§ 6908. Exempt persons. 1. This article shall not be construed:\n a. As prohibiting (i) the domestic care of the sick, disabled or\ninjured by any family member, household member or friend, or person\nemployed primarily in a domestic capacity who does not hold himself or\nherself out, or accept employment as a person licensed to practice\nnursing under the provision of this article; provided that if such\nperson is remunerated, the person does not hold himself or herself out\nas one who accepts employment for performing such care; or the\nadministration of medications or treatment by child day care providers\nor employees or caregivers of child day care programs where such\nproviders, employees or caregivers are acting under the direction and\nauthority of a parent of a child, legal guardian, legal custodian, or an\nadult in whose care a child has been entrusted and who has been\nauthorized by the parent to consent to any health care for the child and\nin compliance with the regulations of the office of children and family\nservices pertaining to the administration of medications and treatment;\nor\n (ii) any person from the domestic administration of family remedies;\nor\n (iii) the providing of care by a person acting in the place of a\nperson exempt under clause (i) of this paragraph, but who does hold\nhimself or herself out as one who accepts employment for performing such\ncare, where nursing services are under the instruction of a licensed\nnurse, or under the instruction of a patient or family or household\nmember determined by a registered professional nurse to be\nself-directing and capable of providing such instruction, and services\nare provided under section three hundred sixty-five-f of the social\nservices law; or\n (iv) the furnishing of nursing assistance in case of an emergency; or\n (v) tasks provided by a direct support staff in programs certified or\napproved by the office for people with developmental disabilities, when\nperformed under the supervision of a registered professional nurse and\npursuant to a memorandum of understanding between the office for people\nwith developmental disabilities and the department, in accordance with\nand pursuant to an authorized practitioner's ordered care, provided\nthat: (1) a registered professional nurse determines, in his or her\nprofessional judgment, which tasks are to be performed based upon the\ncomplexity of the tasks, the skill and experience of the direct support\nstaff, and the health status of the individual being cared for; (2) only\na direct support staff who has completed training as required by the\ncommissioner of the office for people with developmental disabilities\nmay perform tasks pursuant to this subparagraph; (3) appropriate\nprotocols shall be established to ensure safe administration of\nmedications; (4) a direct support staff shall not assess the medication\nneeds of an individual; (5) adequate nursing supervision is provided,\nincluding training and periodic inspection of performance of the tasks.\nThe amount and type of nursing supervision shall be determined by the\nregistered professional nurse responsible for supervising such task\nbased upon the complexity of the tasks, the skill and experience of the\ndirect support staff, and the health status of the individual being\ncared for; (6) a direct support staff shall not be authorized to perform\nany tasks or activities pursuant to this subparagraph that are outside\nthe scope of practice of a licensed practical nurse; (7) a direct\nsupport staff shall not represent himself or herself, or accept\nemployment, as a person licensed to practice nursing under the\nprovisions of this article; (8) direct support staff providing\nmedication administration, tube feeding, or diabetic care shall be\nseparately certified, and shall be recertified on an annual basis; (9)\nthe registered professional nurse shall ensure that there is a consumer\nspecific medication sheet for each medication that is a
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