureau, commission, board or other authority of the State or of any political subdivision thereof which employs law enforcement officers.

"Law enforcement officer" means a person whose public duties include the power to act as an officer for the detection, apprehension, arrest and conviction of offenders against the laws of this State.

"Medical assistance" means professional medical services that are provided to a person experiencing a drug overdose by a health care practitioner, acting within the practitioner's scope of professional practice, including professional medical services that are mobilized through telephone contact with the 911 telephone emergency service.

"Occupational school" means a business, trade, technical, or other school approved by a nationally-recognized accrediting agency.

"Opioid antidote" means any drug, regardless of dosage amount or method of administration, which has been approved by the United States Food and Drug Administration (FDA) for the treatment of an opioid overdose. "Opioid antidote" includes, but is not limited to, naloxone hydrochloride, in any dosage amount, which is administered through nasal spray or any other FDA-approved means or methods.

"Prescriber" means a health care practitioner authorized by law to prescribe medications. "Prescriber" includes, but shall not be limited to, physicians, physician [assistants] associates, and advanced practice nurses.

"Public library" means a library that serves, free of charge, all residents of an area without discrimination and that receives its financial support, in whole or in part, from public funds.

"Public transportation hub" means a passenger station, terminal, or other facility, as designated by the Commissioner of Transportation, where public transportation services are made available.

"Recipient" means any individual who or entity that is prescribed or dispensed an opioid antidote in accordance with section 4 of P.L.2013, c.46 (C.24:6J-4) or section 1 of P.L.2017, c.88 (C.45:14-67.2). The term "recipient" shall include, but shall not be limited to, private citizens, emergency medical responders, emergency medical response entities, law enforcement officers, law enforcement agencies, recognized places of public access, employees and volunteers providing services at, through, or on behalf of a recognized place of public access, public and nonpublic schools, school nurses and other staff at a public or nonpublic school, sterile syringe access programs, and staff and employees of a sterile syringe access program. The term "recipient" shall not include a prescriber or a licensed pharmacist acting within a professional capacity.

"Recognized place of public access" means a public library, institution of higher education, occupational school, or public transportation hub.

"Sterile syringe access program" means a program established pursuant to the provisions of P.L.2006, c.99 (C.26:5C-25 et al.).

(cf: P.L.2021, c.152, s.2)

12. Section 5 of P.L.2013, c.46 (C.24:6J-5) is amended to read as follows:

5. a. (1) A prescriber or other health care practitioner who prescribes or dispenses an opioid antidote in accordance with subsection a. of section 4 of P.L.2013, c.46 (C.24:6J-4), and a pharmacist who dispenses an opioid antidote pursuant to subsection a. of section 4 of P.L.2013, c.46 (C.24:6J-4) or section 1 of P.L.2017, c.88 (C.45:14-67.2), shall ensure that overdose prevention information is provided to the recipient. The overdose prevention information shall include, but need not be limited to: information on opioid overdose prevention and recognition; instructions on how to perform rescue breathing and resuscitation; information on opioid antidote dosage and instructions on opioid antidote administration; information describing the importance of calling the 911 emergency telephone service for assistance with an opioid overdose; and instructions for appropriate care of a person believed to be experiencing an opioid overdose after administration of the opioid antidote.

(2) (Deleted by amendment, P.L.2021, c.152).

b. (1) (Deleted by amendment, P.L.2021, c.152).

(2) The dissemination of overdose prevention information shall be documented by the prescribing or dispensing health care practitioner or dispensing pharmacist in the patient's medical record or another appropriate record, log or other similar recordkeeping location.

c. In order to facilitate the dissemination of overdose prevention information in accordance with this section, the Commissioner of Human Services, in consultation with the Department of Health and Statewide organizations representing physicians, advanced practice nurses, or physician [assistants] associates, and organizations operating community-based programs, sterile syringe access programs, or other programs which address medical or social issues related to substance use disorders, may develop training materials in video, electronic, or other appropriate formats, and disseminate these materials to health care practitioners. The Commissioner of Human Services may make the materials available to the general public through the Internet website of the Department of Human Services, with such modifications as may be appropriate to adapt the materials for use by persons who are not health care practitioners. The commissioner shall ensure the materials are available in English, Spanish, and any other language that the commissioner determines is the first language of a significant number of people who are likely to be prescribed or dispensed an opioid antidote in accordance with subsection a. of section 4 of P.L.2013, c.46 (C.24:6J-4) or dispensed an opioid antidote pursuant to section 1 of P.L.2017, c.88 (C.45:14-67.2).

(cf: P.L.2021, c.152, s.4)

13. Section 3 of P.L.2015, c.215 (C.24:6L-3) is amended to read as follows:

3. As used in [this act] P.L.2015, c.215 (C.24:6L-1 et seq.):

"Commissioner" means the Commissioner of Health.

"Health care professional" means a licensed physician, physician [assistant] associate, advanced practice nurse, pharmacist, or other health care professional whose professional practice is regulated pursuant to Title 45 of the Revised Statutes and whose authorized scope of practice includes prescribing, dispensing, or administering medication, whether independently or through a joint protocol or standing order from a physician.

(cf: P.L.2015, c.215, s.3)

14. Section 2 of P.L.2017, c.254 (C.24:6M-2) is amended to read as follows:

2. As used in sections 1 through 7 of [this act] P.L.2017, c.254 (C.24:6M-1 et seq.):

"Administration supplies" means any supply associated with the administration of prescription drugs, including, but not limited to, diabetes test strips, nebulizers, syringes, and needles.

"Anti-rejection drug" means an over-the-counter drug or prescription drug that suppresses the immune system to prevent or reverse the rejection of a transplanted organ.

"Board" means the State Board of Pharmacy.

"Cancer drug" means a prescription drug that is used to treat cancer or the side effects of cancer, or that is used to treat the side effects of any other prescription drug that is used to treat cancer or the side effects of cancer.

"Commissioner" means the Commissioner of Health.

"Compounded drug" means a sterile or nonsterile compounded formulation for dispensing or administration pursuant to a prescription, that is prepared for a patient with needs that cannot be met by a commercially available prescription drug.

"Controlled dangerous substance" means the same as that term is defined by N.J.S.2C:35-2.

"Correctional facility" means a county or state correctional facility, county juvenile detention facility, secure juvenile facility, federal prison, or other comparable facility.

"Donated drug" means an over-the-counter drug or prescription drug that has been donated to a redistributor in accordance with the provisions of [this act] P.L.2017, c.254 (C.24:6M-1 et seq.).

"Donor" means a drug manufacturer, wholesaler, repackager, returns processor, third-party logistics provider, health care facility, correctional facility, pharmacy, or any other person or entity that is properly licensed and authorized to possess prescription drugs, and which elects to donate over-the-counter drugs, prescription drugs, or administration supplies pursuant to [this act] P.L.2017, c.254 (C.24:6M-1 et seq.).

"Drug donation program" means a program, established pursuant to the provisions of [this act] P.L.2017, c.254 (C.24:6M-1 et seq.), which accepts the donation of unused over-the-counter drugs, prescription drugs, and administration supplies that would otherwise be destroyed, and which provides for the redistribution of those unused drugs and administration supplies to persons who are most in need.

"Grooming and hygiene product" is soap or cleaning solution, shampoo, toothpaste, mouthwash, anti-perspirant, or sun tan lotion or screen, regardless of whether the item meets the definition of "over-the-counter drug."

"Health care facility" means a physician's office; a hospital; an outpatient clinic; a federally qualified health center; a federally qualified health center look-alike; a rural health clinic; a clinic that provides services under the federal Ryan White HIV/AIDS Program; a mental health center or clinic; a Veterans Affairs hospital; and any other health care facility licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.), or a comparable facility licensed to operate within another state.

"Indigent" means a person who has an income that is below 250 percent of the federal poverty level.

"Out-of-State redistributor" means a health care facility, pharmacy, wholesaler, returns processor, or other person or entity that is properly licensed to operate in a state other than New Jersey, and is authorized to dispense over-the-counter drugs and prescription drugs, and which agrees to accept, repackage, transfer to other redistributors, and, if otherwise authorized by law, dispense donated drugs and administration supplies to eligible individuals pursuant to a prescription drug donation program established under the laws of the state in which the person or entity is located.

"Over-the-counter-drug" means a drug that contains a label that meets the requirements of 21 CFR 201.66, including (1) a "Drug Facts" panel; or (2) a statement of the "active ingredient" or "active ingredients" with a list of those ingredients contained in the compound, substance, or preparation. "Over-the-counter drug" does not include a grooming and hygiene product.

"Prescriber" means a licensed physician, physician [assistant] associate, or advanced practice nurse, or any other person who is authorized by the appropriate State professional and occupational licensing board to prescribe drugs and devices as provided by law.

"Prescription drug" means any drug, intended for use in humans, which is required by federal or State law or regulation to be dispensed only pursuant to a prescription. "Prescription drug" includes cancer drugs and anti-rejection drugs, but does not include any controlled dangerous substance or compounded drug.

"Redistributor" means a health care facility, pharmacy, wholesaler, returns processor, or any other person or entity that is properly licensed and authorized to dispense over-the-counter drugs and prescription drugs, and which agrees to accept, repackage, transfer to other redistributors, and, if otherwise authorized by law, dispense donated drugs and administration supplies to eligible individuals pursuant to [this act] P.L.2017, c.254 (C.24:6M-1 et seq.). "Redistributor" includes an out-of-State redistributor.

"Returns processor" shall mean the same as that term is defined by 21 U.S.C. s.360eee (18). "Returns processor" includes a reverse distributor.

"Tamper-evident packaging" means a package or container that has an immediate, outer, or secondary seal that must be broken in order to gain access to the container's contents. "Tamper-evident packaging" includes partially used single-unit dose or blister pack and bottles or vials sealed in pouches or with tamper-evident tape.

"Third-party intermediary" means an organization that is not a wholesaler or third-party logistics provider, and that facilitates the donation or transfer of over-the-counter drugs, prescription drugs, and administration supplies for a drug donation program established pursuant to [this act] P.L.2017, c.254 (C.24:6M-1 et seq.), but which does not take possession or ownership of the drugs.

"Transaction date" means the date at which ownership of the drug was donated or transferred between two participants of the program as established by contract or other arrangement. If no such contract or arrangement exists, the transaction date shall be the date the drug was accepted into inventory by the redistributor.

(cf: P.L.2017, c.254, s.2)

15. Section 11 of P.L.2017, c.28 (C.24:21-15.2) is amended to read as follows:

11. a. A practitioner shall not issue an initial prescription for an opioid drug which is a prescription drug as defined in section 2 of P.L.2003, c.280 (C.45:14-41) in a quantity exceeding a five-day supply for treatment of acute pain. Any prescription for acute pain pursuant to this subsection shall be for the lowest effective dose of immediate-release opioid drug.

b. Prior to issuing an initial prescription of a Schedule II controlled dangerous substance or any opioid drug which is a prescription drug as defined in section 2 of P.L.2003, c.280 (C.45:14-41) in a course of treatment for acute or chronic pain, a practitioner shall:

(1) take and document the results of a thorough medical history, including the patient's experience with non-opioid medication and non-pharmacological pain management approaches and substance use disorder history;

(2) conduct, as appropriate, and document the results of a physical examination;

(3) develop a treatment plan, with particular attention focused on determining the cause of the patient's pain;

(4) access relevant prescription monitoring information under the Prescription Monitoring Program pursuant to section 8 of P.L.2015, c.74 (C. 45:1-46.1); and

(5) limit the supply of any opioid drug prescribed for acute pain to a duration of no more than five days as determined by the directed dosage and frequency of dosage.

c. No less than four days after issuing the initial prescription pursuant to subsection a. of this subsection, the practitioner, after consultation with the patient, may issue a subsequent prescription for the drug to the patient in any quantity that complies with applicable State and federal laws, provided that:

(1) the subsequent prescription would not be deemed an initial prescription under this section;

(2) the practitioner determines the prescription is necessary and appropriate to the patient's treatment needs and documents the rationale for the issuance of the subsequent prescription; and

(3) the practitioner determines that issuance of the subsequent prescription does not present an undue risk of abuse, addiction, or diversion and documents that determination.

d. Prior to issuing the initial prescription of a Schedule II controlled dangerous substance or any opioid drug which is a prescription drug as defined in section 2 of P.L.2003, c.280 (C.45:14-41) in a course of treatment for acute pain and prior to issuing a prescription at the outset of a course of treatment for chronic pain, a practitioner shall discuss with the patient, or the patient's parent or guardian if the patient is under 18 years of age and is not an emancipated minor, the risks associated with the drugs being prescribed, including but not limited to:

(1) the risks of addiction and overdose associated with opioid drugs and the dangers of taking opioid drugs with alcohol, benzodiazepines and other central nervous system depressants;

(2) the reasons why the prescription is necessary;

(3) alternative treatments that may be available; and

(4) risks associated with the use of the drugs being prescribed, specifically that opioids are highly addictive, even when taken as prescribed, that there is a risk of developing a physical or psychological dependence on the controlled dangerous substance, and that the risks of taking more opioids than prescribed, or mixing sedatives, benzodiazepines or alcohol with opioids, can result in fatal respiratory depression.

The practitioner shall include a note in the patient's medical record that the patient or the patient's parent or guardian, as applicable, has discussed with the practitioner the risks of developing a physical or psychological dependence on the controlled dangerous substance and alternative treatments that may be available. The Division of Consumer Affairs shall develop and make available to practitioners guidelines for the discussion required pursuant to this subsection.

e. Prior to the commencement of an ongoing course of treatment for chronic pain with a Schedule II controlled dangerous substance or any opioid, the practitioner shall enter into a pain management agreement with the patient.

f. When a Schedule II controlled dangerous substance or any prescription opioid drug is continuously prescribed for three months or more for chronic pain, the practitioner shall:

(1) review, at a minimum of every three months, the course of treatment, any new information about the etiology of the pain, and the patient's progress toward treatment objectives and document the results of that review;

(2) assess the patient prior to every renewal to determine whether the patient is experiencing problems associated with physical and psychological dependence and document the results of that assessment;

(3) periodically make reasonable efforts, unless clinically contraindicated, to either stop the use of the controlled substance, decrease the dosage, try other drugs or treatment modalities in an effort to reduce the potential for abuse or the development of physical or psychological dependence and document with specificity the efforts undertaken;

(4) review the Prescription Drug Monitoring information in accordance with section 8 of P.L.2015, c.74 (C.45:1-46.1); and

(5) monitor compliance with the pain management agreement and any recommendations that the patient seek a referral.

g. As used in this section:

"Acute pain" means pain, whether resulting from disease, accidental or intentional trauma, or other cause, that the practitioner reasonably expects to last only a short period of time. "Acute pain" does not include chronic pain, pain being treated as part of cancer care, hospice or other end of life care, or pain being treated as part of palliative care.

"Chronic pain" means pain that persists or recurs for more than three months.

"Initial prescription" means a prescription issued to a patient who:

(1) has never previously been issued a prescription for the drug or its pharmaceutical equivalent; or

(2) was previously issued a prescription for, or used or was administered the drug or its pharmaceutical equivalent, but the date on which the current prescription is being issued is more than one year after the date the patient last used or was administered the drug or its equivalent.

When determining whether a patient was previously issued a prescription for, or used or was administered a drug or its pharmaceutical equivalent, the practitioner shall consult with the patient and review the patient's medical record and prescription monitoring information.

"Pain management agreement" means a written contract or agreement that is executed between a practitioner and a patient, prior to the commencement of treatment for chronic pain using a Schedule II controlled dangerous substance or any opioid drug which is a prescription drug as defined in section 2 of P.L.2003, c.280 (C.45:14-41), as a means to:

(1) prevent the possible development of physical or psychological dependence in the patient;

(2) document the understanding of both the practitioner and the patient regarding the patient's pain management plan;

(3) establish the patient's rights in association with treatment, and the patient's obligations in relation to the responsible use, discontinuation of use, and storage of Schedule II controlled dangerous substances, including any restrictions on the refill of prescriptions or the acceptance of Schedule II prescriptions from practitioners;

(4) identify the specific medications and other modes of treatment, including physical therapy or exercise, relaxation, or psychological counseling, that are included as a part of the pain management plan;

(5) specify the measures the practitioner may employ to monitor the patient's compliance, including but not limited to random specimen screens and pill counts; and

(6) delineate the process for terminating the agreement, including the consequences if the practitioner has reason to believe that the patient is not complying with the terms of the agreement.

"Practitioner" means a medical doctor, doctor of osteopathy, dentist, optometrist, podiatrist, physician [assistant] associate, certified nurse midwife, or advanced practice nurse, acting within the scope of practice of their professional license pursuant to Title 45 of the Revised Statutes.

h. This section shall not apply to a prescription for a patient who is currently in active treatment for cancer, receiving hospice care from a licensed hospice or palliative care, or is a resident of a long term care facility, or to any medications that are being prescribed for use in the treatment of substance use disorder.

i. Every policy, contract or plan delivered, issued, executed or renewed in this State, or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, and every contract purchased by the School Employees' Health Benefits Commission or State Health Benefits Commission, on or after the effective date of [this act] P.L.2017, c.28 (C.17:48-6nn et al.), that provides coverage for prescription drugs subject to a co-payment, coinsurance or deductible shall charge a co-payment, coinsurance or deductible for an initial prescription of an opioid drug prescribed pursuant to this section that is either:

(1) proportional between the cost sharing for a 30-day supply and the amount of drugs the patient was prescribed; or

(2) equivalent to the cost sharing for a full 30-day supply of the opioid drug, provided that no additional cost sharing may be charged for any additional prescriptions for the remainder of the 30-day supply.

j. (1) Subject to paragraph (2) of this subsection, if a health care practitioner issues a prescription for an opioid drug which is a controlled dangerous substance to a patient, the prescriber shall additionally issue the patient a prescription for an opioid antidote if any of the following conditions is present:

(a) the patient has a history of substance use disorder;

(b) the prescription for the opioid drug is for a daily dose of more than 90 morphine milligram equivalents; or

(c) the patient holds a current, valid prescription for a benzodiazepine drug that is a Schedule III or Schedule IV controlled dangerous substance.

(2) A practitioner shall not be required to issue more than one prescription for an opioid antidote to a patient under paragraph (1) of this subsection per year.

(3) Nothing in paragraph (2) of this subsection shall be construed to prohibit a practitioner from issuing additional prescriptions for an opioid antidote to a patient upon the patient's request or when the practitioner determines there is a clinical or practical need for the additional prescription.

(cf: P.L.2023, c.177, s.57)

16. Section 2 of P.L.2015, c.37 (C.26:2-192) is amended to read as follows:

2. a. A physician, advanced practice nurse, or physician [assistant] associate who performs annual physical examinations of children 19 years of age or younger shall complete the Student-Athlete Cardiac Screening professional development module developed pursuant to subsection a. of section 3 of P.L.2013, c.71 (C.18A:40-41d).

b. Upon the first renewal of a certification, biennial registration, or renewal of a license by a physician, advanced practice nurse, or physician [assistant] associate after completing the Student-Athlete Cardiac Screening professional development module as required pursuant to subsection a. of this section, a physician, advanced practice nurse, or physician [assistant] associate who performs annual physical examinations of children 19 years of age or younger shall attest to the completion of the module to the Board of Medical Examiners or the Board of Nursing, as appropriate. An application for renewal of a certification, biennial registration, or renewal of a license shall include a check box for attestation regarding compliance with subsection a. of this section for a physician, advanced practice nurse, or physician [assistant] associate who performs annual physical examinations of children 19 years of age or younger.

c. A physician, advanced practice nurse, or physician [assistant] associate who completes the Student-Athlete Cardiac Screening professional development module as required pursuant to subsection a. of this section shall retain on file at that person's professional office a hard copy of the certificate of completion of the module. The hard copy of the certificate of completion of the module shall be made available upon request.

(cf: P.L.2015, c.37, s.2)

17. Section 1 of P.L.2019, c.227 (C.26:2H-5o) is amended to read as follows:

1. As used in [this act] P.L.2019, c.227 (C.26:2H-5o et seq.):

"Appropriate" means consistent with applicable legal, health, and professional standards, the patient's clinical and other circumstances, and the patient's reasonably known wishes and beliefs.

