A08637 Summary:

COSPNSRGottfried, Cymbrowitz, Clark, Quart, Galef, Rosenthal, Ortiz, Saladino, Montesano, Gunther, Lopez P, Steck, Rodriguez, Zebrowski, Weprin, Cusick, Magnarelli, Lentol, McDonald, Fahy, Buchwald
MLTSPNSRBraunstein, Camara, Cook, Curran, Duprey, Giglio, Graf, Hevesi, Lupardo, Malliotakis, McDonough, O'Donnell, Paulin, Perry, Raia, Rivera, Ryan, Sepulveda, Weisenberg
Amd S3309, Pub Health L
Provides for the use of opioid antagonists.
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A08637 Actions:

01/29/2014referred to health
03/10/2014amend (t) and recommit to health
03/10/2014print number 8637a
03/18/2014amend and recommit to health
03/18/2014print number 8637b
04/07/2014reported referred to codes
05/01/2014advanced to third reading cal.618
05/06/2014substituted by s6477b
 02/04/20141ST REPORT CAL.104
 02/10/20142ND REPORT CAL.
 03/27/2014PASSED SENATE
 03/27/2014referred to health
 05/06/2014substituted for a8637b
 05/06/2014ordered to third reading cal.618
 05/06/2014passed assembly
 05/06/2014returned to senate
 06/24/2014SIGNED CHAP.42
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A08637 Memo:

submitted in accordance with Assembly Rule III, Sec 1(f)
SPONSOR: Dinowitz
  TITLE OF BILL: An act to amend the public health law, in relation to use of opioid antagonists   PURPOSE: Allows for the prescribing, dispensing and distribution of an opioid antagonist by a non-patient specific order.   SUMMARY OF PROVISIONS: Section one amends Public Health Law § 3390 to authorize the Commission- er of Health to establish standards for the prescribing, dispensing, distribution, possession and administration of opioid antagonist under the Opioid Overdose Prevention Program. This section expands a health care professional's authority to prescribe, dispense or distribute, directly or indirectly, an opioid antagonist by authorizing such by non-patient-specific prescription. Additionally, this section provides that a pharmacist may dispense through a non-patient-specific prescription. A recipient of the opioid antagonist is authorized to posses, distribute and administer the opioid antagonist. The bill clari- fies that any recipient acting reasonably and in good faith pursuant to this section shall not be liable. Lastly, this section requires the program to report annually. Section two provides that the act shall take effect immediately.   JUSTIFICATION: New York State, like the nation, is in the midst of a severe prescription drug crisis. Prescriptions for opioids, particularly oxyco- done and hydrocodone have skyrocketed. The Centers for Disease Control and Prevention reports that every 19 minutes, one person dies from an accidental overdose or suicide as a result of prescription drug abuse. In 2012, the legislature enacted the seminal I-STOP legislation to track controlled substance prescribing, prevent doctor shopping and weed out unscrupulous doctors. One unfortunate side effect of successfully restricting street access to these controlled substances is that addicts are turning to other drugs, such as heroin. Heroin has now become the cheaper alternative to opioids. On Long Island it is estimated that heroin addiction has increased fourfold since 2011. As detailed in the Senate Health Committee's white paper The Prescription Drug Crisis in New York: A Comprehensive Approach, there is a need to look at the complete spectrum of drug abuse in order to address this crisis. While the state has made great advances, much more is needed. One of the topics raised at the roundtables held by the Health Committee in 2011 and 2012, was access to Naloxone (Narcan). Naloxone, sometimes referred to as the drug-overdose antidote, counter- acts the life threatening depression of the central nervous system and respiratory system caused by an opioid or heroin overdose. If timely administered, Naloxone can prevent overdose deaths. The Department of Health recommends administering Naloxone directly to an individual over- dosing on an opioid after calling 911 and checking for breathing. In 2005, the state authorized non-medical persons to administer Naloxone to an individual in order to prevent an opioid or heroin overdose from becoming fatal. In 2011, the state adopted Good Samaritan protections for witnesses and victims of overdoses. By removing the threat of prose- cution, this measure encourages witnesses of an overdose to call 911 before it becomes deadly. Due to the increase of opioid abuse, expanded access to Naloxone has become a necessary priority to save lives. In Nassau County, EMTs admin- ister Naloxone through their police department's ambulance services and in Suffolk County the state provided first responders with Naloxone. Expanding upon the success of existing programs, more lives could be saved if Naloxone was available to addicts, their families and other people likely to be in a position to assist a person at risk of an opioid related overdose. Currently, parents and family members of addicts are being turned away from Naloxone training programs or are attending the programs and not receiving Naloxone due to the shortage of prescribers participating in such programs. Under this legislation one prescriber would be able to issue a non-patient specific order to numer- ous programs, allowing for increased access. This legislation will also allow for expanded access through pharmacies. By increasing access, this legislation will equip individuals likely to discover an overdose victim with the ability to save their life.   LEGISLATIVE HISTORY: New Bill   FISCAL IMPLICATIONS: None   EFFECTIVE DATE: Immediately
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A08637 Text:

