ASSEMBLY BILL NO. 5309
(Second Reprint)
To the General Assembly:
Pursuant to Article V, Section I, Paragraph 14 of the New Jersey Constitution, I am returning Assembly Bill No. 5309 (Second Reprint) with my recommendations for reconsideration.
This bill requires the State Board of Medical Examiners to include in its continuing medical education requirements up to three optional credits of educational programs or topics concerning menopause as a condition of physician biennial registration. It also directs the Department of Health (“DOH”) to work with medical and nursing schools to integrate menopause education into their curricula, and to do the same with hospitals and professional organizations regarding their continuing medical education offerings. The bill requires the Commissioner of Health to establish an advisory committee to monitor the effectiveness of these training programs, assess participation, and recommend public health measures and areas of further research concerning menopause. Finally, the bill mandates that the New Jersey Board of Nursing require that the continuing education credits needed for license renewal by advanced practice nurses (“APNs”) include up to three optional credits of educational programs or topics concerning menopause.
I applaud the sponsors for their efforts to improve health care practitioners’ understanding of menopause and perimenopause, a crucial area of health care practice that demands more focused attention in medical education both before and after licensure. It is well understood that insufficient training and specialized knowledge in this area can result in patient misdiagnosis, less than adequate treatment, and poor health outcomes.
While I fully support the critical additions the bill seeks to make to medical education and continuing medical education requirements, I am proposing modest amendments to ensure that the bill does not inadvertently blur the distinct roles and functions of DOH and the State’s professional and occupational boards.
Accordingly, I am recommending removing the provisions of the bill that task DOH with developing, promoting, and evaluating menopause-related continuing medical education content. These requirements would place DOH in a position of shaping continuing education standards for health care professionals over which DOH has neither regulatory nor disciplinary authority. DOH is also not the appropriate agency to influence academic content at medical and nursing schools – something traditionally left to accrediting bodies and higher education institutions. Relatedly, I am recommending deleting language in the bill that tasks DOH with establishing financial assistance programs to offset the cost of the training requirements, both because DOH is not the appropriate entity to manage such a program and because the bill does not appropriate any funding to effectuate it.
Rather than assigning to a particular State agency the responsibility to develop a training module on menopause-related topics, my proposed changes establish a requirement that the optional credits for continuing education for health care professionals include relevant information on menopause. Additionally, I am recommending amendments to clarify that the authorization for “up to three” credits of continuing education on menopause to count toward license renewal should not be interpreted as a “cap” on the total number of credits that can be completed concerning menopause; as long as additional credits otherwise meet board requirements for continuing education, physicians and nurses should be able to apply more than three credits of continuing education concerning menopause toward their continuing education requirements. Finally, recognizing that the optional credits authorized by the bill could be beneficial to everyone in the nursing profession, I recommend removing the specific reference to APNs so that this provision applies to all nurses, including Licensed Practice Nurses and Registered Nurses in addition to APNs.
Therefore, I herewith return Assembly Bill No. 5309 (Second Reprint) and recommend that it be amended as follows:
Page 2, Section 1, Line 24: Delete “and”
Page 2, Section 1, Line 25: After “(2)” insert “track participation consistent with paragraph (1) of this subsection; and (3)”
Page 2, Section 2, Line 29: Delete “2.a.” and insert “c.”
Page 2, Section 2, Lines 30-31: Delete “section 1 of this act shall” and insert “subsection b. of this section may”
Page 2, Section 2, Lines 31-32: Delete “training modules, which shall be developed by the Department of Health,” and insert “information”
Page 2, Section 2, Line 39: Delete “b. Training for the” and insert “d. The”
Page 2, Section 2, Line 40: After “be” insert “made”
Page 2, Section 2, Line 43: Delete “training” and insert “educational programs or topics concerning menopause”
Page 3, Section 2, Line 1: Delete “c.” and insert “e.”
Page 3, Section 2, Line 2: Delete “modules” and insert “programs”
Page 3, Section 2, Lines 8-32: Delete in their entirety and insert “f. Nothing in this section shall prevent a physician from completing additional continuing education credits of educational programs or topics concerning menopause for satisfaction of their continuing education requirements.”
Page 3, Section 3, Line_34: Delete “3.” and insert “2.”
Page 3, Section 3, Line_43: Delete “advanced practice”
Page 3, Section 3, Line_45: Delete “and”
Page 4, Section 3, Line_1: After “(2)” insert “track participation consistent with paragraph (1) of this subsection; and (3)”
Page 4, Section 3, Line 5: Delete “shall” and insert “may”
Page 4, Section 3, Lines 6-7: Delete “training modules, which shall be developed by the Department of Health,” and insert “information”
Page 4, Section 3, Line 14: Delete “Training for the” and insert “The”
Page 4, Section 3, Line 14: After “be” insert “made”
Page 4, Section 3, Line 16: Delete “advanced practice”
Page 4, Section 3, Line 18: Delete “advanced practice”
Page 4, Section 3, Line 18: Delete “training” and insert “educational programs or topics concerning menopause”
Page 4, Section 3, Line 20: Delete “Advanced practice nurses” and insert “Nurses”
Page 4, Section 3, Line 21: Delete “modules” and insert “programs”
Page 4, Section 3, Line 25: Delete “In addition to receiving continuing education credits” and insert “Nothing in this section shall prevent a nurse from completing additional continuing education credits of educational programs or topics concerning menopause for satisfaction of their continuing education requirements.”
Page 4, Section 3, Lines 26-33: Delete in their entirety
Page 4, Section 3, Line 34: Insert “3. The Division of Consumer Affairs shall promote awareness of this act, P.L. , c. (C. )(pending before the Legislature as this bill) by providing notice on its website.”
Respectfully,
[seal]
/s/ Philip D. Murphy
Governor
Attest:
/s/ Kate E. McDonnell
Chief Counsel to the Governor