"Hospice care" means a coordinated program of home, outpatient, and inpatient care and services that is operated by a public agency or private organization, or subdivision of either of these entities, and that provides care and services to hospice patients and to hospice patients' families, through a medically directed interdisciplinary team, under interdisciplinary plans of care in order to meet the physical, psychological, social, spiritual, and other special needs that are experienced during the final stages of illness, dying, and bereavement. A hospice care program includes: nursing care by or under the supervision of a registered professional nurse; physical, occupational, or speech or language therapy; medical social services by a certified or licensed social worker under the direction of a physician; services of a certified home health aide; medical supplies, including drugs and biologicals, and the use of medical appliances related to terminal diagnosis; physician's services; short-term inpatient care, including both palliative and respite care and procedures; spiritual and other counseling for hospice patients and hospice patients' families; services of volunteers under the direction of the provider of the hospice care program; and bereavement services for hospice patients' families.

"Medical care" means services provided, requested, or supervised by a physician, physician [assistant] associate, or advanced practice nurse.

"Palliative care" means patient-centered and family-centered medical care that optimizes quality of life by anticipating, preventing, and treating suffering caused by serious illness. Palliative care throughout the continuum of illness involves addressing physical, emotional, social, and spiritual needs and facilitating patient autonomy, access to information, and choice. Palliative care includes, but is not limited to: comprehensive pain and symptom management and discussion of treatment options appropriate to the patient, including hospice care, when appropriate.

"Serious illness" means any medical illness or physical injury or condition that substantially impacts quality of life for more than a short period of time. Serious illness includes, but is not limited to: cancer; heart, renal, or liver failure; lung disease; and Alzheimer's disease and related dementias.

(cf: P.L.2019, c.227, s.1)

18. Section 4 of P.L.2019, c.227 (C.26:2H-5r) is amended to read as follows:

4. a. There is established in the Department of Health the Palliative Care and Hospice Care Advisory Council.

b. It shall be the duty of the council, in collaboration with the Cancer Institute of New Jersey, to implement the provisions of P.L.2019, c.227 (C.26:2H-5o et seq.), including establishing the Palliative Care and Hospice Care Consumer and Professional Information and Education Program pursuant to section 2 of P.L.2019, c.227 (C.26:2H-5p), developing and facilitating the provision of information about palliative care and hospice care for the purposes of section 3 of P.L.2019, c.227 (C.26:2H-5q), and developing resources and programs to facilitate access to palliative care and hospice care services for patients and residents.

c. (1) The council shall be comprised of eleven members, to be appointed as follows: one member of the Senate appointed by the Senate President; one member of the General Assembly appointed by the Speaker of the General Assembly; three public members appointed by the Senate President; three public members appointed by the Speaker of the General Assembly; and three public members appointed by the Governor.

(2) In selecting the public members, the Senate President, the Speaker of the General Assembly, and the Governor shall seek to include persons who have experience, training, or academic background in issues related to the provision of palliative care or hospice care, with an emphasis on addressing physical, emotional, social, and spiritual needs and facilitating patient autonomy, access to information, and choice. Seven of the nine public members shall be comprised as follows: one physician, one advanced practice nurse or physician [assistant] associate, one nurse, one social worker, one chaplain, one pediatric oncologist, and one hospice administrator. The public members shall be board certified or have a hospice and palliative care certification, as appropriate to their discipline. Selections of public members may be made in consultation with: the State Board of Medical Examiners, the New Jersey Board of Nursing, the Physician [Assistant] Associate Advisory Committee, the Board of Pharmacy, the New Jersey Hospital Association, the Health Care Association of New Jersey, the Medical Society of New Jersey, the New Jersey Association of Osteopathic Physicians and Surgeons, the New Jersey State Nurses Association, the Home Care and Hospice Association of New Jersey, LeadingAge New Jersey, the New Jersey State Society of Physician Assistants, and the New Jersey Hospice and Palliative Care Organization, or any successor organization thereof.

d. All appointments shall be made within 30 days after the effective date of P.L.2019, c.227 (C.26:2H-5o et seq.).

e. The public members shall serve for a term of five years; but, of the members first appointed, three shall serve for a term of three years, three for a term of four years, and three for a term of five years. Members are eligible for reappointment upon the expiration of their terms. Vacancies in the membership shall be filled in the same manner as the original appointments.

f. The council shall organize as soon as is practicable upon the appointment of a majority of its members, and shall select a chairperson from among the members.

g. The members of the council shall serve without compensation but may be reimbursed, within the limits of funds made available to the council, for necessary travel expenses incurred in the performance of their duties.

h. The council shall be entitled to call to its assistance and avail itself of the services of the employees of any State, county, or municipal department, board, bureau, commission, or agency as it may require and as may be available for its purposes.

i. The Department of Health shall provide staff support to the council.

(cf: P.L.2019, 227, s.4)

19. Section 1 of P.L.2019, c.392 (C.26:2H-5.34) is amended to read as follows:

1. a. A hospital licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) shall require a health care professional or appropriate staff member to include a notation in a patient's medical record indicating that the patient has an increased risk of confusion, agitation, behavioral problems, and wandering due to a dementia related disorder, if such notation is requested by the patient's caregiver. The notation may be included in the patient's medical record at the time the patient is admitted to the hospital or to the hospital emergency department or when the patient is examined by a health care professional, and shall be prominently displayed in the medical record. A notation made pursuant to this section shall also be included by the hospital on the patient's universal transfer form, and, where practicable, shall be additionally communicated electronically to any licensed health care facility to which the patient may be admitted upon discharge by the hospital.

b. As used in this section:

"Caregiver" means a relative, spouse, partner, friend, or neighbor who has a significant relationship to the patient;

"Dementia" means a chronic or persistent disorder of the mental processes due to organic brain disease, for which no curative treatment is available, and marked by memory disorders, changes in personality, deterioration in personal care, impaired reasoning ability, and disorientation; and

"Health care professional" means a physician, physician [assistant] associate, or advanced practice nurse, who is acting within the scope of the professional's practice and is licensed or whose professional practice is otherwise regulated pursuant to Title 45 of the Revised Statutes

(cf: P.L.2019, c.392, s.1)

20. Section 1 of P.L.2011, c.58 (C.26:2H-128) is amended to read as follows:

1. a. Each assisted living facility and comprehensive personal care home provider licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) shall distribute to each resident and post in a conspicuous, public place in the facility or home, as applicable, a statement of resident rights. The statement of rights shall include, at a minimum, the rights set forth in subsection b. of this section. Each resident, resident family member, and legally appointed guardian, as applicable, shall be informed of the resident rights, and provided with explanations if needed. The provider shall ensure that each resident, or the resident's legally appointed guardian, as applicable, signs a copy of the statement of rights.

b. Every resident of an assisted living facility or comprehensive personal care home that is licensed in the State shall have the right to:

(1) receive personalized services and care in accordance with the resident's individualized general service or health service plan;

(2) receive a level of care and services that address the resident's changing physical and psychosocial status;

(3) have the resident's independence and individuality;

(4) be treated with respect, courtesy, consideration, and dignity;

(5) make choices with respect to services and lifestyle;

(6) privacy;

(7) have or not to have families' and friends' participation in resident service planning and implementation;

(8) receive pain management as needed, in accordance with Department of Health regulations;

(9) choose a physician, advanced practice nurse, or physician [assistant] associate;

(10) appeal an involuntary discharge as specified in department regulations;

(11) receive written documentation that fee increases based on a higher level of care are based on reassessment of the resident and in accordance with department regulations;

(12) receive a written explanation of fee increases that are not related to increased services, upon request by the resident;

(13) participate, to the fullest extent that the resident is able, in planning the resident's own medical treatment and care;

(14) refuse medication and treatment after the resident has been informed, in language that the resident understands, of the possible consequences of this decision;

(15) refuse to participate in experimental research, including the investigations of new drugs and medical devices, and to be included in experimental research only when the resident gives informed, written consent to such participation;

(16) be free from physical and mental abuse and neglect;

(17) be free from chemical and physical restraints, unless a physician, advanced practice nurse, or physician [assistant] associate authorizes the use for a limited period of time to protect the resident or others from injury. Under no circumstances shall a resident be confined in a locked room, or restrained, including with the use of excessive drugs, for punishment or for the convenience of staff;

(18) manage the resident's own finances, and to delegate that responsibility to a family member, assigned guardian, facility administrator, or some other individual with power of attorney. The resident's authorization delegating such authority shall be witnessed and in writing;

(19) receive prior to or at the time of admission, and afterwards through addenda, an admission agreement that complies with all applicable State and federal laws, describes the services provided and the related charges, and includes the policies for payment of fees, deposits, and refunds;

(20) receive a quarterly written account of the resident's funds, the itemized property deposited with the facility for the resident's use and safekeeping, and all financial transactions with the resident, next-of-kin, or guardian, which account shall show the amount of property in the account at the beginning and end of the accounting period, as well as a list of all deposits and withdrawals, substantiated by receipts given to the resident or the resident's guardian;

(21) have daily access during specified hours to the money and property that the resident has deposited with the facility, and to delegate, in writing, this right of access to a representative;

(22) live in safe and clean conditions that do not admit more residents than can safely be accommodated;

(23) not be arbitrarily and capriciously moved to a different bed or room;

(24) wear the resident's own clothes;

(25) keep and use the resident's personal property, unless doing so would be unsafe, impractical, or an infringement on the rights of other residents;

(26) reasonable opportunities for private and intimate physical and social interaction with other people, including the opportunity to share a room with another individual unless it is medically inadvisable;

(27) confidential treatment with regard to information about the resident, subject to the requirements of law;

(28) receive and send mail in unopened envelopes, unless the resident requests otherwise, and the right to request and receive assistance in reading and writing correspondence unless medically contraindicated;

(29) have a private telephone in the resident's living quarters at the resident's own expense;

(30) meet with any visitors of the resident's choice, at any time, in accordance with facility policies and procedures;

(31) take part in activities, and to meet with and participate in the activities of any social, religious, and community groups, as long as these activities do not disrupt the lives of other residents;

(32) refuse to perform services for the facility;

(33) request visits at any time by representatives of the religion of the resident's choice and, upon the resident's request, to attend outside religious services at the resident's own expense;

(34) participate in meals, recreation, and social activities without being subjected to discrimination based on age, race, religion, sex, marital status, nationality, or disability;

(35) organize and participate in a resident council that presents residents' concerns to the administrator of the facility;

(36) be transferred or discharged only in accordance with the terms of the admission agreement and with N.J.A.C. 8:36-5.1(d);

(37) receive written notice at least 30 days in advance when the facility requests the resident's transfer or discharge, except in an emergency, which notice shall include the name and contact information for the New Jersey Office of the Ombudsman for the Institutionalized Elderly;

(38) receive a written statement of resident rights and any regulations established by the facility involving resident rights and responsibilities;

(39) retain and exercise all constitutional, civil, and legal rights to which the resident is entitled by law;

(40) voice complaints without fear of interference, discharge, reprisal, and obtain contact information respecting government agencies to which residents can complain and ask questions, which information also shall be posted in a conspicuous place in the facility;

(41) hire a private caregiver or companion at the resident's expense and responsibility, as long as the caregiver or companion complies with the facility's policies and procedures; and

(42) obtain medications from a pharmacy of the resident's choosing, as long as the pharmacy complies with the facility's medication administration system, if applicable.

(cf: P.L.2012, c.17, s.254)

21. Section 2 of P.L.2011, c.145 (C.26:2H-130) is amended to read as follows:

2. The Legislature finds and declares that:

a. Pursuant to the "New Jersey Advance Directives for Health Care Act," P.L.1991, c.201 (C.26:2H-53 et seq.), this State has statutorily recognized the right of an adult with decision-making capacity to plan ahead for health care decisions through the execution of advance directives and designate a surrogate decision-maker, and to have the wishes expressed in those documents respected, subject to certain limitations, in order to ensure that the right to control decisions about one's own health care is not lost if a patient loses decision-making capacity and is no longer able to participate actively in making his own health care decisions;

b. The Physician Orders for Life-Sustaining Treatment or Practitioner Orders for Life-Sustaining Treatment, or POLST, form complements an advance directive by converting a person's wishes regarding life-sustaining treatment, such as those set forth in an advance directive, into a medical order;

c. The POLST form: contains immediately actionable, signed medical orders on a standardized form; includes medical orders that address a range of life-sustaining interventions as well as the patient's preferred intensity of treatment for each intervention; is typically a brightly colored, clearly identifiable form; and is recognized and honored across various health care settings;

d. The use of a POLST form is particularly appropriate for persons who have a compromised medical condition or a terminal illness, and the experience in other states has shown that the use of the POLST form helps these patients to have their health care preferences honored by health care providers;

e. The use of POLST forms can overcome many of the problems associated with advance directives, which in many cases are designed simply to name an individual to make health care decisions for the patient if the latter becomes incapacitated or otherwise lack specificity in regard to the patient's health care preferences, and are often locked away in file drawers or safe deposit boxes and unavailable to health care providers when the need arises to ensure that the patient's wishes are followed;

f. A completed POLST form is signed by, and more readily available than an advance directive to, the patient's attending physician, physician [assistant] associate, or advanced practice nurse, and provides a specific and detailed set of instructions for a health care professional or health care institution to follow in regard to the patient's preference for the use of various medical interventions;

g. To date, at least the following states, or communities within these states, have established programs providing for the use of the POLST form that have been endorsed by the National POLST Paradigm Task Force or are in the process of developing such programs: Alaska, California, Colorado, Florida, Georgia, Hawaii, Idaho, Indiana, Iowa, Kansas, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, New Hampshire, New York, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Tennessee, Texas, Utah, Washington, West Virginia, Wisconsin, and Wyoming; and

h. The right and preference of New Jerseyans to have their health care preferences respected would be better served by the use of the POLST form in this State to augment the use of advance directives, and the enactment of [this act] P.L.2011, c.145 (C.26:2H-129 et al.) will conduce to that end.

(cf: P.L.2019, c.218, s.3)

22. Section 3 of P.L.2011, c.145 (C.26:2H-131) is amended to read as follows:

3. As used in sections 1 through 12 of [this act] P.L.2011, c.145 (C.26:2H-129 et al.):

"Advance directive" means an advance directive for health care as defined in section 3 of P.L.1991, c.201 (C.26:2H-55).

"Advanced practice nurse" or "APN" means a person who is certified as an advanced practice nurse pursuant to P.L.1991, c.377 (C.45:11-45 et seq.).

"Commissioner" means the Commissioner of Health.

"Decision-making capacity" means a patient's ability to understand and appreciate the nature and consequences of a particular health care decision, including the benefits and risks of that decision, and alternatives to any proposed health care, and to reach an informed decision.

"Department" means the Department of Health.

"Emergency care" means the use of resuscitative measures and other immediate treatment provided in response to a sudden, acute, and unanticipated medical crisis in order to avoid injury, impairment, or death.

"Emergency care provider" means an emergency medical technician, paramedic, or member of a first aid, ambulance, or rescue squad.

"Health care decision" means a decision to accept, withdraw, or refuse a treatment, service, or procedure used to diagnose, treat, or care for a person's physical or mental condition, including life-sustaining treatment.

"Health care institution" means a health care facility licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.), a psychiatric facility as defined in section 2 of P.L.1987, c.116 (C.30:4-27.2), or a State developmental center listed in R.S.30:1-7.

"Health care professional" means a health care professional who is licensed or otherwise authorized to practice a health care profession pursuant to Title 45 or 52 of the Revised Statutes and is currently engaged in that practice.

"Life-sustaining treatment" means the use of any medical device or procedure, artificially provided fluids and nutrition, drugs, surgery, or therapy that uses mechanical or other artificial means to sustain, restore, or supplant a vital bodily function, and thereby increase the expected life span of a patient.

"Patient" means a person who is under the care of a physician, physician [assistant] associate, or APN.

"Patient's representative" means an individual who is designated by a patient or otherwise authorized under law to make health care decisions on the patient's behalf if the patient lacks decision-making capacity.

"Physician" means a person who is licensed to practice medicine and surgery pursuant to chapter 9 of Title 45 of the Revised Statutes.

"Physician [Assistant] Associate" means a health professional who meets the qualifications under P.L.1991, c.378 (C.45:9-27.10 et seq.) and holds a current, valid license issued pursuant to section 4 of P.L.1991, c.378 (C.45:9-27.13).

" Practitioner Orders for Life-Sustaining Treatment form" or "POLST form" means a standardized printed document that is uniquely identifiable and has a uniform color, which:

a. is recommended for use on a voluntary basis by patients who have advanced chronic progressive illness or a life expectancy of less than five years, or who otherwise wish to further define their preferences for health care;

b. does not qualify as an advance directive;

c. is not valid unless it meets the requirements for a completed POLST form as set forth in [this act] P.L.2011, c.145 (C.26:2H-129 et al.);

d. provides a means by which to indicate whether the patient has made an anatomical gift pursuant to P.L.2008, c.50 (C.26:6-77 et al.);

e. is intended to provide direction to emergency care personnel regarding the use of emergency care, and to a health care professional regarding the use of life-sustaining treatment, with respect to the patient, by indicating the patient's preference concerning the use of specified interventions and the intensity of treatment for each intervention;

f. is intended to accompany the patient, and to be honored by all personnel attending the patient, across the full range of possible health care settings, including the patient's home, a health care institution, or otherwise at the scene of a medical emergency; and

g. may be modified or revoked at any time by a patient with decision-making capacity or the patient's representative in accordance with the provisions of section 7 of [this act] P.L.2011, c.145 (C.26:2H-135).

"Resuscitative measures" means cardiopulmonary resuscitation provided in the event that a patient suffers a cardiac or respiratory arrest.

(cf: P.L.2019, c.218, s.4)

23. Section 6 of P.L.2011, c.145 (C.26:2H-134) is amended to read as follows:

6. a. A health care professional, health care institution, or emergency care provider shall treat a patient who has a completed POLST form in accordance with the information contained therein, except as otherwise provided in [this act] P.L.2011, c.145 (C.26:2H-129 et al.).

b. A POLST form shall be deemed to be completed, and therefore valid for the purposes of [this act] P.L.2011, c.145 (C.26:2H-129 et al.) if it:

(1) contains information indicating a patient's health care preferences;

(2) has been voluntarily signed by a patient with decision-making capacity, or by the patient's representative in accordance with the patient's known preferences or in the best interests of the patient;

(3) includes the signature of the patient's attending physician, physician [assistant] associate, or APN and the date of that signature; and

(4) meets any other requirements to be deemed valid for the purposes of [this act] P.L.2011, c.145 (C.26:2H-129 et al.).

c. A document executed in another state, which meets the requirements of [this act] P.L.2011, c.145 (C.26:2H-129 et al.) for a POLST form, shall be deemed to be completed and valid for the purposes of [this act] P.L.2011, c.145 (C.26:2H-129 et al.) to the same extent as a POLST form completed in this State.

(cf: P.L.2019, c.218, s.6)

24. Section 7 of P.L.2011, c.145 (C.26:2H-135) is amended to read as follows:

7. a. If the goals of care of a patient with a completed POLST form change, the patient's attending physician, physician [assistant] associate, or APN may, after conducting an evaluation of the patient and after obtaining informed consent from the patient or, if the patient has lost decision-making capacity, the patient's representative in accordance with subsection d. of this section, issue a new order that modifies or supersedes the completed POLST form consistent with the most current information available about the patient's health status and goals of care.

b. A patient with decision-making capacity, may, at any time, modify or revoke the patient's completed POLST form or otherwise request alternative treatment to the treatment that was ordered on the form.

c. If the orders in a patient's completed POLST form regarding the use of any intervention specified therein conflict with the patient's more recent verbal or written directive to the patient's attending physician, physician [assistant] associate, or APN, then the physician, physician [assistant] associate, or APN shall honor the more recent directive from the patient in accordance with the provisions of subsection e. of this section.

d. The POLST form shall provide the patient with the choice to authorize the patient's representative to revoke or modify the patient's completed POLST form if the patient loses decision-making capacity. If the patient so authorizes the patient's representative, the patient's representative may, at any time after the patient loses decision-making capacity and after consultation with the patient's attending physician or APN, request the physician, physician [assistant] associate, or APN to modify or revoke the completed POLST form, or otherwise request alternative treatment to the treatment that was ordered on the form, as the patient's representative deems necessary to reflect the patient's health status or goals of care. If the patient does not authorize the patient's representative to revoke or modify the patient's completed POLST form, the patient's representative may not revoke or modify the patient's completed POLST form.

e. A verbal or written request by a patient or the patient's representative to modify or revoke a patient's completed POLST form, in accordance with the provisions of this section, shall be effectuated once the patient's attending physician, physician [assistant] associate, or APN has signed the POLST form attesting to that request for modification or revocation.