                STATE OF NEW YORK
                   IN ASSEMBLY
                                    January 29, 2014
        Introduced  by  M.  of A. DINOWITZ, GOTTFRIED, CYMBROWITZ, CLARK, QUART,
          Multi-Sponsored by -- M. of A. BRAUNSTEIN, COOK, GIGLIO, HEVESI, McDO-
          NALD, PAULIN, PERRY, RIVERA, ROSA, SEPULVEDA -- read once and referred
          to  the  Committee  on  Health  -- committee discharged, bill amended,

          ordered reprinted as amended and  recommitted  to  said  committee  --
          again  reported from said committee with amendments, ordered reprinted
          as amended and recommitted to said committee
        AN ACT to amend the public health law, in  relation  to  use  of  opioid
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
     1    Section 1. Section 3309 of the public health law, as added by  chapter
     2  413 of the laws of 2005, is amended to read as follows:
     3    §  3309. Opioid overdose prevention. 1. The commissioner is authorized
     4  to establish standards for approval of any  opioid  overdose  prevention
     5  program,  and  opioid  antagonist prescribing, dispensing, distribution,
     6  possession  and  administration  pursuant  to  this  section  which  may

     7  include,  but not be limited to, standards for program directors, appro-
     8  priate clinical oversight, training, record keeping and reporting.
     9    2. Notwithstanding any inconsistent provisions of  section  sixty-five
    10  hundred  twelve  of  the  education  law or any other law, the purchase,
    11  acquisition, possession or use of an opioid antagonist pursuant to  this
    12  section  shall  not  constitute the unlawful practice of a profession or
    13  other violation under title eight of the education law or this article.
    14    3. (a) As used in this section:
    15    (i) "Opioid antagonist" means a drug approved by  the  Food  and  Drug
    16  Administration  that, when administered, negates or neutralizes in whole
    17  or in part the pharmacological effects of an opioid in the body. "Opioid
    18  antagonist" shall be limited to naloxone and other medications  approved

    19  by the department for such purpose.
    20    (ii) "Health care professional" means a person licensed, registered or
    21  authorized  pursuant  to  title  eight of the education law to prescribe
    22  prescription drugs.
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.

        A. 8637--B                          2
     1    (iii) "Pharmacist" means a person licensed or authorized  to  practice
     2  pharmacy  pursuant  to article one hundred thirty-seven of the education
     3  law.
     4    (iv)  "Opioid  antagonist  recipient" or "recipient" means a person at

     5  risk of experiencing an opioid-related overdose,  or  a  family  member,
     6  friend  or other person in a position to assist a person experiencing or
     7  at risk of experiencing an opioid-related overdose, or  an  organization
     8  registered  as  an  opioid  overdose prevention program pursuant to this
     9  section.
    10    (b)(i) A health care professional may prescribe by a  patient-specific
    11  or  non-patient-specific  prescription, dispense or distribute, directly
    12  or indirectly, an opioid antagonist to an opioid antagonist recipient.
    13    (ii) A  pharmacist  may  dispense  an  opioid  antagonist,  through  a
    14  patient-specific  or  non-patient-specific prescription pursuant to this
    15  paragraph, to an opioid antagonist recipient.

    16    (iii) An opioid antagonist recipient may possess an opioid  antagonist
    17  obtained  pursuant  to this paragraph, may distribute such opioid antag-
    18  onist to a recipient, and may administer such  opioid  antagonist  to  a
    19  person the recipient reasonably believes is experiencing an opioid over-
    20  dose.
    21    (iv) The provisions of this paragraph shall not be deemed to require a
    22  prescription for any opioid antagonist that does not otherwise require a
    23  prescription;  nor shall it be deemed to limit the authority of a health
    24  care professional to prescribe, dispense or distribute, or of a  pharma-
    25  cist to dispense, an opioid antagonist under any other provision of law.
    26    4.  Use  of  an  opioid  antagonist  pursuant to this section shall be

    27  considered first aid or emergency treatment for the purpose of any stat-
    28  ute relating to liability.
    29    [4.] A recipient or opioid  overdose  prevention  program  under  this
    30  section,  acting  reasonably  and  in good faith in compliance with this
    31  section, shall not be  subject  to  criminal,  civil  or  administrative
    32  liability solely by reason of such action.
    33    5.  The  commissioner shall publish findings on statewide opioid over-
    34  dose data that reviews overdose death rates  and  other  information  to
    35  ascertain  changes in the cause and rates of fatal opioid overdoses. The
    36  report may be part of existing state mortality  reports  issued  by  the
    37  department,  and  shall  be  submitted  annually [for three years and as

    38  deemed necessary by the commissioner thereafter,] to the  governor,  the
    39  temporary  president  of  the senate [and], the speaker of the assembly,
    40  and the chairs of the senate and assembly health committees. The  report
    41  shall include, at a minimum, the following information:
    42    (a)  information  on  opioid  overdose  deaths, including age, gender,
    43  ethnicity, and geographic location;
    44    (b) data on emergency room utilization for  the  treatment  of  opioid
    45  overdose;
    46    (c) data on utilization of pre-hospital services;
    47    (d)  [suggested  improvements in data collection.] data on utilization
    48  of opioid antagonists; and
    49    (e) any other information necessary to ascertain the  success  of  the
    50  program and ways to further reduce overdoses.

    51    § 2. This act shall take effect immediately.
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