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so Steven Ill start with you you are an advocate for the nurse Modernization Act here in New York in this role what were the biggest challenges and rewards and why welcome everybody so I would say the biggest challenge so let me give a little background on the Modernization Act for those of you who dont know what its about so prior to this law taking effect which took effect January 1st of this year nurse practitioners in New York State needed a written collaborative agreement in order to practice so this was agreement signed by the nurse practitioner in the physician and was required to practice if that agreement in any way stopped existing if the physician lost her license if they went on and and you know something happened bad to them they could no longer legally collaborate with that nurse practitioner in the state which meant that that nurse practitioner had no practice so we saw this as a big issue in addition we saw that there were physicians who were paying nurse practition