(cf: P.L.2019, c.218, s.7)

25. Section 8 of P.L.2011, c.145 (C.26:2H-136) is amended to read as follows:

8. a. In the event of a disagreement among the patient, the patient's representative, and the patient's attending physician, physician [assistant] associate, or APN concerning the patient's decision-making capacity or the appropriate interpretation and application of the terms of a completed POLST form to the patient's course of treatment, the parties:

(1) may seek to resolve the disagreement by means of procedures and practices established by the health care institution, including, but not limited to, consultation with an institutional ethics committee, or with a person designated by the health care institution for this purpose; or

(2) may seek resolution by a court of competent jurisdiction.

b. A health care professional involved in the patient's care, other than the attending physician, physician [assistant] associate, or APN, or an administrator of a health care institution may also seek to resolve a disagreement concerning the patient's decision-making capacity or the appropriate interpretation and application of the terms of a completed POLST form to the patient's course of treatment in the same manner as set forth in subsection a. of this section.

(cf: P.L.2019, c.218, s.8)

26. Section 6 of P.L.1984, c.146 (C.26:2K-12) is amended to read as follows:

6. a. (1) Only a hospital exclusively authorized to develop and maintain advanced life support services in the municipality in which the trauma center is located pursuant to section 1 of P.L.2015, c.70 (C.26:2K-12.1), or a hospital authorized by the commissioner with an accredited emergency department may develop and maintain a mobile intensive care unit, and provide advanced life support services utilizing licensed physicians, registered professional nurses trained in advanced life support nursing, and mobile intensive care paramedics.

(2) (a) A mobile intensive care unit, when in service, shall be staffed by a minimum of two persons, which two persons may be two mobile intensive care paramedics, two registered professional nurses trained in advanced life support nursing, or one mobile intensive care paramedic and one registered professional nurse trained in advanced life support nursing. Any individual providing advanced life support as provided in this paragraph shall be authorized to render care within that individual's scope of practice, as determined by the commissioner and based on the agency EMS medical director's determination of competency.

(b) The Department of Health shall establish criteria for and a process by which a hospital may apply to the department for permission to operate a mobile intensive care unit that is staffed by one emergency medical technician and one mobile intensive care paramedic or registered professional nurse trained in advanced life support nursing, if the hospital is experiencing a staffing shortage.

(3) Agency EMS medical directors shall have the authority to establish advanced life support protocols, within the scope of practice for advanced life support providers established by [this act] P.L.2022, c.118 (C.26:2K-8.1 et al.) and the commissioner, which protocols shall include, but shall not be limited to, protocols concerning medications, equipment, procedures, and clinical practice. Such advanced life support protocols shall be submitted to the commissioner for approval. The commissioner may approve or deny advanced life support protocols submitted by an agency EMS medical director or may approve such protocols subject to amendments that the commissioner deems to be necessary. Aspects of clinical practice that exceed the scope established by commissioner shall be submitted by an agency EMS medical director to the mobile intensive care advisory council for review and recommendation to the commissioner, which shall be acted upon by the commissioner within 90 days.

(4) The commissioner with the approval of the State Board of Medical Examiners shall establish education and competency requirements which a board-certified or board-eligible emergency medicine physician, advanced practice nurse, or physician [assistant] associate who is employed by a hospital with a mobile intensive care unit shall be required to meet in order to obtain authorization from the department to deliver care within the respective scope of practice of the board-certified or board-eligible emergency medicine physician, advanced practice nurse, or physician [assistant] associate, as the case may be, in a pre-hospital setting or an interfacility setting. An authorized board-certified or board-eligible emergency medicine physician, advanced practice nurse, or physician [assistant] associate may deliver such care if and to the extent approved by the agency EMS medical director.

b. A hospital authorized by the commissioner pursuant to subsection a. of this section shall provide mobile intensive care unit services on a seven-day-a-week basis.

c. The commissioner shall establish, in writing, criteria which a hospital shall meet in order to qualify for the authorization.

d. The commissioner may withdraw his authorization if the hospital or unit violates any provision of [this act] P.L.1984, c.146 (C.26:2K-7 et seq.) or rules or regulations promulgated pursuant thereto.

e. Nothing in this section shall be construed to alter the scope of practice of any licensed health care professional under Title 45 of the Revised Statutes or the scope or authority of any agency, board, department, or other entity in this State that is responsible for licensing health care workers.

(cf: P.L.2022, c.118, s.8)

27. Section 8 of P.L.1984, c.146 (C.26:2K-14) is amended to read as follows:

8. No emergency medical technician, mobile intensive care paramedic, licensed physician, hospital or its board of trustees, officers and members of the medical staff, registered nurse, advanced practice nurse, physician [assistant] associate, or other employees of the hospital, first aid, ambulance or rescue squad, licensed emergency medical services agency, or officers and members of a first aid, ambulance or rescue squad shall be liable for any civil damages as the result of an act or the omission of an act committed while in training for or in the rendering of basic and advanced life support services in good faith and in accordance with [this act] P.L.1984, c.146 (C.26:2K-7 et seq.) and P.L.2022, c.118 (C.26:2K-8.1 et al.).

(cf: P.L.2022, c.118, s.10)

28. Section 1 of P.L.2021, c.430 (C.26:3A2-20.3) is amended to read as follows:

1. As used in [this act] P.L.2021, c.430 (C.26:3A2-20.3 et seq.):

"Confidential case report" means a report created by a local overdose fatality review team summarizing the data collected and analyzed regarding a confirmed fatal drug overdose.

"De-identifiable data" means data or information not containing personally identifiable information.

"Health care provider" means a physician, advanced practice nurse, or physician [assistant] associate acting within the scope of a valid license or certification issued pursuant to Title 45 of the Revised Statutes.

"Local team" means a local overdose fatality review team.

"Mental health provider" means a psychiatrist, a psychologist, an advanced practice nurse practitioner with a specialty in psychiatric mental health, a clinical social worker, a professional counselor, or a marriage and family therapist who is licensed to provide mental health services pursuant to Title 45 of the Revised Statutes.

"Overdose" means "drug overdose" as that term is defined in section 3 of P.L.2013, c.46 (C.24:6J-3).

"Personally identifiable information" means any information about an individual that can be used to distinguish or trace an individual's identity, including, but not limited to, an individual's name, address, social security number, date and place of birth, mother's maiden name, biometric records, and medical, educational, financial, and employment information.

"Public health purpose" means a purpose of protecting and improving the health of people and their communities. "Public health purpose" includes, but is not limited to, implementing educational programs, recommending policies, administering services, conducting research, and promoting healthcare equity, in an effort to protect the health of entire populations.

"Substance use disorder" shall have the same meaning prescribed by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and any subsequent editions, and shall include the symptoms of withdrawal from a substance use disorder.

"Substance use disorder treatment provider" means any individual or entity licensed, registered, or certified pursuant to the laws of this State to treat substance use disorders or who holds a current and valid waiver under the federal Drug Addiction Treatment Act of 2000 (Pub. L. 106-310) from the federal Substance Abuse and Mental Health Services Administration to treat individuals with substance use disorder using medications approved for that indication by the United States Food and Drug Administration.

(cf: P.L.2021, c.430, s.1)

29. Section 1 of P.L.2019, c.336 (C.26:4-48.2) is amended to read as follows:

1. a. Notwithstanding any other provision of law to the contrary, a health care professional who diagnoses a patient as having a sexually transmitted disease may provide expedited partner therapy to a sexual partner of the patient pursuant to [this act] P.L.2019, c.336 (C.26:4-48.2 et seq.).

b. Expedited partner therapy shall consist of the health care professional:

(1) prescribing or dispensing medication for the treatment of the sexually transmitted disease. The medication shall be prescribed or dispensed in the sexual partner's name or, if not known, in the name of "Expedited Partner Therapy," and provided to the patient to give to the sexual partner;

(2) providing the patient with printed informational materials, which have been distributed by the department pursuant to subsection a. of section 2 of [this act] P.L.2019, c.336 (C.26:4-48.2 et seq.), for the patient to give to the sexual partner; and

(3) requesting that the patient advise the sexual partner of the importance of seeking clinical treatment for the sexually transmitted disease from a health care professional.

The health care professional shall not be required to perform a clinical examination of the sexual partner as a condition of providing expedited partner therapy.

c. A health care professional may provide expedited partner therapy to any sexual partner of the patient, provided that:

(1) the patient indicates with reasonable certainty that the patient has had sexual contact with the sexual partner within the past 60 days under circumstances in which there was a risk of transmission of a sexually transmitted disease;

(2) the patient indicates with reasonable certainty that the sexual partner is unable or unwilling to seek clinical services in a timely manner; and

(3) the patient indicates with reasonable certainty that the patient will be able to contact the sexual partner for the purposes of providing expedited partner therapy.

d. As used in [this act] P.L.2019, c.336 (C.26:4-48.2 et seq.):

"Commissioner" means the Commissioner of Health.

"Department" means the Department of Health.

"Health care professional" means a physician, advanced practice nurse, certified nurse midwife, or physician [assistant] associate who is authorized to issue prescriptions for the medications used in expedited partner therapy and for whom the treatment of sexually transmitted disease is within the physician's, advanced practice nurse's, certified nurse midwife's, or physician [assistant's] associate’s scope of training and practice.

(cf: P.L.2019, c.336, s.1)

30. Section 4 of P.L.1983, c.308 (C.26:6-8.1) is amended to read as follows:

4. a. Where there has been an apparent death that is not governed by the provisions of section 4 of P.L.1991, c.90 (C.26:6A-4), a registered professional nurse licensed by the New Jersey Board of Nursing under P.L.1947, c.262 (C.45:11-23 et seq.) or a physician [assistant] associate licensed pursuant to P.L.1991, c.378 (C.45:9-27.10 et seq.) may make the actual determination and pronouncement of death and shall attest to this pronouncement by: signing in the space designated for this signature on the certificate of death under R.S.26:6-7; or, for the purposes of the NJ-EDRS, transmitting orally or in writing a report of the pronouncement to the attending, covering, or resident physician, or the county medical examiner.

b. (Deleted by amendment, P.L.2006, c.86).

(cf: P.L.2015, c.224, s.13)

31. Section 1 of P.L.1988, c.125 (C.26:6-8.2) is amended to read as follows:

1. If the attending physician, registered professional nurse, physician [assistant] associate, or the Chief State Medical Examiner, Deputy Chief State Medical Examiner, or county or intercounty medical examiner or assistant county or intercounty medical examiner who makes the actual determination and pronouncement of death determines or has knowledge that the deceased person was HIV positive or infected with hepatitis B virus or that the deceased person suffered from AIDS, or any of the contagious, infectious, or communicable diseases as shall be determined by the Commissioner of Health, the attending physician, registered professional nurse, physician [assistant] associate, or the Chief State Medical Examiner, Deputy Chief State Medical Examiner, or county or intercounty medical examiner or assistant county or intercounty medical examiner shall immediately place with the remains written notification of the condition and shall provide written notification of the condition to the funeral director who is responsible for the handling and the disposition of the body.

(cf: P.L.2018, c.62, s.26)

32. Section 2 of P.L.2005, c.222 (C.26:13-2) is amended to read as follows:

2. As used in [this act] P.L.2005, c.222 (C.26:13-1 et al.):

"Biological agent" means any microorganism, virus, bacterium, rickettsiae, fungus, toxin, infectious substance, or biological product that may be naturally occurring or engineered as a result of biotechnology, or any naturally occurring or bioengineered component of any such microorganism, virus, bacterium, rickettsiae, fungus, infectious substance, or biological product, capable of causing death, disease, or other biological malfunction in a human, an animal, a plant, or another living organism.

"Bioterrorism" means the intentional use or threat of use of any biological agent, to cause death, disease, or other biological malfunction in a human, animal, plant, or other living organism, or degrade the quality and safety of the food, air, or water supply.

"Chemical weapon" means a toxic chemical and its precursors, except where intended for a lawful purpose as long as the type and quantity is consistent with such a purpose. Chemical weapon includes, but is not limited to: nerve agents, choking agents, blood agents, and incapacitating agents.

"Commissioner" means the Commissioner of Health, or the commissioner's designee.

"Contagious disease" means an infectious disease that can be transmitted from person to person.

"Department" means the Department of Health.

"Health care facility" means any non-federal institution, building or agency, or portion thereof whether public or private for profit or nonprofit that is used, operated or designed to provide health services, medical or dental treatment or nursing, rehabilitative, or preventive care to any person. Health care facility includes, but is not limited to: an ambulatory surgical facility, home health agency, hospice, hospital, infirmary, intermediate care facility, dialysis center, long-term care facility, medical assistance facility, mental health center, paid and volunteer emergency medical services, outpatient facility, public health center, rehabilitation facility, residential treatment facility, skilled nursing facility, and adult day care center. Health care facility also includes, but is not limited to, the following related property when used for or in connection with the foregoing: a laboratory, research facility, pharmacy, laundry facility, health personnel training and lodging facility, patient, guest and health personnel food service facility, and the portion of an office or office building used by persons engaged in health care professions or services.

"Health care provider" means any person or entity who provides health care services including, but not limited to: a health care facility, bioanalytical laboratory director, perfusionist, physician, physician [assistant] associate, pharmacist, dentist, nurse, paramedic, respiratory care practitioner, medical or laboratory technician, and ambulance and emergency medical workers.

"Infectious disease" means a disease caused by a living organism or other pathogen, including a fungus, bacteria, parasite, protozoan, virus, or prion. An infectious disease may, or may not, be transmissible from person to person, animal to person, or insect to person.

"Isolation" means the physical separation and confinement of an individual or groups of individuals who are infected or reasonably believed to be infected, on the basis of signs, symptoms or laboratory analysis, with a contagious or possibly contagious disease from non-isolated individuals, to prevent or limit the transmission of the disease to non-isolated individuals.

"Local health agency" means a county, regional, municipal, or other governmental agency organized for the purpose of providing health services, administered by a full-time health officer and conducting a public health program pursuant to law.

"Local Information Network and Communications System Agency" or "LINCS agency" means the lead local public health agency in each county or identified city, as designated and determined by the commissioner pursuant to section 21 of [this act] P.L.2005, c.222 (C.26:13-21), responsible for providing central planning, coordination, and delivery of specialized services within the designated county or city, in partnership with the other local health agencies within that jurisdiction, in order to prepare for and respond to acts of bioterrorism and other forms of terrorism or other public health emergencies or threats, and to discharge the activities as specified under [this act] P.L.2005, c.222 (C.26:13-1 et al.).

"Microorganism" includes, but is not limited to, bacteria, viruses, fungi, rickettsiae, or protozoa.

"Nuclear or radiological device" means: any nuclear device which is an explosive device designed to cause a nuclear yield; an explosive radiological dispersal device used directly or indirectly to spread radioactive material; or a simple radiological dispersal device which is any act, container or any other device used to release radiological material for use as a weapon.

"Overlap agent or toxin" means: any microorganism or toxin that poses a risk to both human and animal health and includes:

Anthrax - Bacillus anthracis

Botulism - Clostridium botulinum toxin, Botulinum neurotoxins, Botulinum neurotoxin producing species of Clostridium

Plague - Yersinia pestis

Tularemia - Francisella tularensis

Viral Hemorrhagic Fevers - Ebola, Marburg, Lassa, Machupo

Brucellosis- Brucellosis species

Glanders - Burkholderia mallei

Melioidosis - Burkholderia pseudomallei

Psittacosis - Chlamydophila psittaci

Coccidiodomycosis - Coccidiodes immitis

Q Fever - Coxiella burnetii

Typhus Fever - Rickettsia prowazekii

Viral Encephalitis - VEE (Venezuelan equine encephalitis virus), EEE (Eastern equine encephalitis), WEE (Western equine encephalitis)

Toxins - Ricinus communis, Clostridium perfringens, Staph. Aureus, Staphylococcal enterotoxins, T-2 toxin, Shigatoxin

Nipah - Nipah virus

Hantavirus - Hantavirus

West Nile Fever - West Nile virus

Hendra - Hendra virus

Rift Valley Fever - Rift Valley Fever virus

Highly Pathogenic Avian Influenza

"Public health emergency" means an occurrence or imminent threat of an occurrence that:

a. is caused or is reasonably believed to be caused by any of the following: (1) bioterrorism or an accidental release of one or more biological agents; (2) the appearance of a novel or previously controlled or eradicated biological agent; (3) a natural disaster; (4) a chemical attack or accidental release of toxic chemicals; or (5) a nuclear attack or nuclear accident; and

b. poses a high probability of any of the following harms: (1) a large number of deaths, illness, or injury in the affected population; (2) a large number of serious or long-term impairments in the affected population; or (3) exposure to a biological agent or chemical that poses a significant risk of substantial future harm to a large number of people in the affected population.

"Quarantine" means the physical separation and confinement of an individual or groups of individuals, who are or may have been exposed to a contagious or possibly contagious disease and who do not show signs or symptoms of a contagious disease, from non-quarantined individuals, to prevent or limit the transmission of the disease to non-quarantined individuals.

"Toxin" means the toxic material of plants, animals, microorganisms, viruses, fungi, or infectious substances, or a recombinant molecule, whatever its origin or method of production, including:

a. any poisonous substance or biological product that may be engineered as a result of biotechnology or produced by a living organism; or

b. any poisonous isomer or biological product, homolog, or derivative of such a substance.

(cf: P.L.2012, c.17, s.356)

33. Section 3 of P.L.2019, c.160 (C.30:4-82.7) is amended to read as follows:

3. For the purposes of [this act] P.L.2019, c.160 (C.30:4-82.5 et seq.):

"Clinician" means a State licensed physician, except if the clinician makes mental health evaluations, the term shall mean a State licensed psychiatrist or psychologist, or an advanced practice nurse or clinical nurse specialist with a specialty in psychiatric nursing.

"Commissioner" means the Commissioner of Corrections.

"Correctional facility" means any State correctional facility or county correctional facility, and any State, county, or private facility detaining persons pursuant to any intergovernmental service agreement or other contract with any State, county, or federal agency, including, but not limited to, United States Immigration and Customs Enforcement.

"County correctional facility" means a county jail, penitentiary, prison, or workhouse.

"Emergency confinement" means the segregation of an inmate in a correctional facility when there is reasonable cause to believe that this segregation is necessary for reducing a substantial risk of imminent serious harm to the inmate or others, as evidenced by recent conduct.

"Facility administrator" or "administrator" means the chief operating officer or senior administrative designee of a correctional facility.

"Inmate" means a person confined in a correctional facility.

"Isolated confinement" means confinement of an inmate in a correctional facility, pursuant to disciplinary, administrative, protective, investigative, medical, or other classification, in a cell or similarly confined holding or living space, alone or with other inmates, for approximately 20 hours or more per day in a State correctional facility or 22 hours or more per day in a county correctional facility, with severely restricted activity, movement, and social interaction. Isolated confinement shall not include confinement due to a facility-wide or unit-wide lockdown that is required to ensure the safety of inmates and staff. "Less restrictive intervention" means a placement or conditions of confinement, or both, in the current or an alternative correctional facility, under conditions less restrictive of an inmate's movement, privileges, activities, or social interactions.

"Medical isolation" means isolated confinement of an inmate for medical reasons, including a mental health emergency or when necessary for preventing the spread of a communicable disease.

"Medical staff" means State licensed physicians, physician [assistants] associates, advanced practice nurses or clinical nurse specialists or, for mental health evaluations or decisions, those registered nurses with a specialty in psychiatric nursing, or comparably credentialed employees or contractors employed to provide healthcare.

"Member of a vulnerable population" means any inmate who:

a. is 21 years of age or younger;

b. is 65 years of age or older;

c. has a disability based on a mental illness, as defined in subsection r. of section 2 of P.L.1987, c.116 (C.30:4-27.2), a history of psychiatric hospitalization, or has recently exhibited conduct, including but not limited to serious self-mutilation, indicating the need for further observation or evaluation to determine the presence of mental illness;

d. has a developmental disability, as defined in subsection b. of section 3 of P.L.1985, c.145 (C.30:6D-25);

e. has a serious medical condition which cannot effectively be treated in isolated confinement;

f. is pregnant, is in the postpartum period, or has recently suffered a miscarriage or terminated a pregnancy;

g. has a significant auditory or visual impairment; or

h. is perceived to be lesbian, gay, bisexual, transgender, or intersex.

