NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A358
SPONSOR: Barrett TITLE OF BILL:
An act to amend the education law, in relation to authorizing pharma-
cists to dispense HIV pre-exposure and post-exposure prophylaxis
PURPOSE OF THE BILL:
This legislation would facilitate greater access to HIV-preventive medi-
cation, called PrEP, by allowing pharmacists to dispense the medication
via a standing order.
SUMMARY OF SPECIFIC PROVISIONS:
§ 1: Subdivision 7-a of Section 6527 of the Education Law, as added by
Chapter 502 in the Laws of 2016, is amended to allow physicians to issue
a non-patient specific standing order for PrEP.
§ 2: Subdivision 8 of Section 6909 of the Education Law, as added by
Chapter 502 of the Laws of 2016, is amended to allow nurse practitioners
to issue a non-patient specific standing order for PrEP.
§ 3: Amends subdivision 5 and adds a new subdivision 10 to Section 6801
of the Education:Law to allow pharmacists to executive a non-patient
specific standing order for PrEP, subject to the following conditions:
i. The pharmacist must complete a training program created by NYS DOH on
the use of PrEP;
ii. The patient is HIV negative, as documented by a negative HIV test
obtained within the previous 7 days;
iii. The patient does not self-report having any HIV symptoms;
iv. The patient does not report taking medications that conflict with
PrEP;
v. The pharmacist has not furnished more than a 60-day supply More often
than once every two years;
vi. The pharmacist provides the patient with infortriation, published by
NYS DOH, advising the patient on proper use, safety, and testing; and
VK-12/20
vii. The pharmacist provides a list of local doctors and/or clinics to
patients who do not have a regular doctor.
§ 4: Effective date.
JUSTIFICATION:
While much progress has been made in the fight against HIV and AIDS,
there is still a need for new tools and greater access to life-saving
medication. In 2018, our state saw 2,481 New Yorkers newly diagnosed
with HIV+. This number calls for new policies that target high-risk
populations with high bathers to preventive treatments. Pre-exposure
prophylaxis, or PrEP, is currently on the market under the brand name
"Truvada" as a long-term daily pill that is highly effective at prevent-
ing new transmissions of HIV. This legislation would allow pharthacists
to dispense the medication before a patient receives a doctor's
prescription for a maximum of 60 days. This tool will allow people to
access PrEP even if they don't have a regular doctor, are waiting for an
appointment, have just moved to a new place or have just become sexually
active.
PrEP has been used for well over a decade as a successful medication in
preventing new HIV transmissions. With this legislation, New York will
expand access to more residents, which will help further reduce
infections. Many people at high-risk of HIV are unlikely to have a regu-
lar doctor and may not know how to access this medication. By reducing
a bather to the medication, we can increase the number of people using
the medication and reduce infections.
PRIOR LEGISLATIVE HISTORY:
2021-2022: A.2198/S.728
2019-2020: A.9013-A/S.7704-A.
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:
None.
EFFECTIVE DATE:
This act shall take effect on the one hundred eightieth day after it
shall have become a law. Effective immediately, the addition, amendment
and/or repeal of any rule or regulation necessary for the implementation
of this act on its effective date are authorized to be made and
completed on or before such date.
STATE OF NEW YORK
________________________________________________________________________
358
2025-2026 Regular Sessions
IN ASSEMBLY(Prefiled)
January 8, 2025
___________
Introduced by M. of A. BARRETT -- read once and referred to the Commit-
tee on Higher Education
AN ACT to amend the education law, in relation to authorizing pharma-
cists to dispense HIV pre-exposure and post-exposure prophylaxis
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subdivision 7-a of section 6527 of the education law, as
2 added by chapter 502 of the laws of 2016, is amended to read as follows:
3 7-a. A licensed physician may prescribe and order a patient specific
4 order or non-patient specific order to a licensed pharmacist, pursuant
5 to regulations promulgated by the commissioner in consultation with the
6 commissioner of health, and consistent with the public health law, for
7 dispensing up to a seven day starter pack of HIV post-exposure prophy-
8 laxis for the purpose of preventing human immunodeficiency virus
9 infection following a potential human immunodeficiency virus exposure. A
10 licensed physician may also prescribe and order a patient specific or
11 non-patient specific order to a licensed pharmacist, pursuant to regu-
12 lations promulgated by the commissioner in consultation with the commis-
13 sioner of health, and consistent with the public health law and section
14 sixty-eight hundred one of this title, for HIV pre-exposure prophylaxis,
15 provided, however, that the regulations promulgated pursuant to this
16 subdivision shall require that the HIV pre-exposure prophylaxis author-
17 ized to be dispensed by a licensed pharmacist shall provide for at least
18 a thirty-day, but no more than a sixty-day, supply of such prophylaxis.