"Postpartum period" means the 45 days after childbirth. "Protective custody" means confinement of an inmate in a cell or similarly confined holding or living space, under conditions necessary to protect the inmate or others.

"State correctional facility" means a State prison or other penal institution or an institution or facility designated by the commissioner as a place of confinement under section 2 of P.L.1969, c.22 (C.30:4-91.2).

(cf: P.L.2019, c.160, s.3)

34. Section 2 of P.L.1970, c.289 (C.30:4-165.8) is amended to read as follows:

2. a. The moving papers shall include: (1) a verified complaint; (2) an affidavit from a practicing physician or a psychologist licensed pursuant to P.L.1966, c.282 (C.45:14B-1 et seq.) who has made a personal examination of the alleged incapacitated person not more than six months prior to the filing of the verified complaint; and (3) one of the following documents: (a) an affidavit from the chief executive officer, medical director, or other officer having administrative control over the program from which the individual is receiving functional or other services provided by the Division of Developmental Disabilities; (b) an affidavit from a designee of the Division of Developmental Disabilities having personal knowledge of the functional capacity of the individual who is the subject of the guardianship action; (c) a second affidavit from a practicing physician or psychologist licensed pursuant to P.L.1966, c.282 (C.45:14B-1 et seq.); (d) a copy of the Individualized Education Program, including any medical or other reports, for the individual who is subject to the guardianship action, which shall have been prepared no more than two years prior to the filing of the verified complaint; or (e) an affidavit from a licensed care professional having personal knowledge of the functional capacity of the individual who is the subject of the guardianship action. The documents described in paragraphs (2) and (3) of this subsection shall set forth with particularity the facts supporting the belief that the alleged incapacitated person suffers from a significant chronic functional impairment to such a degree that the person either lacks the cognitive capacity to make decisions for himself or to communicate, in any way, decisions to others.

b. As used in this section:

"Designee of the Division of Developmental Disabilities" means an evaluator, care manager, case manager, or other employee or contractor affiliated with the Division of Developmental Disabilities, whether or not such person has administrative control over the program from which the individual is receiving functional or other services.

"Individualized education program" means a written plan which sets forth present levels of academic achievement and functional performance, measurable annual goals, and short-term objectives or benchmarks, and describes an integrated, sequential program of individually designed instructional activities and related services necessary to achieve the stated goals and objectives.

"Licensed care professional" means a duly certified or licensed advanced practice nurse, board certified assistant behavior analyst, board certified behavior analyst, clinical nurse practitioner, licensed practical nurse, family counselor, nurse, occupational therapist, physical therapist, physician [assistant] associate, professional counselor, registered nurse, social worker, or speech language pathologist.

"Significant chronic functional impairment" includes, but is not limited to, a lack of comprehension of concepts related to personal care, health care, or medical treatment.

(cf: P.L.2015, c.132, s.1)

35. Section 6 of P.L.1968, c.413 (C.30:4D-6) is amended to read as follows:

6. a. Subject to the requirements of Title XIX of the federal Social Security Act, the limitations imposed by [this act] P.L.1968, c.413 (C.30:4D-1 et seq.) and by the rules and regulations promulgated pursuant thereto, the department shall provide medical assistance to qualified applicants, including authorized services within each of the following classifications:

(1) Inpatient hospital services

(2) Outpatient hospital services;

(3) Other laboratory and X-ray services;

(4) (a) Skilled nursing or intermediate care facility services;

(b) Early and periodic screening and diagnosis of individuals who are eligible under the program and are under age 21, to ascertain their physical or mental health status and the health care, treatment, and other measures to correct or ameliorate defects and chronic conditions discovered thereby, as may be provided in regulation of the Secretary of the federal Department of Health and Human Services and approved by the commissioner;

(5) Physician's services furnished in the office, the patient's home, a hospital, a skilled nursing, or intermediate care facility or elsewhere.

As used in this subsection, "laboratory and X-ray services" includes HIV drug resistance testing, including, but not limited to, genotype assays that have been cleared or approved by the federal Food and Drug Administration, laboratory developed genotype assays, phenotype assays, and other assays using phenotype prediction with genotype comparison, for persons diagnosed with HIV infection or AIDS.

b. Subject to the limitations imposed by federal law, by [this act] P.L.1968, c.413 (C.30:4D-1 et seq.), and by the rules and regulations promulgated pursuant thereto, the medical assistance program may be expanded to include authorized services within each of the following classifications:

(1) Medical care not included in subsection a.(5) above, or any other type of remedial care recognized under State law, furnished by licensed practitioners within the scope of their practice, as defined by State law;

(2) Home health care services;

(3) Clinic services;

(4) Dental services;

(5) Physical therapy and related services;

(6) Prescribed drugs, dentures, and prosthetic devices; and eyeglasses prescribed by a physician skilled in diseases of the eye or by an optometrist, whichever the individual may select;

(7) Optometric services;

(8) Podiatric services;

(9) Chiropractic services;

(10) Psychological services;

(11) Inpatient psychiatric hospital services for individuals under 21 years of age, or under age 22 if they are receiving such services immediately before attaining age 21;

(12) Other diagnostic, screening, preventative, and rehabilitative services, and other remedial care;

(13) Inpatient hospital services, nursing facility services, and immediate care facility services for individuals 65 years of age or over in an institution for mental diseases;

(14) Intermediate care facility services;

(15) Transportation services;

(16) Services in connection with the inpatient or outpatient treatment or care of substance use disorder, when the treatment is prescribed by a physician and provided in a licensed hospital or in a narcotic and substance use disorder treatment center approved by the Department of Health pursuant to P.L.1970, c.334 (C.26:2G-21 et. seq.) and whose staff includes a medical director, and limited those services eligible for federal financial participation under Title XIX of the federal Social Security Act;

(17) Any other medical care and any other type of remedial care recognized under State law, specified by the Secretary of the federal Department of Health and Human Services, and approved by the commissioner;

(18) Comprehensive maternity care, which may include: the basic number of prenatal and postpartum visits recommended by the American College of Obstetrics and Gynecology; additional prenatal and postpartum visits that are medically necessary; necessary laboratory, nutritional assessment and counseling, health education, personal counseling, managed care, outreach, and follow-up services; treatment of conditions which may complicate pregnancy doula care; and physician or certified nurse midwife delivery services. For the purposes of this paragraph, "doula" means a trained professional who provides continuous physical, emotional, and informational support to a mother before, during, and shortly after childbirth, to help her to achieve the healthiest, most satisfying experience possible;

(19) Comprehensive pediatric care, which may include: ambulatory, preventive, and primary care health services. The preventive services shall include, at a minimum, the basic number of preventive visits recommended by the American Academy of Pediatrics;

(20) Services provided by a hospice which is participating in the Medicare program established pursuant to Title XVIII of the Social Security Act, Pub.L.89-97 (42 U.S.C. s.1395 et seq.). Hospice services shall be provided subject to approval of the Secretary of the federal Department of Health and Human Services for federal reimbursement;

(21) Mammograms, subject to approval of the Secretary of the federal Department of Health and Human Services for federal reimbursement, including one baseline mammogram for women who are at least 35 but less than 40 years of age; one mammogram examination every two years or more frequently, if recommended by a physician, for women who are at least 40 but less than 50 years of age; and one mammogram examination every year for women age 50 and over;

(22) Upon referral by a physician, advanced practice nurse, or physician [assistant] associate of a person who has been diagnosed with diabetes, gestational diabetes, or pre-diabetes, in accordance with standards adopted by the American Diabetes Association:

(a) Expenses for diabetes self-management education or training to ensure that a person with diabetes, gestational diabetes, or pre-diabetes can optimize metabolic control, prevent and manage complications, and maximize quality of life. Diabetes self-management education shall be provided by an in-State provider who is:

(i) a licensed, registered, or certified health care professional who is certified by the National Certification Board of Diabetes Educators as a Certified Diabetes Educator, or certified by the American Association of Diabetes Educators with a Board Certified-Advanced Diabetes Management credential, including, but not limited to: a physician, an advanced practice or registered nurse, a physician [assistant] associate, a pharmacist, a chiropractor, a dietitian registered by a nationally recognized professional association of dietitians, or a nutritionist holding a certified nutritionist specialist (CNS) credential from the Board for Certification of Nutrition Specialists; or

(ii) an entity meeting the National Standards for Diabetes Self-Management Education and Support, as evidenced by a recognition by the American Diabetes Association or accreditation by the American Association of Diabetes Educators;

(b) Expenses for medical nutrition therapy as an effective component of the person's overall treatment plan upon a: diagnosis of diabetes, gestational diabetes, or pre-diabetes; change in the beneficiary's medical condition, treatment, or diagnosis; or determination of a physician, advanced practice nurse, or physician [assistant] associate that reeducation or refresher education is necessary. Medical nutrition therapy shall be provided by an in-State provider who is a dietitian registered by a nationally-recognized professional association of dietitians, or a nutritionist holding a certified nutritionist specialist (CNS) credential from the Board for Certification of Nutrition Specialists, who is familiar with the components of diabetes medical nutrition therapy;

(c) For a person diagnosed with pre-diabetes, items and services furnished under an in-State diabetes prevention program that meets the standards of the National Diabetes Prevention Program, as established by the federal Centers for Disease Control and Prevention; and

(d) Expenses for any medically appropriate and necessary supplies and equipment recommended or prescribed by a physician, advanced practice nurse, or physician [assistant] associate for the management and treatment of diabetes, gestational diabetes, or pre-diabetes, including, but not limited to: equipment and supplies for self-management of blood glucose; insulin pens; insulin pumps and related supplies; and other insulin delivery devices;

(23) Expenses incurred for the provision of group prenatal services to a pregnant woman, provided that:

(a) the provider of such services, which shall include, but not be limited to, a federally qualified health center or a community health center operating in the State:

(i) is a site accredited by the Centering Healthcare Institute, or is a site engaged in an active implementation contract with the Centering Healthcare institute, that utilizes the Centering Pregnancy model; and

(ii) incorporates the applicable information outlined in any best practices manual for prenatal and postpartum maternal care developed by the Department of Health into the curriculum for each group prenatal visit;

(b) each group prenatal care visit is at least 1.5 hours in duration, with a minimum of two women and a maximum of 20 women in participation; and

(c) no more than 10 group prenatal care visits occur per pregnancy. As used in this paragraph, "group prenatal care services" means a series of prenatal care visits provided in a group setting which are based upon the Centering Pregnancy model developed by the Centering Healthcare Institute and which include health assessments, social and clinical support, and educational activities;

(24) Expenses incurred for the provision of pasteurized donated human breast milk, which shall include human milk fortifiers if indicated in a medical order provided by a licensed medical practitioner, to an infant under the age of six months; provided that the milk is obtained from a human milk bank that meets quality guidelines established by the Department of Health and a licensed medical practitioner has issued a medical order for the infant under at least one of the following circumstances:

(a) the infant is medically or physically unable to receive maternal breast milk or participate in breast feeding, or the infant's mother is medically or physically unable to produce maternal breast milk in sufficient quantities or participate in breast feeding despite optimal lactation support; or

(b) the infant meets any of the following conditions:

(i) a body weight below healthy levels, as determined by the licensed medical practitioner issuing the medical order for the infant;

(ii) the infant has a congenital or acquired condition that places the infant at a high risk for development of necrotizing enterocolitis; or

(iii) the infant has a congenital or acquired condition that may benefit from the use of donor breast milk and human milk fortifiers, as determined by the Department of Health;

(25) Comprehensive tobacco cessation benefits to an individual who is 18 years of age or older, or who is pregnant. Coverage shall include: brief and high intensity individual counseling, brief and high intensity group counseling, and telemedicine as defined by section 1 of P.L.2017, c.117 (C.45:1-61); all medications approved for tobacco cessation by the U.S. Food and Drug Administration; and other tobacco cessation counseling recommended by the Treating Tobacco Use and Dependence Clinical Practice Guideline issued by the U.S. Public Health Service. Notwithstanding the provisions of any other law, rule, or regulation to the contrary, and except as otherwise provided in this section:

(a) Information regarding the availability of the tobacco cessation services described in this paragraph shall be provided to all individuals authorized to receive the tobacco cessation services pursuant to this paragraph at the following times: no later than 90 days after the effective date of P.L.2019, c.473; upon the establishment of an individual's eligibility for medical assistance; and upon the redetermination of an individual's eligibility for medical assistance;

(b) The following conditions shall not be imposed on any tobacco cessation services provided pursuant to this paragraph: copayments or any other forms of cost-sharing, including deductibles; counseling requirements for medication; stepped care therapy or similar restrictions requiring the use of one service prior to another; limits on the duration of services; or annual or lifetime limits on the amount, frequency, or cost of services, including, but not limited to, annual or lifetime limits on the number of covered attempts to quit; and

(c) Prior authorization requirements shall not be imposed on any tobacco cessation services provided pursuant to this paragraph except in the following circumstances where prior authorization may be required: for a treatment that exceeds the duration recommended by the most recently published United States Public Health Service clinical practice guidelines on treating tobacco use and dependence; or for services associated with more than two attempts to quit within a 12-month period;

(26) Provided that there is federal financial participation available, benefits for expenses incurred in conducting a colorectal cancer screening in accordance with United States Preventive Services Task Force recommendations. The method and frequency of screening to be utilized shall be in accordance with the most recent published recommendations of the United States Preventive Services Task Force and as determined medically necessary by the covered person's physician, in consultation with the covered person.

No deductible, coinsurance, copayment, or any other cost-sharing requirement shall be imposed for a colonoscopy performed following a positive result on a non-colonoscopy, colorectal cancer screening test recommended by the United States Preventive Services Task Force; and

(27) (a) Within 24 months of the effective date of P.L.2023, c.187 (C.30:4D-6u et al.), and conditional on the receipt of all necessary federal approvals and the securing of federal financial participation pursuant to section 2 of P.L.2023, c.187 (C.30:4D-6u), community-based palliative care benefits which shall include, but not be limited to, all of the following:

(i) specialized medical care and emotional and spiritual support for beneficiaries with serious advanced illnesses;

(ii) relief of symptoms, pain, and stress of serious illness;

(iii) improvement of quality of life for both the beneficiary and the beneficiary's family; and

(iv) appropriate care for any age and for any stage of serious illness, along with curative treatment.

(b) Benefits provided under this paragraph shall include, but shall not be limited to, services provided by a hospice pursuant to paragraph (20) of subsection b. of this section, provided that:

(i) hospice services may be provided at the same time that curative treatment is available, to the extent that services are not duplicative;

(ii) hospice services may be provided to beneficiaries whose conditions may result in death, regardless of the estimated length of the beneficiary's remaining period of life; and

(iii) the Division of Medical Assistance and Health Services in the Department of Human Services may include any other service deemed appropriate under the benefits provided under this paragraph.

(c) Providers authorized to deliver benefits provided under this paragraph shall include Medicaid-approved licensed hospice agencies, Medicaid-approved home health agencies licensed to provide hospice care, and other Medicaid-approved licensed health care providers.

(d) Nothing in this paragraph shall be construed to result in the elimination or reduction of covered benefits or services under the Medicaid program.

(e) This paragraph shall not affect a beneficiary's eligibility to receive, concurrently with services provided for in this paragraph, any services, including home health services, for which the beneficiary would have been eligible in the absence of this paragraph, to the extent that services are not duplicative.

c. Payments for the foregoing services, goods and supplies furnished pursuant to [this act] P.L.1968, c.413 (C.30:4D-1 et seq.) shall be made to the extent authorized by [this act] P.L.1968, c.413 (C.30:4D-1 et seq.), the rules and regulations promulgated pursuant thereto and, where applicable, subject to the agreement of insurance provided for under [this act] P.L.1968, c.413 (C.30:4D-1 et seq.). The payments shall constitute payment in full to the provider on behalf of the recipient. Every provider making a claim for payment pursuant to [this act] P.L.1968, c.413 (C.30:4D-1 et seq.) shall certify in writing on the claim submitted that no additional amount will be charged to the recipient, the recipient's family, the recipient's representative or others on the recipient's behalf for the services, goods, and supplies furnished pursuant to [this act] P.L.1968, c.413 (C.30:4D-1 et seq.).

No provider whose claim for payment pursuant to [this act] P.L.1968, c.413 (C.30:4D-1 et seq.) has been denied because the services, goods, or supplies were determined to be medically unnecessary shall seek reimbursement from the recipient, his family, his representative or others on his behalf for such services, goods, and supplies provided pursuant to [this act] P.L.1968, c.413 (C.30:4D-1 et seq.); provided, however, a provided may seek reimbursement from a recipient for services, goods, or supplies not authorized by [this act] P.L.1968, c.413 (C.30:4D-1 et seq.), if the recipient elected to receive the services, goods or supplies with the knowledge that they were not authorized.

d. Any individual eligible for medical assistance (including drugs) may obtain such assistance from any person qualified to perform the service or services required (including an organization which provides such services, or arranges for their availability on a prepayment basis), who undertakes to provide the individual such services.

No copayment or other form of cost-sharing shall be imposed on any individual eligible for medical assistance, except as mandated by federal law as a condition of federal financial participation.

e. Anything in [this act] P.L.1968, c.413 (C.30:4D-1 et seq.) to the contrary notwithstanding, no payments for medical assistance shall be made under [this act] P.L.1968, c.413 (C.30:4D-1 et seq.) with respect to care or services for any individual who:

(1) Is an inmate of a public institution (except as a patient in a medical institution); provided, however, that an individual who is otherwise eligible may continue to receive services for the month in which he becomes an inmate, should the commissioner determine to expand the scope of Medicaid eligibility to include such an individual, subject to the limitations imposed by federal law and regulations, or

(2) Has not attained 65 years of age and who is a patient in an institution for mental diseases, or

(3) Is over 21 years of age and who is receiving inpatient psychiatric hospital services in a psychiatric facility; provided, however, that an individual who was receiving such services immediately prior to attaining age 21 may continue to receive such services until the individual reaches age 22. Nothing in this subsection shall prohibit the commissioner from extending medical assistance to all eligible persons receiving inpatient psychiatric services; provided that there is federal financial participation available.

f. (1) A third party as defined in section 3 of P.L.1968, c.413 (C.30:4D-3) shall not consider a person's eligibility for Medicaid in this or another state when determining the person's eligibility for enrollment or the provision of benefits by that third party.

(2) In addition, any provision in a contract of insurance, health benefits plan, or other health care coverage document, will, trust, agreement, court order, or other instrument which reduces or excludes coverage or payment for health care-related goods and services to or for an individual because of that individual's actual or potential eligibility for or receipt of Medicaid benefits shall be null and void, and no payments shall be made under [this act] P.L.1979, c.365 (C.30:4D-7.1 et al.) as a result of any such provision.

(3) Notwithstanding any provision of law to the contrary, the provisions of paragraph (2) of this subsection shall not apply to a trust agreement that is established pursuant to 42 U.S.C. s.1396p(d)(4)(A) or (C) to supplement and augment assistance provided by government entities to a person who is disabled as defined in section 1614(a)(3) of the federal Social Security Act (42 31 U.S.C. s.1382c (a)(3)).

g. The following services shall be provided to eligible medically needy individuals as follows:

(1) Pregnant women shall be provided prenatal care and delivery services and postpartum care, including the services cited in subsections a.(1), (3), and (5) of this section and subsections b.(1)-(10), (12), (15), and (17) of this section, and nursing facility services cited in subsection b.(13) of this section.

(2) Dependent children shall be provided with services cited in subsections a.(3) and (5) of this section and subsections b.(1), (2), (3), (4), (5), (6), (7), (10), (12), (15), and (17) of this section, and nursing facility services cited in subsection b.(13) of this section.

(3) Individuals who are 65 years of age or older shall be provided with services cited in subsections a.(3) and (5) of this section and subsections b.(1)-(5), (6) excluding prescribed drugs, (7), (8), (10), (12), (15), and (17) of this section, and nursing facility services cited in subsection b.(13) of this section.

(4) Individuals who are blind or disabled shall be provided with services cited in subsections a.(3) and (5) of this section and subsections b.(1)-(5), (6) excluding prescribed drugs, (7), (8), (10), 3 (12), (15), and (17) of this section, and nursing facility services cited in subsection b.(13) of this section.

(5) (a) Inpatient hospital services, subsection a.(1) of this section, shall only be provided to eligible medically needy individuals, other than pregnant women, if the federal Department of Health and Human Services discontinues the State's waiver to establish inpatient hospital reimbursement rates for the Medicare and Medicaid programs under the authority of section 601(c)(3) of the Social Security Act Amendments of 1983, Pub.L.98-21 (42 U.S.C. s.1395ww(c)(5)). Inpatient hospital services may be extended to other eligible medically needy individuals if the federal Department of Health and Human Services directs that these services be included.

(b) Outpatient hospital services, subsection a.(2) of this section, shall only be provided to eligible medically needy individuals if the federal Department of Health and Human Services discontinues the State's waiver to establish outpatient hospital reimbursement rates for the Medicare and Medicaid programs under the authority of section 601(c)(3) of the Social Security Amendments of 1983, Pub.L.98-21 (42 U.S.C. s.1395ww(c)(5)). Outpatient hospital services may be extended to all or to certain medically needy individuals if the federal Department of Health and Human Services directs that these services be included. However, the use of outpatient hospital services shall be limited to clinic services and to emergency room services for injuries and significant acute medical conditions.

h. In the case of a qualified disabled and working individual pursuant to section h6408 of Pub.L.101-239 (42 U.S.C. s.1396d), the only medical assistance provided under this [act] section shall be the payment of premiums for Medicare part A under 42 U.S.C. ss.1395i-2 and 1395r.

i. In the case of a specified low-income Medicare beneficiary pursuant to 42 U.S.C. s.1396a(a)10(E)iii, the only medical assistance provided under this [act] section shall be the payment of premiums for Medicare part B under 42 U.S.C. s.1395r as provided for in 42 U.S.C. s.1396d(p)(3)(A)(ii).

j. In the case of a qualified individual pursuant to 42 U.S.C. s.1396a(aa), the only medical assistance provided under this [act] section shall be payment for authorized services provided during the period in which the individual requires treatment for breast or cervical cancer, in accordance with criteria established by the commissioner.

k. In the case of a qualified individual pursuant to 42 U.S.C. s.1396a(ii), the only medical assistance provided under this [act] section shall be payment for family planning services and supplies as described at 42 U.S.C. s.1396d(a)(4)(C), including medical diagnosis and treatment services that are provided pursuant to a family planning service in a family planning setting.

(cf: P.L.2023, c.187, s.1)

36. Section 2 of P.L.2011, c.114 (C.30:4D-8.2) is amended to read as follows:

2. As used in [this act] P.L.2011, c.114 (C.30:4D-8.1 et seq.):

"ACO" means an accountable care organization.

"Behavioral health care provider" means a provider licensed or approved by the Department of Human Services to render services to New Jersey residents.

"Department" means the Department of Human Services.

"Designated area" means a municipality or defined geographic area in which no fewer than 5,000 Medicaid recipients reside.

"Disproportionate share hospital" means a hospital designated by the Commissioner of Human Services pursuant to Pub.L.89-87 (42 U.S.C. s.1396a et seq.) and Pub.L.102-234.

"Medicaid" means the Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.).

"Medicaid ACO Demonstration Project" or "demonstration project" means the demonstration project established pursuant to [this act] P.L.2011, c.114 (C.30:4D-8.1 et seq.).

"Primary care provider" includes the following licensed individuals: physicians, physician [assistants] associates, advanced practice nurses, and nurse midwives whose professional practice involves the provision of primary care, including internal medicine, family medicine, geriatric care, pediatric care, or obstetrical/gynecological care.

"Qualified behavioral health care provider" means a behavioral health care provider who participates in the Medicaid program and renders clinic-based and home-based services to individuals residing in the designated area served by the Medicaid ACO.

"Qualified primary care provider" means a primary care provider who participates in the Medicaid program and who spends at least 25% of his professional time or 10 hours per seven-day week, whichever is less, rendering clinical or clinical supervision services at an office or clinic setting located within the designated area served by a Medicaid ACO.

(cf: P.L.2011, c.114, s.2)

37. Section 3 of P.L.2003, c.214 (C.30:9A-24) is amended to read as follows:

3. a. Any teaching staff member, who, as a result of information obtained in the course of the person's employment, has reasonable cause to suspect or believe that a student has attempted or completed suicide, shall promptly report such information to the division in a form and manner prescribed by the division.

b. A nonpublic school is encouraged to require any member of its professional staff, who, as a result of information obtained in the course of the person's employment, has reasonable cause to suspect or believe that a student has attempted or completed suicide, to promptly report such information to the division in a form and manner prescribed by the division.

As used in this subsection, "nonpublic school" means an elementary or secondary school within the State, other than a public school, offering education in grades K-12 or any combination thereof, at which a child may legally fulfill compulsory school attendance requirements.

c. Any licensed psychologist, social worker, marriage and family therapist, professional counselor, physician, physician [assistant] associate, alcohol and drug counselor, or registered nurse or licensed practical nurse licensed in this State pursuant to Title 45 of the Revised Statutes, who, as a result of information obtained in the course of the person's employment, has reasonable cause to suspect or believe that a youth has attempted or completed suicide, shall promptly report such information to the division in a form and manner prescribed by the division.

d. Any public health official, probation officer, employee of the Superior Court, Chancery Division, Family Part, Certified Domestic Violence Specialist, or member of a professional group identified by the council as having a likelihood to know about suicide attempts and deaths, who, as a result of information obtained in the course of the person's employment, has reasonable cause to suspect or believe that a youth has attempted or completed suicide, is encouraged to promptly report such information to the division in a form and manner prescribed by the division.

e. The reporting form established by the division shall not require the reporter to identify the student or youth by name or other unique identifier, but may require that the reporter supply non-identifying demographic information about the student or youth, other attempts made by the student or youth and the response or referral made to deal with the incident.

f. The reporting form shall be submitted to a designated employee of the division with responsibility for compiling data from the reports. Information contained in the reports shall not be considered a public record, but the division may aggregate the data for the purpose of preparing an annual report pursuant to section 6 of [this act] P.L.2003, c.214 (C.30:9A-22 et seq.).

g. The division shall offer to provide persons who are required or encouraged to report an attempted or completed suicide with current information about public and private assistance available to survivors and families of attempted and completed suicides and professionals who deal with suicide.

h. The reporting of an attempted or completed suicide pursuant to this section shall not replace or alter any other requirement of law or professional standard or obligation that requires a person to evaluate a death or report an attempted or completed suicide.

i. Any person who reports an attempted or completed suicide pursuant to [this act] P.L.2003, c.214 (C.30:9A-22 et seq.) shall have immunity from any civil or criminal liability on account of that report, unless the person has acted in bad faith or with malicious purpose.

j. No provision of [this act] P.L.2003, c.214 (C.30:9A-22 et seq.) shall be deemed to require the disclosure of, or penalize the failure to disclose, any information which would be privileged pursuant to the provisions of sections 18 through 23, inclusive, of P.L.1960, c.52 (C.2A:84A-18 through 2A:84A-23).

(cf: P.L.2003, c.214, s.3)

38. Section 1 of P.L.1949, c.280 (C.39:4-204) is amended to read as follows:

1. The phrase "person with a disability" means:

a. any person who has lost the use of one or more limbs as a consequence of paralysis, amputation, or other permanent disability or who has a permanent disability as to be unable to ambulate without the aid of an assisting device or whose mobility is otherwise limited as certified by a physician with a plenary license to practice medicine and surgery in this State or a bordering State; a podiatrist licensed to practice in this State or a bordering state; a physician stationed at a military or naval installation located in this State who is licensed to practice in any state; a chiropractic physician licensed to practice in this State or a bordering state; a physician [assistant] associate licensed to practice in this State or a bordering state; or a nurse practitioner licensed to practice in this State or a bordering state ; or

b. any citizen and resident of this State honorably discharged or released under honorable circumstances from active service in any branch of the Armed Forces of the United States who is adjudicated by the United States Department of Veterans Affairs, or its successor, as being permanently 100 percent disabled.

(cf: P.L.2017, c.166, s.1)

39. Section 2 of P.L.1949, c.280 (C.39:4-205) is amended to read as follows:

2. The Chief Administrator of the New Jersey Motor Vehicle Commission shall issue, at the expense of the State of New Jersey, person with a disability identification cards upon the application of qualifying persons with disabilities and after an investigation of the qualifying status of each applicant. The card shall, amongst other things, identify the persons with disabilities and the registration number of the vehicle for which any wheelchair symbol license plates have been issued under the provisions of section 3 of P.L.1949, c.280 (C.39:4-206) and shall state that he is a person with a disability validly qualified to receive a card, that the card is for the exclusive use of the person to whom it has been duly issued, is nontransferable and will be forfeited if presented by any other person, and that any abuse of any privilege, benefit, precedence, or consideration granted to any person to whom the card may be issued will be sufficient cause for revocation of the card, corresponding windshield placard and wheelchair symbol license plates, and the same may be forfeited or revoked accordingly, and in the absence of forfeiture or revocation the card shall be valid until the last day of the 36th calendar month following the calendar month in which that card was issued.

Every application for the issuance or renewal of a person with a disability identification card shall contain a statement signed by a physician, podiatrist, chiropractic physician, physician [assistant] associate, or nurse practitioner licensed to practice in this State or a bordering state or a physician stationed at a military or naval installation located in this State who is licensed to practice in any state, certifying that the applicant's stated disability qualifies the applicant to meet the definition of "person with a disability" pursuant to section 1 of P.L.1949, c.280 (C.39:4-204).

A person who qualifies as a veteran with a permanent disability pursuant to subsection b. of section 1 of P.L.1949, c.280 (C.39:4-204) may submit, in lieu of a statement signed by a certified medical professional, an application that contains a statement signed by a representative of the United States Department of Veterans Affairs certifying that the person is permanently 100 percent disabled. A person who qualifies as a veteran with a 100 percent disability shall not be required to resubmit the statement issued by a representative of the United States Department of Veteran Affairs if the Chief Administrator has previously scanned and retained the statement, and the statement is legible and accessible at the time of renewal. The Chief Administrator may request an additional statement if the Chief Administrator is advised that there has been a change in the person's status as a veteran with a 100 percent disability.

In order to be approved, the application for a person with a disability identification card shall be submitted to the commission not more than 60 days following the date upon which a physician, podiatrist, chiropractic physician, physician [assistant] associate, nurse practitioner, or representative of the United States Department of Veterans Affairs certifies that the applicant meets the definition of "person with a disability" pursuant to section 1 of P.L.1949, c.280 (C.39:4-204). The application shall also include any additional information pertinent to the certification which the chief administrator, in the chief administrator's discretion, may require, including, but not limited to, the National Provider Identifier or state-issued licensing number of the physician, podiatrist, chiropractic physician, physician [assistant] associate, or nurse practitioner who certifies the applicant's eligibility for a person with a disability identification card.

(cf: P.L.2023, c.40, s.1)

40. Section 3 of P.L.1949, c.280 (C.39:4-206) is amended to read as follows:

3. The chief administrator shall issue to such applicant, also, a placard of such size and design as shall be determined by the chief administrator in consultation with the Division of Vocational Rehabilitation Services in the Department of Labor and Workforce Development and the Division of Disability Services in the Department of Human Services, indicating that a person with a disability identification card has been issued to the person designated therein, which shall be displayed in such manner as the chief administrator shall determine on the motor vehicle used to transport the person with a disability, when the vehicle is parked overtime or in special parking places established for use by persons with disabilities. If issued in conjunction with a person with a disability identification card pursuant to section 2 of P.L.1949, c.280 (C.39:4-205), the placard issued pursuant to this paragraph shall be valid until the last day of the 36th calendar month following the calendar month in which such placard was issued. If the placard is issued following the date on which the chief administrator issued the applicant a person with a disability identification card pursuant to section 2 of P.L.1949, c.280 (C.39:4-205), then that placard shall be valid up until the date on which the person with a disability identification card is deemed invalid. Any placard issued by the chief administrator shall display, in a clearly visible manner, the date on which it shall become invalid. The placard may be renewed upon application in accordance with the requirements of this chapter.

Any placard issued prior to the effective date of P.L.2013, c.3 shall be deemed invalid on the last day of the 36th calendar month following the calendar month in which such effective date occurs. The chief administrator may recall any placard deemed invalid pursuant to this section.

Notwithstanding any provision of P.L.1949, c.280 (C.39:4-204 et seq.) to the contrary, the chief of police of each municipality in this State shall issue a temporary placard of not more than six months' duration to any person who has temporarily lost the use of one or more limbs or has a temporary disability as to be unable to ambulate without the aid of an assisting device or whose mobility is otherwise temporarily limited, as certified by a physician with a plenary license to practice medicine and surgery in this State or a bordering State; a podiatrist licensed to practice in this State or a bordering state; a physician stationed at a military or naval installation located in this State who is licensed to practice in any state; a chiropractic physician licensed to practice in this State or a bordering state; a physician [assistant] associate licensed to practice in this State or a bordering state; or a nurse practitioner licensed to practice in this State or a bordering state. Each temporary placard issued under the provisions of this section shall display, in a clearly visible manner, the date on which it shall become invalid.

The temporary placard shall be granted upon written certification by a physician with a plenary license to practice medicine and surgery in this State or a bordering State; a podiatrist licensed to practice in this State or a bordering state; a physician stationed at a military or naval installation located in this State who is licensed to practice in any state; a chiropractic physician licensed to practice in this State or a bordering state, a physician [assistant] associate licensed to practice in this State or a bordering state; or a nurse practitioner licensed to practice in this State or a bordering state that the person meets the conditions constituting temporary disability as provided in this section. This certification shall be provided on a standard form to be developed by the chief administrator in consultation with local chiefs of police and representatives of persons with disabilities. The form shall contain only those conditions constituting temporary disability as are provided in this section. The physical presence of the person with a disability shall not be required for the issuance of a temporary placard.

The temporary placard may be renewed one time at the discretion of the issuing authority for a period of not more than six months' duration. The placard shall be displayed on the motor vehicle used by the person with a temporary disability and shall give the person the right to park overtime or to use special parking places established for use by persons with disabilities in any municipality of this State.

The fee for the issuance of a temporary placard issued pursuant to this section shall be $4[.00] and payable to the New Jersey Motor Vehicle Commission. No fee shall be charged for the issuance of a permanent placard issued pursuant to this section.

The chief administrator may, in addition, issue license plates bearing the national wheelchair symbol for:

a. Not more than two motor vehicles owned, operated or leased by a person with a disability or by any person furnishing transportation on his behalf; or

b. Any two motorcycles owned, operated or leased by a person with a disability.

(cf: P.L.2013, c.3, s.3)

41. Section 1 of P.L.2021, c.17 (C.40:48J-1) is amended to read as follows:

1. a. (1) The owner of property used as a hospital or a satellite emergency care facility, which is exempt from taxation pursuant to section 3 of P.L.2021, c.17 (C.54:4-3.6j), shall annually be assessed a community service contribution to the municipality in which the licensed beds of the hospital are located and, in the case of a satellite emergency care facility, to the municipality in which such facility is located. These contributions shall be remitted directly to the municipalities in which the contributions are assessed.

(2) If a hospital and municipality have entered into a voluntary agreement prior to the enactment of P.L.2021, c.17 (C.40:48J-1 et al.), the hospital shall be required to pay the greater of the community service contribution required under paragraph (1) of subsection b. of this section, or the amount agreed upon in a voluntary agreement for the duration of the agreement between the municipality and the hospital.

(3) Nothing in this section shall be construed to prohibit a municipality and a hospital from entering into a voluntary agreement requiring additional payments by the hospital to the municipality pursuant to this section.

b. (1) For tax year 2021, the annual community service contribution required pursuant to this section shall, for a hospital, be equal to $3 a day for each licensed bed at the hospital in the prior tax year, and shall, for a satellite emergency care facility, be equal to $300 for each day in the prior tax year. For tax year 2022 and each tax year thereafter, the per day amount used to calculate an annual community service contribution for a hospital and a satellite emergency care facility shall increase by two percent over the prior tax year. The Commissioner of Health shall annually promulgate the per day amount to apply for each tax year. For the purposes of this subsection, the number of licensed beds per hospital shall not be less than the number of such beds in existence on January 1, 2020.

(2) An annual community service contribution shall be reduced by an amount equal to the sum of any payments remitted to the municipality in which the licensed beds of the hospital or satellite emergency care facility, as the case may be, is located, pursuant to a voluntary agreement operative in the prior tax year between the owner and the municipality to compensate for any municipal services benefitting the occupants and premises of the hospital or satellite emergency care facility.

(3) An annual community service contribution shall be payable in equal quarterly installments. The installments shall be payable on February 1, May 1, August 1, and November 1.

c. The obligation to remit an annual community service contribution pursuant to this section is legal, valid, and binding. If a quarterly installment of an annual community service contribution installment is not paid as and when due pursuant to subsection b. of this section, the unpaid balance shall constitute a municipal lien on the hospital or satellite emergency care facility property after 30 days, and shall be enforced and collected in the same manner as unpaid property taxes.

d. A municipality that receives an annual community service contribution installment pursuant to this section, or a payment under a voluntary agreement that reduces the amount of such contribution pursuant to paragraph (2) of subsection b. of this section, shall forthwith, upon receipt, remit five percent of the installment or voluntary payment, as the case may be, to the county in which the municipality is located.

e. The Commissioner of Health, in consultation with the New Jersey Health Care Facilities Financing Authority in the Department of Health and the Director of the Division of Local Government Services in the Department of Community Affairs, shall, by the first day of the fourth month next following the enactment of P.L.2021, c.17 (C.40:48J-1 et al.), adopt regulations necessary to effectuate the provisions of this section pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.).

f. Notwithstanding any other provision of this section to the contrary, an owner of property used as a hospital shall be exempt from remitting an annual community service contribution for the hospital if the owner certifies to the Department of Health that, in the prior year, the hospital did not bill any patient for inpatient or outpatient professional or technical services rendered at the hospital and the hospital has provided community benefit over the preceding three years for which the hospital has filed such forms averaging at least 12 percent of the hospital's total expenses, as documented on IRS Form 990, Schedule H, part 1, line 7K, column F. The hospital shall file a copy of the documentation as enumerated in this subsection with the municipal tax assessor on or before December 1 of the pre-tax year. Upon receipt of a copy of the documentation, the tax assessor shall notify the hospital, on or before December 31, that it is exempt from payment of the community service contribution for the tax year commencing January 1.

g. As used in this section:

"Hospital" means a general acute care hospital licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.), which maintains and operates organized facilities and services as approved and licensed by the Department of Health for the diagnosis, treatment, or care of persons suffering from acute illness, injury, or deformity and in which all diagnosis, treatment, and care are administered by or performed under the direction of persons licensed to practice medicine or osteopathy in the State, and includes all land and buildings that are used in the delivery of health care services by such hospital and its medical providers or that are used for the management, maintenance, administration, support, and security of such hospital and its medical providers. "Hospital" shall not include a hospital owned or operated by a federal, State, regional, or local government entity, directly or as an instrumentality thereof.

"Licensed bed" means one of the total number of acute care beds for which an acute care hospital is approved for patient care by the Commissioner of Health, excluding skilled nursing, psychiatric, sub-acute, and newborn beds, and further excluding any acute care beds not commissioned for use.

"Medical provider" means an individual or entity which, acting within the scope of a licensure or certification, provides health care services, and includes, but is not limited to, a physician, physician [assistant] associate, psychologist, pharmacist, dentist, nurse, nurse practitioner, social worker, paramedic, respiratory care practitioner, medical or laboratory technician, ambulance or emergency medical worker, orthotist or prosthetist, radiological or other diagnostic service facility, bioanalytical laboratory, health care facility, or other limited licensed health care professional, and further includes administrative support staff of the individual or entity.

"Owner" means an association or corporation organized as a nonprofit entity pursuant to Title 15 of the Revised Statutes or Title 15A of the New Jersey Statutes exclusively for hospital purposes that owns a hospital.

"Satellite emergency care facility" means a facility, which is owned and operated by a hospital, and which provides emergency care and treatment for patients.