19 § 2. Subdivision 8 of section 6909 of the education law, as added by
20 chapter 502 of the laws of 2016, is amended to read as follows:
21 [8.] 12. A certified nurse practitioner may prescribe and order a
22 patient specific order or non-patient specific order to a licensed phar-
23 macist, pursuant to regulations promulgated by the commissioner in
24 consultation with the commissioner of health, and consistent with the
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD00284-01-5
A. 358 2
1 public health law, for dispensing up to a seven day starter pack of HIV
2 post-exposure prophylaxis for the purpose of preventing human immunode-
3 ficiency virus infection following a potential human immunodeficiency
4 virus exposure. A certified nurse practitioner may also prescribe and
5 order a patient specific or non-patient specific order to a licensed
6 pharmacist, pursuant to regulations promulgated by the commissioner in
7 consultation with the commissioner of health, and consistent with the
8 public health law and section sixty-eight hundred one of this title, for
9 HIV pre-exposure prophylaxis, provided, however, that the regulations
10 promulgated pursuant to this subdivision shall require that the HIV
11 pre-exposure prophylaxis authorized to be dispensed by a licensed phar-
12 macist shall provide for at least a thirty-day, but no more than a
13 sixty-day, supply of such prophylaxis.
14 § 3. Subdivision 5 of section 6801 of the education law, as added by
15 chapter 502 of the laws of 2016, is amended and a new subdivision 10 is
16 added to read as follows:
17 5. A licensed pharmacist may execute a non-patient specific order, for
18 dispensing up to a seven day starter pack of HIV post-exposure prophy-
19 laxis medications for the purpose of preventing human immunodeficiency
20 virus infection, by a physician licensed in this state or nurse practi-
21 tioner certified in this state, pursuant to rules and regulations
22 promulgated by the commissioner in consultation with the commissioner of
23 health following a potential human immunodeficiency virus exposure. The
24 pharmacist shall also inform the patient of the availability of pre-ex-
25 posure prophylaxis for persons who are at substantial risk of acquiring
26 HIV.
27 10. A licensed pharmacist may execute a non-patient specific order,
28 for dispensing HIV pre-exposure prophylaxis, pursuant to rules and regu-
29 lations promulgated by the commissioner in consultation with the commis-
30 sioner of health provided, however, that the rules and regulations
31 promulgated pursuant to this subdivision shall require that the HIV
32 pre-exposure prophylaxis authorized to be dispensed by a licensed phar-
33 macist shall provide for at least a thirty-day, but no more than a
34 sixty-day, supply of such prophylaxis. And provided, further, that the
35 following conditions shall be met before a pharmacist may dispense pre-
36 exposure prophylaxis:
37 (a) The pharmacist has completed a training program created by the
38 department of health on the use of pre-exposure prophylaxis. The train-
39 ing program shall educate pharmacists about the requirements of this
40 subdivision, the risks and side effects of the medication, patient
41 insurance and cost burdens, and any other information such department
42 deems necessary or important;
43 (b) The patient is HIV negative, as documented by a negative HIV test
44 result obtained within the previous seven days from an HIV
45 antigen/antibody test or antibody-only test or from a rapid, point-of-
46 care fingerstick blood test approved by the federal food and drug admin-
47 istration. If the patient does not provide evidence of a negative HIV
48 test in accordance with this paragraph, the pharmacist may recommend an
49 HIV test. If the patient tests positive for HIV infection, the pharma-
50 cist shall direct the patient to a licensed physician and provide the
51 patient with a list of health care service providers and clinics within
52 the county where the pharmacist is located or adjacent counties;
53 (c) The patient does not report any signs or symptoms of acute HIV
54 infection on a self-reported checklist of acute HIV infection signs and
55 symptoms;
A. 358 3
1 (d) The patient does not report taking any contraindicated medica-
2 tions;
3 (e) The pharmacist does not furnish more than a sixty-day supply of
4 pre-exposure prophylaxis to a single patient more than once every two
5 years, unless directed otherwise by a prescriber.
6 (f) The pharmacist provides written information, published by the
7 department of health, to the patient on the ongoing use of pre-exposure
8 prophylaxis, which may include education about side effects, safety
9 during pregnancy and breastfeeding, adherence to recommended dosing, and
10 the importance of timely testing and treatment, as applicable, for HIV,
11 renal function, hepatitis B, hepatitis C, sexually transmitted diseases,
12 and pregnancy for individuals of child-bearing capacity. The pharmacist
13 shall notify the patient that the patient must be seen by a licensed
14 physician to receive subsequent prescriptions for pre-exposure prophy-
15 laxis; and
16 (g) The pharmacist provides information, with the patient's consent,
17 to the patient or, when the patient lacks capacity to consent, a person
18 authorized to consent to health care for such individual, on the impor-
19 tance of having a health care provider, developed by the commissioner of
20 health, and if the patient does not have a health care provider the
21 pharmacist shall provide the patient a list of licensed physicians,
22 clinics, or other health care service providers within the county where
23 the pharmacist is located or adjacent counties.
24 § 4. This act shall take effect on the one hundred eightieth day after
25 it shall have become a law. Effective immediately, the addition, amend-
26 ment and/or repeal of any rule or regulation necessary for the implemen-
27 tation of this act on its effective date are authorized to be made and
28 completed on or before such date.