"Voluntary agreement" means any payment in lieu of taxes agreement or other agreement entered into between the owner of the property and the municipality for the purpose of compensating the municipality for any municipal services the municipality provides to the hospital.

(cf: P.L.2021, c.17, s.1)

42. Section 2 of P.L.1978, c.73 (C.45:1-15) is amended to read as follows:

2. The provisions of [this act] P.L.1978, c.73 (C.45:1-14 et seq.) shall apply to the following boards and all professions or occupations regulated by, through or with the advice of those boards: the New Jersey State Board of Accountancy, the New Jersey State Board of Architects, the New Jersey State Board of Cosmetology and Hairstyling, the Board of Examiners of Electrical Contractors, the New Jersey State Board of Dentistry, the State Board of Mortuary Science of New Jersey, the State Board of Professional Engineers and Land Surveyors, the State Board of Marriage and Family Therapy Examiners, the State Board of Medical Examiners, the New Jersey Board of Nursing, the New Jersey State Board of Optometrists, the State Board of Examiners of Ophthalmic Dispensers and Ophthalmic Technicians, the Board of Pharmacy, the State Board of Professional Planners, the State Board of Psychological Examiners, the State Board of Examiners of Master Plumbers, the State Board of Court Reporting, the State Board of Veterinary Medical Examiners, the State Board of Chiropractic Examiners, the State Board of Respiratory Care, the State Real Estate Appraiser Board, the State Board of Social Work Examiners, the State Board of Examiners of Heating, Ventilating, Air Conditioning and Refrigeration Contractors, the Elevator, Escalator, and Moving Walkway Mechanics Licensing Board, the State Board of Physical Therapy Examiners, the State Board of Polysomnography, the Professional Counselor Examiners Committee, the New Jersey Cemetery Board, the Orthotics and Prosthetics Board of Examiners, the Occupational Therapy Advisory Council, the Electrologists Advisory Committee, the Acupuncture Advisory Committee, the Alcohol and Drug Counselor Committee, the Athletic Training Advisory Committee, the Certified Psychoanalysts Advisory Committee, the Fire Alarm, Burglar Alarm, and Locksmith Advisory Committee, the Home Inspection Advisory Committee, the Interior Design Examination and Evaluation Committee, the Hearing Aid Dispensers Examining Committee, the Perfusionists Advisory Committee, the Physician [Assistant] Associate Advisory Committee, the Audiology and Speech-Language Pathology Advisory Committee, the New Jersey Board of Massage and Bodywork Therapy, the Genetic Counseling Advisory Committee, the State Board of Dietetics and Nutrition, and any other entity hereafter created under Title 45 to license or otherwise regulate a profession or occupation.

(cf: P.L.2019, c.331, s.18)

43. Section 24 of P.L.2007, c.244 (C.45:1-44) is amended to read as follows:

24. Definitions. As used in sections 25 through 30 of P.L.2007, c.244 (C.45:1-45 through C.45:1-50):

"CDS registration" means registration with the Division of Consumer Affairs to manufacture, distribute, dispense, or conduct research with controlled dangerous substances issued pursuant to section 11 of P.L.1970, c.226 (C.24:21-11).

"Certified medical assistant" means a person who is a graduate of a post-secondary medical assisting educational program accredited by the Commission on Allied Health Education and Accreditation (CAHEA), or its successor, the Accrediting Bureau of Health Education Schools (ABHES), or its successor, or any accrediting agency recognized by the U.S. Department of Education, which educational program includes, at a minimum, 330 clock hours of instruction, and encompasses training in the administration of intramuscular and subcutaneous injections, as well as instruction and demonstration in: pertinent anatomy and physiology appropriate to injection procedures; choice of equipment; proper technique, including sterile technique; hazards and complications; and emergency procedures; and who maintains current certification or registration, as appropriate, from the Certifying Board of the American Association of Medical Assistants (AAMA), the National Center for Competency Testing (NCCT), the National Healthcareer Association (NHA), the American Medical Certification Association (AMCA), the National Association for Health Professionals (NAHP), the National Certification Medical Association (NCMA), the American Medical Technologists (AMT), or any other recognized certifying body approved by the State Board of Medical Examiners.

"Controlled dangerous substance" means any substance that is listed in Schedules II, III, and IV of the schedules provided under the "New Jersey Controlled Dangerous Substances Act," P.L.1970, c.226 (C.24:21-1 et seq.). Controlled dangerous substance also means any substance that is listed in Schedule V under the "New Jersey Controlled Dangerous Substances Act" when the director has determined that reporting Schedule V substances is required by federal law, regulation, or funding eligibility.

"Dental resident" means a person who practices dentistry as a resident pursuant to R.S.45:6-20 and, pursuant to N.J.A.C.13:30-1.3, is a graduate of a dental school approved by the Commission on Dental Accreditation and has passed Part I and Part II of the National Board Dental examination and obtained a resident permit from the New Jersey Board of Dentistry.

"Director" means the Director of the Division of Consumer Affairs in the Department of Law and Public Safety.

"Division" means the Division of Consumer Affairs in the Department of Law and Public Safety.

"Licensed athletic trainer" means an individual who is licensed by the State Board of Medical Examiners to practice athletic training, pursuant to the "Athletic Training Licensure Act," P.L.1984, c.203 (C.45:9-37.35 et seq.).

"Licensed health care professional" means a registered nurse, licensed practical nurse, advanced practice nurse, physician [assistant] associate, or dental hygienist licensed pursuant to Title 45 of the Revised Statutes.

"Licensed pharmacist" means a pharmacist licensed pursuant to P.L.2003, c.280 (C.45:14-40 et seq.).

"Medical resident" means a graduate physician who is authorized to practice medicine and surgery by means of a valid permit issued by the State Board of Medical Examiners to a person authorized to engage in the practice of medicine and surgery while in the second year or beyond of a graduate medical education program pursuant to N.J.A.C.13:35-1.5.

"Medical scribe" means an individual trained in medical documentation who assists a physician or other licensed health care professional by documenting the patient's encounter with the professional in the patient's medical record and gathering data for the professional, including, but not limited to, nursing notes, patient medical records, laboratory work, and radiology tests.

"Mental health practitioner" means a clinical social worker, marriage and family therapist, alcohol and drug counselor, professional counselor, psychologist, or psychoanalyst licensed or otherwise authorized to practice pursuant to Title 45 of the Revised Statutes.

"Pharmacy permit holder" means an individual or business entity that holds a permit to operate a pharmacy practice site pursuant to P.L.2003, c.280 (C.45:14-40 et seq.).

"Practitioner" means an individual currently licensed, registered, or otherwise authorized by this State or another state to prescribe drugs in the course of professional practice.

"Registered dental assistant" is a person who has fulfilled the requirements for registration established by "The Dental Auxiliaries Act," P.L.1979, c.46 (C.45:6-48 et al.) and works under the direct supervision of a licensed dentist.

"Ultimate user" means a person who has obtained from a dispenser and possesses for the person's own use, or for the use of a member of the person's household or an animal owned by the person or by a member of the person's household, a controlled dangerous substance.

(cf: P.L.2017, c.341, s.2)

44. Section 2 of P.L.2019, c.339 (C.45:1-53.1) is amended to read as follows:

2. a. Any pharmacist or other health care professional who is charged with an offense in violation of section 1 of P.L.2019, c.339 (C.2C:35-11.1) shall promptly notify the applicable licensing board of the pending charge. Failure to provide the prompt notice required by this subsection shall be deemed grounds for disciplinary action by the applicable licensing board.

b. Upon conviction of an offense in violation of section 1 of P.L.2019, c.339 (C.2C:35-11.1)), the CDS registration of the pharmacist or other health care professional shall be revoked for a period of not less than five years and that professional's certification or license shall be revoked by the applicable licensing board based solely upon the fact of the conviction, for a period of time to be determined by that board.

c. Pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), a licensing or certifying board, specified in section 2 of P.L.1978, c.73 (C.45:1-15), or other licensing or certifying authority that has jurisdiction over health care professionals pursuant to Title 45 of the Revised Statutes, may adopt rules and regulations to effectuate the provisions of P.L.2019, c.339 (C.2C:35-11.1 et al.).

d. As used in this section:

"Health care professional" means a professional licensed pursuant to Title 45 of the Revised Statutes to provide a health care service to a patient including, but not limited to: a licensed physician, advanced practice nurse, nurse, pharmacist, psychologist, psychiatrist, psychoanalyst, clinical social worker, physician [assistant] associate, professional counselor, dentist, orthotist, prosthetist, respiratory therapist, speech pathologist, audiologist, optometrist, veterinarian, or any other health care professional acting within the scope of a valid license or certification issued pursuant to Title 45 of the Revised Statutes.

"Pharmacist" means a pharmacist licensed pursuant to P.L.2003, c.280 (C.45:14-40 et seq.).

(cf: P.L.2019, c.339, s.2)

45. Section 3 of P.L.2017, c.69 (C.45:1-58) is amended to read as follows:

3. As used in [this act] P.L.2017, c.69 (C.45:1-56 et seq.):

"Animal or veterinary facility" means an animal or veterinary facility as defined in section 1 of P.L.1983, c.98 (C.45:16-1.1).

"Antineoplastic" means inhibiting or preventing the growth and spread of tumors or malignant cells.

"Hazardous drugs" means drugs that exhibit one or more of the following characteristics in humans or animals: carcinogenicity; teratogenicity or other developmental toxicity; reproductive toxicity; organ toxicity at low doses; genotoxicity; or structure and toxicity profiles that mimic existing hazardous drugs. This term includes, but is not limited to, antineoplastic drugs.

"Health care facility" means a general acute care hospital, satellite emergency department, hospital-based off-site ambulatory care facility in which ambulatory surgical procedures are performed, or ambulatory surgical facility licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).

"Health care professional" means a physician, physician [assistant] associate, advanced practice nurse, registered nurse, licensed practical nurse, pharmacist, or veterinarian licensed or certified pursuant to Title 45 of the Revised Statutes. "Health care professional" shall not include a licensed dentist or dental hygienist.

"Pharmacy practice site" means a pharmacy practice site licensed pursuant to P.L.2003, c.280 (C.45:14-40 et seq.).

"Stakeholder group" means a group of stakeholders in the areas of health care and workplace safety, which shall consist of: a representative of the Rutgers Cancer Institute of New Jersey; a representative of the New Jersey Hospital Association; a representative of the New Jersey Veterinary Medical Association; a representative of the Medical Society of New Jersey; a representative of the New Jersey State Society of Physician Assistants; practicing physicians from impacted specialties including, but not limited to, oncology; pharmacists; practicing advanced practice nurses, registered nurses, and licensed practical nurses, including at least one representative from the New Jersey Chapters of the Oncology Nursing Society; three representatives from organized labor unions representing health care personnel employed by health care professionals or employed in health care facilities, pharmacy practice sites, or animal or veterinary facilities, two of whom shall serve at the recommendation of the New Jersey State AFL-CIO; and other interested stakeholders.

(cf: P.L.2017, c.69, s.3)

46. Section 1 of P.L.2017, c.117 (C.45:1-61) is amended to read as follows:

1. As used in P.L.2017, c.117 (C.45:1-61 et al.):

"Asynchronous store-and-forward" means the acquisition and transmission of images, diagnostics, data, and medical information either to, or from, an originating site or to, or from, the health care provider at a distant site, which allows for the patient to be evaluated without being physically present.

"Cross-coverage service provider" means a health care provider, acting within the scope of a valid license or certification issued pursuant to Title 45 of the Revised Statutes, who engages in a remote medical evaluation of a patient, without in-person contact, at the request of another health care provider who has established a proper provider-patient relationship with the patient.

"Distant site" means a site at which a health care provider, acting within the scope of a valid license or certification issued pursuant to Title 45 of the Revised Statutes, is located while providing health care services by means of telemedicine or telehealth.

"Health care provider" means an individual who provides a health care service to a patient, and includes, but is not limited to, a licensed physician, nurse, nurse practitioner, psychologist, psychiatrist, psychoanalyst, clinical social worker, physician [assistant] associate, professional counselor, respiratory therapist, speech pathologist, audiologist, optometrist, or any other health care professional acting within the scope of a valid license or certification issued pursuant to Title 45 of the Revised Statutes.

"On-call provider" means a licensed or certified health care provider who is available, where necessary, to physically attend to the urgent and follow-up needs of a patient for whom the provider has temporarily assumed responsibility, as designated by the patient's primary care provider or other health care provider of record.

"Originating site" means a site at which a patient is located at the time that health care services are provided to the patient by means of telemedicine or telehealth.

"Telehealth" means the use of information and communications technologies, including telephones, remote patient monitoring devices, or other electronic means, to support clinical health care, provider consultation, patient and professional health-related education, public health, health administration, and other services in accordance with the provisions of P.L.2017, c.117 (C.45:1-61 et al.).

"Telemedicine" means the delivery of a health care service using electronic communications, information technology, or other electronic or technological means to bridge the gap between a health care provider who is located at a distant site and a patient who is located at an originating site, either with or without the assistance of an intervening health care provider, and in accordance with the provisions of P.L.2017, c.117 (C.45:1-61 et al.). "Telemedicine" does not include the use, in isolation, of electronic mail, instant messaging, phone text, or facsimile transmission.

"Telemedicine or telehealth organization" means a corporation, sole proprietorship, partnership, or limited liability company that is organized for the primary purpose of administering services in the furtherance of telemedicine or telehealth.

(cf: P.L.2021, c.310, s.3)

47. Section 3 of P.L.2020, c.133 (C.45:1-69) is amended to read as follows:

3. As used in [this act] P.L.2020, c.133 (C.45:1-67 et seq.):

"Advertisement" means any communication or statement that is directly controlled or administered by a health care professional or a health care professional's office personnel, whether printed, electronic or oral, that names the health care professional in relation to his or her practice, profession, or institution in which the individual is employed, volunteers or otherwise provides health care services. This includes business cards, letterhead, patient brochures, e-mail, Internet, audio and video, and any other communication or statement used in the course of business or where the health care professional is utilizing a professional degree or license to influence opinion or infer expertise in a health care topic. "Advertisement" does not include office building placards or exterior building signage.

"Health care professional" means a person licensed, certified, registered or otherwise authorized pursuant to Title 45 or Title 52 of the Revised Statutes, or by any principal department of the Executive Branch of State government or any entity within any department or any other entity hereafter created to license or otherwise regulate a health care profession. "Health care professional" shall include, but shall not be limited to, health care professionals regulated by the following entities: the State Board of Medical Examiners, the New Jersey Board of Nursing, the New Jersey State Board of Dentistry, the New Jersey State Board of Optometrists, the Board of Pharmacy, the State Board of Chiropractic Examiners, the Acupuncture Examining Board, the State Board of Physical Therapy Examiners, the Orthotics and Prosthetics Board of Examiners, the State Board of Psychological Examiners, the State Board of Examiners of Ophthalmic Dispensers and Ophthalmic Technicians, the Audiology and Speech-Language Pathology Advisory Committee, the Occupational Therapy Advisory Council and the Certified Psychoanalysts Advisory Committee. "Health care professional" for purposes of [this act] P.L.2020, c.133 (C.45:1-57 et seq.) does not include individuals licensed in veterinarian medicine or health care professionals working in non-patient care settings, and who do not have any direct patient care interactions.

"Hospital" means an acute care general hospital licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).

"Licensee" means a health care professional with an active New Jersey license, certification, registration, or other valid authorization.

"Long-term care facility" means a nursing home, assisted living residence, comprehensive personal care home, residential health care facility, or dementia care home licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).

"Professional degree" means the academic degree conferred to a health care professional, including, but not limited to, "medical doctor" (M.D.); "doctor of osteopathy" (D.O.); "doctor of dental surgery" (D.D.S.); "doctor of medicine in dentistry" (D.M.D.); "doctor of podiatric medicine" (D.P.M.); "doctor of optometry" (O.D.); "doctor of chiropractic" (D.C.); and "doctor of nursing" (D.N.).

"Professional license" means the credential issued by the State to identify the profession practiced by a health care professional, including, but not limited to, "physician," "chiropractor," "advanced practice nurse," "dentist," "optometrist," "psychologist," "physician [assistant] associate," "acupuncturist," and "podiatrist."

(cf: P.L.2020, c.133, s.3)

48. Section 4 of P.L.2020, c.133 (C.45:1-70) is amended to read as follows:

4. a. An advertisement for health care services that includes the name of a health care professional shall identify the type of professional license and professional degree issued to the health care professional and shall not contain deceptive or misleading information, including, but not limited to, any affirmative communication or representation that misstates, falsely describes, holds out, or falsely details the health care professional's skills, training, expertise, education, public or private board certification, or licensure.

b. When providing in-person care, a health care professional shall communicate the professional licensure and professional degree held by the professional in the following formats:

(1) a name tag or embroidered identification to be worn during all patient encounters that is to include at a minimum:

(a) the full name of the health care professional; however, in a hospital, licensed ambulatory care facility or behavioral health care facility, or long-term care facility and at the discretion of facility administrators, either the health care professional's full first name and last name or the full first name and first letter of the last name;

(b) the professional license and professional degree issued to the health care professional; and

(c) a recent photograph of the health care professional if providing direct patient care at a hospital, unless otherwise directed by hospital administrators; and

(2) a poster or other signage, in font of a sufficient size, placed in a clear and conspicuous manner at the office or offices where the health care professional provides health care services to scheduled patients in an ambulatory setting, that states the type of professional license and professional degree held by the health care professional. For purposes of this subsection, "office" does not include in-patient hospital or emergency department patient care. This subsection shall not apply to telehealth or telemedicine services authorized under P.L.2017, c.117 (C.45:1-61 et al.).

c. A medical doctor or doctor of osteopathic medicine who supervises or participates in collaborative practice agreements with non-physician health care professionals, including, but not limited to, physician [assistants] associates and advance practice nurses, who provide in-person patient care at the same practice location shall be required to clearly and conspicuously post in each office when a medical doctor or doctor of osteopathic medicine is present. For purposes of this subsection, "office" does not include in-patient hospital or emergency department patient care.

d. A medical doctor or doctor of osteopathic medicine shall not advertise or hold oneself out to the public in any manner as being certified by a public or private board, including, but not limited to, a multidisciplinary board, or as "board certified" unless the board either:

(1) is a member of the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA); or

(2) is a non-ABMS or non-AOA board that requires as prerequisites for issuing certification:

(a) successful completion of a post-graduate training program approved by the Accreditation Council for Graduate Medical Education (ACGME) or the AOA that provides complete training in the specialty or subspecialty certified by the non-ABMS or non-AOA board;

(b) certification by an ABMS or AOA board covering that training field that provides complete ACGME- or AOA-accredited training in the specialty or subspecialty certified by the non-ABMS or non-AOA board; and

Any advertisement for a medical doctor or doctor of osteopathic medicine shall state the full name of the certification board.

e. The Division of Consumer Affairs in the Department of Law and Public Safety 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 subsections a. and b. of this section.

(cf: P.L.2020, c.133, s.4)

49. R.S.45:9-1 is amended to read as follows:

45:9-1. The State Board of Medical Examiners, hereinafter in this chapter designated as the "board" shall consist of 21 members, one of whom shall be the Commissioner of Health, or the commissioner's designee, three of whom shall be public members and one an executive department designee as required pursuant to section 2 of P.L.1971, c.60 (C.45:1-2.2), and 16 of whom shall be persons of recognized professional ability and honor, and shall possess a license to practice their respective professions in New Jersey, and all of whom shall be appointed by the Governor in accordance with the provisions of section 2 of P.L.1971, c.60 (C.45:1-2.2); provided, however, that said board shall consist of 12 graduates of schools of medicine or osteopathic medicine who shall possess the degree of M.D. or D.O. The number of osteopathic physicians on the board shall be a minimum of, but not limited to, two members. In addition the membership of said board shall comprise: one podiatric physician who does not possess a license to practice in any other health care profession regulated under Title 45 of the Revised Statutes; one physician [assistant] associate; one certified nurse midwife; and one licensed bio-analytical laboratory director, who may or may not be the holder of a degree of M.D. The term of office of members of the board hereafter appointed shall be three years or until their successors are appointed. A member is eligible for reappointment for one additional term of office, but no member shall serve more than two consecutive terms of office. Said appointees shall, within 30 days after receipt of their respective commissions, take and subscribe the oath or affirmation prescribed by law and file the same in the office of the Secretary of State.

(cf: P.L.2013, c.253, s.35)

50. R.S.45:9-21 is amended to read as follows:

45:9-21. The prohibitory provisions of this chapter shall not apply to the following:

a. A commissioned surgeon or physician of the regular United States Army, Navy, or Marine hospital service while so commissioned and actively engaged in the performance of his official duties. This exemption shall not apply to reserve officers of the United States Army, Navy or Marine Corps, or to any officer of the National Guard of any state or of the United States;

b. A lawfully qualified physician or surgeon of another state taking charge temporarily, on written permission of the board, of the practice of a lawfully qualified physician or surgeon of this State during his absence from the State, upon written request to the board for permission so to do. Before such permission is granted by the board and before any person may enter upon such practice he must submit proof that he can fulfill the requirements demanded in the other sections of this article relating to applicants for admission by examination or indorsement from another state. Such permission may be granted for a period of not less than two weeks nor more than four months upon payment of a fee of $50. The board in its discretion may extend such permission for further periods of two weeks to four months but not to exceed in the aggregate one year;

c. A physician or surgeon of another state of the United States and duly authorized under the laws thereof to practice medicine or surgery therein, if such practitioner does not open an office or place for the practice of his profession in this State;

d. A person while actually serving as a member of the resident medical staff of any legally incorporated charitable or municipal hospital or asylum approved by the board. Hereafter such exemption of any such resident physician shall not apply with respect to any individual after he shall have served as a resident physician for a total period of five years;

e. The practice of dentistry by any legally qualified and registered dentist;

f. The ministration to, or treatment of, the sick or suffering by prayer or spiritual means, whether gratuitously or for compensation, and without the use of any drug material remedy;

g. The practice of optometry by any legally qualified and registered optometrist;

h. The practice of podiatric medicine by any legally licensed podiatrist;

i. The practice of pharmacy by a legally licensed and registered pharmacist of this State, but this exception shall not be extended to give to said licensed pharmacist the right and authority to carry on the business of a dispensary, unless the dispensary shall be in charge of a legally licensed and registered physician and surgeon of this State;

j. A person claiming the right to practice medicine and surgery in this State who has been practicing therein since before July 4, 1890, if said right or title was obtained upon a duly registered diploma, of which the holder and applicant was the lawful possessor, issued by a legally chartered medical institution which, in the opinion of the board, was in good standing at the time the diploma was issued;

k. A professional nurse, or a registered physical therapist, masseur, while operating in each particular case under the specific direction of a regularly licensed physician or surgeon. This exemption shall not apply to such assistants of persons who are licensed as osteopaths, chiropractors, optometrists or other practitioners holding limited licenses;

l. A person while giving aid, assistance or relief in emergency or accident cases pending the arrival of a regularly licensed physician, or surgeon or under the direction thereof;

m. The operation of a bio-analytical laboratory by a licensed bio-analytical laboratory director, or any person working under the direct and constant supervision of a licensed bio-analytical laboratory director;

n. Any employee of a State or county institution holding the degree of M.D. or D.O., regularly employed on a salary basis on its medical staff or as a member of the teaching or scientific staff of a State agency, may apply to the State Board of Medical Examiners of New Jersey and may, in the discretion of said board, be granted exemption from the provisions of this chapter; provided said employee continues as a member of the medical staff of a State agency or county institution or of the teaching or scientific staff of a State agency and does not conduct any type of private medical practice;

o. The practice of chiropractic by any legally licensed chiropractor; or

p. The practice of a physician [assistant] associate in compliance with the provisions of P.L.1991, c.378 (C.45:9-27.10 et al.).

(cf: P.L.2005, c.259, s.16)

51. Section 1 of P.L.1991, c.378 (C.45:9-27.10) is amended to read as follows:

1. [This act] P.L.1991, c.378 (C.45:9-27.10 et al.) shall be known and may be cited as the "Physician [Assistant] Associate Licensing Act."

(cf: P.L.1991, c.378, s.1)

52. Section 2 of P.L.1991, c.378 (C.45:9-27.11) is amended to read as follows:

2. As used in [this act] P.L.1991, c.378 (C.45:9-27.10 et al.):

"Accredited program" means an education program for physician [assistants] associates which is accredited by the Accreditation Review Commission on Education for the Physician Assistant or its predecessor or successor agency.

"Board" means the State Board of Medical Examiners created pursuant to R.S.45:9-1.

"Committee" means the Physician [Assistant] Associate Advisory Committee established pursuant to section 11 of P.L.1991, c.378 (C.45:9-27.20).

"Director" means the Director of the Division of Consumer Affairs.

"Health care facility" means a health care facility as defined in section 2 of P.L.1971, c.136 (C.26:2H-2).

"Institution" means any of the charitable, hospital, relief and training institutions, noninstitutional agencies, and correctional institutions enumerated in R.S.30:1-7.

"Physician [assistant] associate" means a health professional who meets the qualifications under P.L.1991, c.378 (C.45:9-27.10 [et seq] et al.) and holds a current, valid license issued pursuant to section 4 of P.L.1991, c.378 (C.45:9-27.13).

"Physician" means a person licensed to practice medicine and surgery pursuant to chapter 9 of Title 45 of the Revised Statutes.

"Veterans' home" means the New Jersey Veterans' Memorial Home - Menlo Park, the New Jersey Veterans' Memorial Home - Vineland, and the New Jersey Veterans' Memorial Home - Paramus.

(cf: P.L.2015, c.224, s.1)

53. Section 3 of P.L.1991, c.378 (C.45:9-27.12) is amended to read as follows:

3. a. (1) No person shall practice as a physician [assistant] associate or present, call or represent himself as a physician [assistant] associate unless that person is licensed pursuant to section 4 of [this act] P.L.1991, c.378 (45:9-27.13).

(2) Nothing in [this act] P.L.1991, c.378 (C.45:9-27.10 et al.) shall be construed to limit, preclude, or otherwise interfere with the practice of any person licensed by an appropriate agency of the State of New Jersey, provided that such duties are consistent with the accepted standards of the person's profession and the person does not present himself as a physician [assistant] associate.

b. No person shall assume, represent himself as, or use the title or designation "physician [assistant] associate" or "physician [assistant] associate - certified" or the abbreviation "PA-C" or any other title or designation which indicates or implies that he is a physician [assistant] associate unless that person is licensed pursuant to section 4 of [this act] P.L.1991, c.378 (C.45:9-27.13).

(cf: P.L.1991, c.378, s.3)

54. Section 4 of P.L.1991, c.378 (C.45:9-27.13) is amended to read as follows:

4. a. The board shall issue a license as a physician [assistant] associate to an applicant who has fulfilled the following requirements:

(1) Is at least 18 years of age;

(2) Is of good moral character;

(3) Has successfully completed an accredited program; and

(4) Has passed the national certifying examination administered by the National Commission on Certification of Physician Assistants, or its successor.

b. In addition to the requirements of subsection a. of this section, an applicant for renewal of a license as a physician [assistant] associate shall:

(1) Execute and submit a sworn statement made on a form provided by the board that neither the license for which renewal is sought nor any similar license or other authority issued by another jurisdiction has been revoked or suspended; and

(2) Present satisfactory evidence that any continuing education requirements have been completed as required by P.L.1991, c.378 (C.45:9-27.10 et seq.).

c. The board, in consultation with the committee, may accept, in lieu of the requirements of subsection a. of this section, proof that an applicant for licensure holds a current license in a state which has standards substantially equivalent to those of this State.

d. (Deleted by amendment, P.L.2015, c.224)

e. A physician [assistant] associate who notifies the board in writing on forms prescribed by the board may elect to place the physician [assistant's] associate’s license on inactive status. A physician [assistant] associate with an inactive license shall not be subject to the payment of renewal fees and shall not practice as a physician [assistant] associate. A licensee who engages in practice while the physician [assistant's] associate’s license is lapsed or on inactive status shall be deemed to have engaged in professional misconduct in violation of subsection e. of section 8 of P.L.1978, c.73 (C.45:1-21) and shall be subject to disciplinary action by the committee pursuant to P.L.1978, c.73 (C.45:1-14 et seq.). A physician [assistant] associate requesting restoration from an inactive status shall be required to pay the current renewal fee and shall be required to meet the criteria for renewal as specified by the board.

(cf: P.L.2015, c.224, s.2)

55. Section 11 of P.L.2015, c.224 (C.45:9-27.13a) is amended to read as follows:

11. a. A physician [assistant] associate who engages in clinical practice in this State is required to be covered by medical malpractice liability insurance, or if such liability coverage is not available, by a letter of credit. The board shall establish by regulation the minimum amount for medical malpractice liability insurance coverage or lines of credit.

b. The physician [assistant] associate shall include, on the physician [assistant's] associate’s license renewal form, the name and address of the insurance carrier or the institution issuing the letter of credit to the physician [assistant] associate.

c. A physician [assistant] associate who is in violation of this section is subject to disciplinary action and civil penalties pursuant to sections 8, 9, and 12 of P.L.1978, c.73 (C.45:1-21 to 22 and 45:1-25).

d. The board shall notify all licensed physician [assistants] associates of the requirements of this section within 30 days of the date of enactment of P.L.2015, c.224 (C.45:9-27.13a et al.).

(cf: P.L.2015, c.224, s.11)

56. Section 6 of P.L.1991, c.378 (C.45:9-27.15) is amended to read as follows:

6. a. A physician [assistant] associate may practice in all medical care settings, including, but not limited to, a physician's office, a health care facility, an institution, a veterans' home, or a private home, provided that:

(1) the physician [assistant] associate performs medical services within the physician [assistant's] associate’s education, training, and experience under the supervision of a physician pursuant to section 9 of P.L.1991, c.378 (C.45:9-27.18);

(2) the practice of the physician [assistant] associate is limited to those procedures enumerated under section 7 of P.L.1991, c.378 (C.45:9-27.16), and any other procedures that are delegated to the physician [assistant] associate by the supervising physician, as authorized under subsection d. of section 7 of P.L.1991, c.378 (C.45:9-27.16);

(3) (Deleted by amendment, P.L.2015, c.224)

(4) the supervising physician or physician [assistant] associate advises the patient at the time that services are rendered that they are to be performed by the physician [assistant] associate;

(5) the physician [assistant] associate conspicuously wears an identification tag using the term "physician [assistant] associate" or the designation, "PA-C" or "PA" whenever acting in that capacity; and

(6) any entry by a physician [assistant] associate in a clinical record is appropriately signed and followed by the designation, "PA-C" or "PA."

b. Any physician [assistant] associate who practices in violation of any of the conditions specified in subsection a. of this section shall be deemed to have engaged in professional misconduct in violation of subsection e. of section 8 of P.L.1978, c.73 (C.45:1-21).

(cf: P.L.2015, c.224, s.3)

57. Section 7 of P.L.1991, c.378 (C.45:9-27.16) is amended to read as follows:

7. a. A physician [assistant] associate may perform the following procedures:

(1) Approaching a patient to elicit a detailed and accurate history, perform an appropriate physical examination, identify problems, record information, and interpret and present information to the supervising physician;

(2) Suturing and caring for wounds including removing sutures and clips and changing dressings, except for facial wounds, traumatic wounds requiring suturing in layers, and infected wounds;

(3) Providing patient counseling services and patient education consistent with directions of the supervising physician;

(4) Assisting a physician in an inpatient setting by conducting patient rounds, recording patient progress notes, determining and implementing therapeutic plans jointly with the supervising physician, and compiling and recording pertinent narrative case summaries;

(5) Assisting a physician in the delivery of services to patients requiring continuing care in a private home, nursing home, extended care facility, or other setting, including the review and monitoring of treatment and therapy plans; and

(6) Referring patients to, and promoting their awareness of, health care facilities and other appropriate agencies and resources in the community.

(7) (Deleted by amendment, P.L.2015, c.224)

b. A physician [assistant] associate may perform the following procedures only when directed, ordered, or prescribed by the supervising physician, or when performance of the procedure is delegated to the physician [assistant] associate by the supervising physician as authorized under subsection d. of this section:

(1) Performing non-invasive laboratory procedures and related studies or assisting duly licensed personnel in the performance of invasive laboratory procedures and related studies;

(2) Giving injections, administering medications, and requesting diagnostic studies;

(3) Suturing and caring for facial wounds, traumatic wounds requiring suturing in layers, and infected wounds;

(4) Writing prescriptions or ordering medications in an inpatient or outpatient setting in accordance with section 10 of P.L.1991, c.378 (C.45:9-27.19);

(5) Prescribing the use of patient restraints; and

(6) Authorizing qualifying patients for the medical use of cannabis and issuing written instructions for medical cannabis to registered qualifying patients pursuant to P.L.2009, c.307 (C.24:6I-1 et al.).

c. A physician [assistant] associate may assist a supervising surgeon in the operating room when a qualified assistant physician is not required by the board and a second assistant is deemed necessary by the supervising surgeon.

d. A physician [assistant] associate may perform medical services beyond those explicitly authorized in this section, when such services are delegated by a supervising physician with whom the physician [assistant] associate has signed a delegation agreement pursuant to section 8 of P.L.1991, c.378 (C.45:9-27.17). The procedures delegated to a physician [assistant] associate shall be limited to those customary to the supervising physician's specialty and within the supervising physician's and the physician [assistant's] associate’s competence and training.

e. Notwithstanding subsection d. of this section, a physician [assistant] associate shall not be authorized to measure the powers or range of human vision, determine the accommodation and refractive states of the human eye, or fit, prescribe, or adapt lenses, prisms, or frames for the aid thereof. Nothing in this subsection shall be construed to prohibit a physician [assistant] associate from performing a routine visual screening.

(cf: P.L.2019, c.153, s.45)

58. Section 8 of P.L.1991, c.378 (C.45:9-27.17) is amended to read as follows:

8. a. (Deleted by amendment, P.L.2015, c.224)

b. Any physician who permits a physician [assistant] associate under the physician's supervision to practice contrary to the provisions of P.L.1991, c.378 (C.45:9-27.10 et seq.) shall be deemed to have engaged in professional misconduct in violation of subsection e. of section 8 of P.L.1978, c.73 (C.45:1-21) and shall be subject to disciplinary action by the board pursuant to P.L.1978, c.73 (C.45:1-14 et seq.);

c. In the performance of all practice-related activities, including, but not limited to, the ordering of diagnostic, therapeutic, and other medical services, a physician [assistant] associate shall be conclusively presumed to be the agent of the physician under whose supervision the physician [assistant] associate is practicing.

d. A physician who supervises a physician [assistant] associate may maintain a written delegation agreement with the physician [assistant] associate. A physician [assistant] associate shall sign a separate written agreement with each physician who delegates medical services in accordance with the provisions of subsection d. of section 7 of P.L.1991, c.378 (C.45:9-27.16). However, a written delegation agreement may be executed by a single-specialty physician practice, provided it is signed by all of the delegating physicians supervising the physician [assistant] associate. In the case of a multi-specialty physician practice, a written delegation agreement may be executed for each physician specialty within the practice, provided it is signed by all of the delegating physicians supervising the physician [assistant] associate in that specialty area. Nothing in this section shall authorize the execution of a global written delegation agreement between a physician [assistant] associate and a multi-specialty physician practice. The agreement shall:

(1) state that the physician will exercise supervision over the physician [assistant] associate in accordance with the provisions of P.L.1991, c.378 (C.45:9-27.10 et seq.) and any rules adopted by the board;

(2) be signed and dated annually by the physician and the physician [assistant] associate, and updated as necessary to reflect any changes in the practice or the physician [assistant's] associate’s role in the practice; and

(3) be kept on file at the practice site, be provided to the Physician [Assistant] Associate Advisory Committee, and be kept on file by the committee.

e. The delegation agreement shall include, but need not be limited to, the following provisions:

(1) The physician [assistant's] associate’s role in the practice, including any specific aspects of care that require prior consultation with the supervising physician;

(2) A determination of whether the supervising physician requires personal review of all charts and records of patients and countersignature by the supervising physician of all medical services performed under the delegation agreement, including prescribing and administering medication as authorized under section 10 of P.L.1991, c.378 (C.45:9-27.19). This provision shall state the specified time period in which a review and countersignature shall be completed by the supervising physician. If no review and countersignature is necessary, the agreement must specifically state such provision; and

(3) The locations of practice where the physician [assistant] associate may practice under the delegation agreement, including licensed facilities in which the physician authorizes the physician [assistant] associate to provide medical services.

(cf: P.L.2015, c.224, s.5)

59. Section 9 of P.L.1991, c.378 (C.45:9-27.18) is amended to read as follows:

9. a. A physician [assistant] associate shall be under the supervision of a physician at all times during which the physician [assistant] associate is working in an official capacity.

b. Supervision of a physician [assistant] associate shall be continuous but shall not be construed as necessarily requiring the physical presence of the supervising physician, provided that the supervising physician and physician [assistant] associate maintain contact through electronic, or other means of, communication.

(1) (Deleted by amendment, P.L.2015, c.224)

(2) (Deleted by amendment, P.L.2015, c.224)

(3) (Deleted by amendment, P.L.2015, c.224)

c. (Deleted by amendment, P.L.2015, c.224)

(1) (Deleted by amendment, P.L.2015, c.224)

(2) (Deleted by amendment, P.L.2015, c.224)

(3) (Deleted by amendment, P.L.2015, c.224)

d. (Deleted by amendment, P.L.2015, c.224)

(1) (Deleted by amendment, P.L.2015, c.224)

(2) (Deleted by amendment, P.L.2015, c.224)

(3) (Deleted by amendment, P.L.2015, c.224)

e. It is the obligation of each supervising physician and physician [assistant] associate to ensure that: (1) the physician [assistant's] associate’s scope of practice is identified; (2) delegation of medical tasks is appropriate to the physician [assistant's] associate’s level of competence; (3) the relationship of, and access to, the supervising physician is defined; and (4) a process for evaluation of the physician [assistant's] associate’s performance is established.

(cf: (P.L.2015, c.224, s.6)

60. Section 12 of P.L.2015, c.224 (C.45:9-27.18a) is amended to read as follows:

12. a. A physician [assistant] associate licensed in this State, or licensed or authorized to practice in any other jurisdiction of the United States or credentialed as a physician [assistant] associate by a federal employer, who is responding to a need for medical care created by an emergency or a State or local disaster, excluding an emergency situation that occurs in the place of the physician [assistant's] associate’s employment, may render such care as the physician [assistant] associate is able to provide without supervision, or with such supervision as is available.

b. A physician who supervises a physician [assistant] associate providing medical care in response to an emergency or a State or local disaster shall not be required to meet the requirements set forth for a supervising physician in P.L.1991, c.378 (C.45:9-27.10 et seq.).

c. (1) A physician [assistant] associate licensed in this State, or licensed or authorized to practice in any other jurisdiction of the United States, who voluntarily and gratuitously, and other than in the ordinary course of employment or practice, renders emergency medical assistance, shall not be liable for civil damages for any personal injury that results from an act or omission by the physician [assistant] associate in rendering emergency care that may constitute ordinary negligence.

(2) A physician who supervises a physician [assistant] associate voluntarily and gratuitously providing emergency care as described in this subsection shall not be liable for civil damages for any personal injury that results from an act or omission by the physician [assistant] associate rendering emergency care.

d. The immunity granted under subsection c. of this section shall not apply to an act or omission constituting gross, willful, or wanton negligence or when the medical assistance is rendered at a hospital, physician's office, or other health care delivery entity where those services are normally rendered.

(cf: P.L.2015, c.224, s.12)

61. Section 10 of P.L.1991, c.378 (C.45:9-27.19) is amended to read as follows:

10. A physician [assistant] associate may order, prescribe, dispense, and administer medications and medical devices and issue written instructions to registered qualifying patients for medical cannabis to the extent delegated by a supervising physician.

a. Controlled dangerous substances may only be ordered or prescribed if:

(1) a supervising physician has authorized a physician [assistant] associate to order or prescribe Schedule II, III, IV, or V controlled dangerous substances in order to:

(a) continue or reissue an order or prescription for a controlled dangerous substance issued by the supervising physician;

(b) otherwise adjust the dosage of an order or prescription for a controlled dangerous substance originally ordered or prescribed by the supervising physician, provided there is prior consultation with the supervising physician;

(c) initiate an order or prescription for a controlled dangerous substance for a patient, provided there is prior consultation with the supervising physician if the order or prescription is not pursuant to subparagraph (d) of this paragraph; or

(d) initiate an order or prescription for a controlled dangerous substance as part of a treatment plan for a patient with a terminal illness, which for the purposes of this subparagraph means a medical condition that results in a patient's life expectancy being 12 months or less as determined by the supervising physician;

(2) the physician [assistant] associate has registered with, and obtained authorization to order or prescribe controlled dangerous substances from, the federal Drug Enforcement Administration and any other appropriate State and federal agencies; and

(3) the physician [assistant] associate complies with all requirements which the board shall establish by regulation for the ordering, prescription, or administration of controlled dangerous substances, all applicable educational program requirements, and continuing professional education programs approved pursuant to section 16 of P.L.1991, c.378 (C.45:9-27.25).

b. (Deleted by amendment, P.L.2015, c.224)

c. (Deleted by amendment, P.L.2015, c.224)

d. In the case of an order or prescription for a controlled dangerous substance or written instructions for medical cannabis, the physician [assistant] associate shall print on the order or prescription or the written instructions the physician [assistant's] associate’s Drug Enforcement Administration registration number.

e. The dispensing of medication or a medical device by a physician [assistant] associate shall comply with relevant federal and State regulations, and shall occur only if: (1) pharmacy services are not reasonably available; (2) it is in the best interest of the patient; or (3) the physician [assistant] associate is rendering emergency medical assistance.

f. A physician [assistant] associate may request, receive, and sign for prescription drug samples and may distribute those samples to patients.

g. A physician [assistant] associate may issue written instructions to a registered qualifying patient for medical cannabis pursuant to section 10 of P.L.2009, c.307 (C.24:6I-10) only if:

(1) a supervising physician has authorized the physician [assistant] associate to issue written instructions to registered qualifying patients;

(2) the physician [assistant] associate verifies the patient's status as a registered qualifying patient; and

(3) the physician [assistant] associate complies with the requirements for issuing written instructions for medical cannabis established pursuant to P.L.2009, c.307 (C.24:6I-1 et al.).

(cf: P.L.2019, c.153, s.46)

62. Section 12 of P.L.2017, c.341 (C.45:9-27.19b) is amended to read as follows:

12. a. Notwithstanding any other provision of law to the contrary, a physician [assistant] associate who is otherwise authorized to order, prescribe, and dispense controlled dangerous substances pursuant to P.L.1991, c.378 (C.45:9-27.10 et seq.) may dispense narcotic drugs for maintenance treatment or detoxification treatment if the physician [assistant] associate has met the training and registration requirements set forth in subsection (g) of 21 U.S.C. s.823. A physician [assistant] associate who is authorized to dispense such drugs may do so regardless of whether the physician [assistant's] associate’s supervising physician has met the training and registration requirements set forth in subsection (g) of 21 U.S.C. s.823, provided that the written delegation agreement between the supervising physician and the physician [assistant] associate executed pursuant to subsection d. of section 8 of P.L.1991, c.378 (C.45:9-27.17) included the supervising physician's written approval for the physician [assistant] associate to dispense the drugs.

b. Notwithstanding any other provision of law to the contrary, a physician [assistant] associate under the direct supervision of a licensed physician may make the determination as to the medical necessity for services for the treatment of substance use disorder, as provided in P.L.2017, c.28 (C.17:48-6nn et al.), and may prescribe such services.

(cf: P.L.2017, c.341, s.12)

63. Section 11 of P.L.1991, c.378 (C.45:9-27.20) is amended to read as follows:

11. There is created within the State Board of Medical Examiners, a Physician [Assistant] Associate Advisory Committee. The committee shall consist of five members who are residents of this State, one of whom shall be a public member and one of whom shall be a physician licensed pursuant to chapter 9 of Title 45 of the Revised Statutes. The remaining three members shall be, except for those first appointed, physician [assistants] associates licensed in accordance with the provisions of [this act] P.L.1991, c.378 (C.45:9-27.10 et al.). The physician [assistant] associate members first appointed to the committee need not be licensed in this State but shall be physician [assistants] associates certified by the National Commission on Certification of Physician Assistants or its successor.

The Governor shall appoint the members of the committee for a term of three years, except that of the members first appointed, two shall be appointed for a term of one year, two shall be appointed for a term of two years and one shall be appointed for a term of three years. Each member shall serve until his successor has been qualified. Any vacancy in the membership of the committee shall be filled for the unexpired term in the same manner as the original appointments were made. No member shall serve for more than two consecutive terms in addition to any unexpired term to which he has been appointed. The Governor may remove a member of the committee for cause.

Members of the committee shall be compensated and reimbursed for actual expenses reasonably incurred in the performance of their official duties in accordance with subsection a. of section 2 of P.L.1977, c.285 (C.45:1-2.5).

(cf: P.L.1992, c.102, s.6)

64. Section 14 of P.L.1991, c.378 (C.45:9-27.23) is amended to read as follows:

14. a. The committee may have the following powers and duties, as delegated by the board:

(1) to evaluate and pass upon the qualifications of candidates for licensure;

(2) to take disciplinary action, in accordance with P.L.1978, c.73 (C.45:1-14 et seq.), against a physician [assistant] associate who violates any provision of [this act] P.L.1991, c.378 (C.45:9-27.10 et al.); and

(3) (Deleted by amendment, P.L.2015, c.224)

(4) subject to the requirements of section 16 of P.L.1991, c.378 (C.45:9-27.25), to adopt standards for and approve continuing education programs.

b. In addition to the powers and duties specified in subsection a. of this section, the committee may make recommendations to the board regarding any subjects pertinent to this act or to the practice of physician [assistants] associates.

(cf: P.L.2015, c.224, s.9)

65. Section 16 of P.L.1991, c.378 (C.45:9-27.25) is amended to read as follows:

16. a. The board, or the committee if so delegated by the board, shall:

(1) approve only such continuing professional education programs as are available to all physician [assistants] associates in this State on a reasonable nondiscriminatory basis. Programs may be held within or without this State, but shall be held so as to enable physician [assistants] associates in all areas of the State to attend;

(2) establish standards for continuing professional education programs, including the specific subject matter and content of courses of study and the selection of instructors;

(3) accredit educational programs offering credits towards the continuing professional education requirements; and

(4) establish the number of credits of continuing professional education required of each applicant for license renewal. Each credit shall represent or be equivalent to one hour of actual course attendance, or in the case of those electing an alternative method of satisfying the requirements of [this act] P.L.1991, c.378 (C.45:9-27.10 et al.), shall be approved by the board and certified pursuant to procedures established for that purpose.

b. The board may, at its discretion:

(1) waive the requirements of paragraph (2) of subsection b. of section 4 of [this act] P.L.1991, c.378 (C.45:9-27.13) for due cause; and

(2) accredit courses with non-hourly attendance, including home study courses, with appropriate procedures for the issuance of credit upon satisfactory proof of the completion of such courses.

c. If any applicant for renewal of registration completes a number of credit hours in excess of the number established pursuant to paragraph (4) of subsection a. of this section, the excess credit may, at the discretion of the board, be applicable to the continuing education requirement for the following biennial renewal period but shall not be applicable thereafter.

(cf: P.L.1992, c.102, s.11)

66. Section 20 of P.L.2017, c.28 (C.45:9-27.25a) is amended to read as follows:

20. a. The State Board of Medical Examiners shall require that the number of credits of continuing medical education required of each person licensed as a physician [assistant] associate, as a condition of biennial renewal pursuant to section 4 of P.L.1991, c.378 (C.45:9-27.13), include one credit of educational programs or topics 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. The continuing medical education requirement in this subsection shall be subject to the provisions of section 16 of P.L.1991, c.378 (C.45:9-27.25), including, but not limited to, the authority of the board to waive the provisions of this section for a specific individual if the board deems it is appropriate to do so.

b. The State Board of Medical Examiners, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt such rules and regulations as are necessary to effectuate the purposes of this section.

(cf: P.L.2017, c.28, s.20)

67. Section 9 of P.L.2019, c.218 (C.45:9-27.25b) is amended to read as follows:

9. a. The State Board of Medical Examiners shall require that the number of credits of continuing medical education required of each person licensed as a physician [assistant] associate, as a condition of biennial renewal pursuant to section 4 of P.L.1991, c.378 (C.45:9-27.13), include two credits of educational programs on topics related to end-of-life care. The continuing medical education requirement in this subsection shall be subject to the provisions of section 16 of P.L.1991, c.378 (C.45:9-27.25), including, but not limited to, the authority of the board to waive the provisions of this section for a specific individual if the board deems it is appropriate to do so.

(cf: P.L.2019, c.218, s.9)

68. Section 3 of P.L.2021, c.79 (C.45:9-27.25c) is amended to read as follows:

3. The State Board of Medical Examiners shall require that the number of credits of continuing medical education required of each person licensed as a physician [assistant] associate who provides perinatal treatment and care to pregnant persons, as a condition of biennial renewal pursuant to section 4 of P.L.1991, c.378 (C.45:9-27.13), include one credit of educational programs or topics concerning explicit and implicit bias, which educational programs and topics shall meet the requirements for a training program set forth in subsection b. of section 1 of P.L.2021, c.79 (C.26:2H-12.108). The continuing medical education requirement in this subsection shall be subject to the provisions of section 16 of P.L.1991, c.378 (C.45:9-27.25).

(cf: P.L.2021, c.79, s.3)

69. Section 3 of P.L.1991, c.31 (C.45:14E-3) is amended to read as follows:

3. As used in this [act] chapter:

a. "Board" means the State Board of Respiratory Care established pursuant to section 4 of P.L.1991, c.31 (C.45:14E-4).

b. "Director" means the Director of the Division of Consumer Affairs in the Department of Law and Public Safety.

c. "Respiratory care" means the health specialty involving disease prevention, treatment, management, control, and care for patients with deficiencies and abnormalities of the cardiac and pulmonary system. The care shall include the use of medical gases, air and oxygen-administering apparatus, environmental control systems, humidification and aerosols, drugs and medications, apparatus for cardiopulmonary support and control, postural drainage, chest percussion and vibration and breathing exercise, pulmonary rehabilitation, performance of cardiopulmonary resuscitation, maintenance of natural and mechanical airways, insertion and maintenance of artificial airways, and insertion and maintenance of peripheral arterial and peripheral venous catheters. The care shall also include testing techniques to assist in diagnosis, monitoring, treatment, and research, including but not necessarily limited to, the measurement of cardiopulmonary volumes, pressure and flow, and the drawing and analyzing of samples of arterial, capillary, and venous blood. Respiratory care shall also include: educating patients and caregivers about respiratory care procedures as part of a patient's disease management program; and providing professional consultation services to health care, educational, and community organizations, and State and local agencies.

d. "Respiratory care practitioner" means a person licensed by the board to practice respiratory care under the direction or supervision of a licensed physician, physician [assistant] associate, or advanced practice nurse, and who may transcribe and implement written, verbal, and protocol orders for respiratory care.

e. "Respiratory care protocols" means policies and protocols developed by a licensed health care facility through collaboration, when appropriate, with administrators, physicians, registered nurses, physical therapists, respiratory care practitioners, and other licensed health care practitioners.

f. "Respiratory care education program" means a program of respiratory care education accredited by the Commission on Accreditation for Respiratory Care (CoARC), or its predecessor or successor organization.

(cf: P.L.2017, c.120, s.1)

70. Section 14 of P.L.2022, c.65 (C.52:17B-71b) is amended to read as follows:

14. a. The applicant for an initial law enforcement license or a probationary license shall have the burden of demonstrating to the satisfaction of the commission that the applicant meets all requirements for the issuance of a law enforcement license. The requirements for an initial license and a probationary license shall include, but not be limited to, that an applicant:

(1) be at least 18 years of age;

(2) be a citizen of the United States, if required for the position for which licensure is sought;

(3) be at least a high school graduate or have earned a General Educational Development (GED) diploma;

(4) be fingerprinted in accordance with the standards established by the commission;

(5) have passed a medical examination by a licensed physician, physician [assistant] associate, or licensed advanced practice registered nurse, based on specifications established by the commission;

(6) have passed a psychological examination by a licensed psychologist or psychiatrist based on specifications established by the commission;

(7) be of good moral character as determined by a background investigation conducted under the procedures established by the commission and successfully pass a criminal background records check in accordance with the Prison Rape Elimination Act (PREA), 28 C.F.R. 115.317, if applicable;

(8) successfully meet and complete all required basic physical and educational training courses as required by the commission;

(9) successfully pass a drug screening test as prescribed by the commission;

(10) possess a valid driver's license;

(11) not have received a dishonorable discharge from military service;

(12) successfully complete any probationary period prescribed by the commission;

(13) not have been convicted of any of the following:

(a) a crime in this State or any other state, territory, country, or of the United States, including a conviction of an offense which if committed in this State would be deemed a crime under either State or federal law without regard to its designation elsewhere;

(b) an act of domestic violence pursuant to P.L.1991, c.261 (C.2C:25-17 et seq.);

(d) a disorderly persons offense or petty disorderly persons offense involving dishonesty, fraud, or a lack of good moral character, unless the commission determines the offense to be de minimis in nature or inconsequential to the applicant's ability to meet the standards expected of a law enforcement officer;

(e) two or more motor vehicle offenses for operating a motor vehicle while under the influence of drugs or alcohol pursuant to R.S.39:4-50 or two or more motor vehicle offenses for reckless driving pursuant to R.S.39:4-96; or

(f) any offense listed in (b) through (e) of this paragraph committed in violation of the laws of another state, territory, country, or the United States;

(14) not be the subject of or had a domestic violence restraining order pursuant to P.L.1991, c.261 (C.2C:25-17 et seq.), an extreme risk protective order, or a temporary extreme risk protective order pursuant to P.L.2018, c.35 (C.2C:58-20 et seq.) issued against the applicant;

(15) not be an active member of a group or organization that advocates for, espouses, or promotes the overthrow of a local, state, or federal government or discrimination or violence against or hatred or bias toward individuals or groups based on race, creed, color, national origin, ancestry, age, sex, marital status, sexual orientation, gender identity or expression, or any other protected characteristic under the "Law Against Discrimination," P.L.1945, c.169 (C.10:5-1 et seq.), or knowingly engage in any activity, conduct, or behavior relating to such group or organization with the intent to support, endorse or advocate for, or which the applicant knows or should know will have the effect of supporting, furthering, or advocating for, the goals of such group or organization, where active membership or knowing engagement would undermine public confidence in the ability of the individual law enforcement officer or the employing law enforcement agency to carry out the public safety mission, or where active membership or knowing engagement would cause substantial disruption to proper law enforcement functioning;

(16) not have engaged in conduct or behavior in the applicant's personal or professional life, including, but not limited to, making statements, posting, sharing, or commenting in support of any posting, on social media or otherwise, that demonstrates, espouses, advocates, or supports discrimination or violence against, or hatred or bias toward, individuals or groups based on race, creed, color, national origin, ancestry, age, sex, marital status, sexual orientation, gender identity or expression, or any other protected characteristic under the "Law Against Discrimination," P.L.1945, c.169 (C.10:5-1 et seq.), where the conduct or behavior would undermine public confidence in the ability of the individual law enforcement officer or the employing law enforcement agency to carry out the public safety mission, or where the conduct or behavior would cause substantial disruption to proper law enforcement functioning;

(17) provide to the commission and the applicant's employing law enforcement unit a complete list of all social media accounts maintained by the applicant and grant to the commission and the applicant's employing law enforcement unit access to all outwardly facing activity and publicly accessible components of the accounts;

(18) not currently be listed on the National Decertification Index as being decertified as a law enforcement officer or having the license or certification as a law enforcement officer revoked or denied;

(19) pay or cause to be paid any fees, if applicable, established by the commission; and

(20) any other requirements established by the commission.

b. The commission may waive the requirements of subparagraphs (d) and (e) of paragraph (13) of subsection a. of this section if the applicant demonstrates to the licensing committee's satisfaction that:

(1) the applicant's conviction or convictions occurred five or more years prior to submission of an application for licensure as a law enforcement officer;

(2) the applicant has taken rehabilitative steps since the applicant's conviction or convictions to become a law-abiding citizen through actions, including but not limited to continuing education, maintaining gainful employment, and having no further convictions; and

(3) the applicant is currently of good moral character and submits at least three letters of recommendation from members of the applicant's community detailing the applicant's good moral character.

c. An applicant for licensure shall provide to the commission or the applicant's employing law enforcement unit documented proof, in a form and manner as required by the commission, that the applicant is in compliance with paragraphs (1) through (20) of subsection a. of this section. The commission shall promulgate in its rules and regulations the form, manner, and substance of documents required by the commission to provide sufficient proof of the qualifications required by this section. An application for initial licensure or license renewal of a person employed as full-time sworn member of any State, county, or municipal law enforcement agency or department, division or instrumentality of those governments on the effective date of P.L.2022, c.65 (C.52:17B-71a et al.) shall not be denied based solely on consideration of disciplinary actions based on conduct occurring prior to the date of enactment of P.L.2022, c.65 (C.52:17B-71a et al.).

d. The commission shall have the authority to issue a license for employment as a law enforcement officer if an applicant satisfies all licensing requirements. A license issued pursuant to this section shall expire three years after its date of issuance, before which time the law enforcement officer shall be required to apply for a license renewal pursuant to section 17 of P.L.2022, c.65 (C.52:17B-71d).

e. Law enforcement officers from jurisdictions outside of New Jersey and federal law enforcement officers applying for licensure in this State shall be required to meet all of the requirements set forth in this section and also shall be required to complete a waiver form that allows the commission and any hiring law enforcement unit to review the officer's internal affairs records from any and all prior law enforcement positions.

f. A person appointed as a permanent law enforcement officer prior to the effective date of P.L.2022, c.65 (C.52:17B-71a et al.) shall apply for a law enforcement license in accordance with section 17 of P.L.2022, c.65 (C.52:17B-71d). The commission shall devise a process and schedule for submission of a law enforcement license application for the officers.

g. At the discretion of the commission, licenses issued pursuant to this section may serve as authorization for a licensee to serve in one of the following positions, provided the licensee meets the requisite qualifications for that status: a full-time permanent law enforcement officer; a Class One, Class Two, or Class Three special law enforcement officer; or a probationary law enforcement officer.

h. In all situations where a law enforcement officer has been convicted of an offense set forth in subparagraph (a), (b), or (c) of paragraph (13) of subsection a. of this section, the commission shall deny the issuance of a license to an applicant.

i. Any decision to deny a license shall be accompanied by a written statement in a form to be prescribed by the commission.

(cf: P.L.2022, c.65, s.14)

71. Section 3 of P.L.2021, c.17 (C.54:4-3.6j) is amended to read as follows:

3. a. Property, including land and buildings, used as a hospital or a satellite emergency care facility, which is owned by an association or corporation organized as a nonprofit entity pursuant to Title 15 of the Revised Statutes or Title 15A of the New Jersey Statutes exclusively for hospital purposes, shall be exempt from taxation, provided that, except as provided in subsection b. of this section, if any portion of the property is leased to a profit-making organization or otherwise used for purposes which are not themselves exempt from taxation, that portion shall be subject to taxation and the remaining portion only shall be exempt from taxation.

b. If any portion of a hospital or a satellite emergency care facility is leased to or otherwise used by a profit-making medical provider for medical purposes related to the delivery of health care services directly to the hospital, that portion shall be exempt from taxation, provided that the portion of the hospital or satellite emergency care facility is used exclusively for hospital purposes.

c. The owner of property exempt from taxation pursuant to subsection a. of this section shall be assessed an annual community service contribution pursuant to section 1 of P.L.2021, c.17 (C.40:48J-1).

d. As used in this section:

"Satellite emergency care facility" means a facility, which is owned and operated by a hospital, and which provides emergency care and treatment for patients.

(cf: P.L.2021, c.17, s.3)

72. This act shall take effect immediately.

STATEMENT

This bill replaces instances of “physician assistant” and its variants in the statutory law of this State to “physician associate” and makes certain technical changes.

In May 2021, the American Academy of Physician Associates (AAPA), formerly the American Academy of Physician Assistants, the national organization representing physician associates voted to change the title of “physician assistant” to “physician associate.” The State’s statutory law has been changed to conform to the AAPA’s usage of its preferred term.