A01124 Summary:

BILL NO    A01124A

SAME AS    SAME AS S07660, SAME AS A09878

SPONSOR    Rosenthal (MS)

COSPNSR    Gottfried, Ortiz, Kellner, Hooper

MLTSPNSR   Clark, Dinowitz, DiPietro, Perry, Rivera

Amd S3309-a, Pub Health L

Authorizes the commissioner of health to establish standards, and review and
implement requirements for the performance of continuing medical education on
pain management, palliative care and addiction.
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A01124 Memo:

BILL NUMBER:A1124A

TITLE OF BILL:  An act to amend the public health law, in relation to
the prescription pain medication awareness program and providing for
the repeal of such provisions upon expiration thereof

PURPOSE: To require health care professionals authorized to prescribe
controlled substances to complete medical education on pain
management, palliative care, and addition.

SUMMARY OF PROVISIONS:

Section one amends the Prescription Pain Medication Awareness Program
under Public Health Law S 3309-a to require health care professionals
licensed under title 8 of the education law to treat humans and
authorized to prescribe controlled substances to complete three hours
of continuing medical education every two years that involves pain
management. The curricula must include but is not limited to, I-Stop
and drug enforcement administration requirements for prescribing
control substances; pain management; appropriate proscribing; managing
acute pain; pain; palliative medicine; preventative, screening and
signs of addiction; responses to abuse and addiction; and end of life
care. The Commissioner may allow for exemptions if the health care
professionals met requirements per the commissioners satisfaction. The
commissioner must report on the impact of this legislation and any
recommendations no later than three years after its enactment.

JUSTIFICATION: Many patients suffer endlessly from debilitating pain
and other symptoms caused by the inadequate treatment of pain or other
symptoms which could be controlled. Many health care professionals are
unaware of the resources available to their patients to relieve
chronic and acute pain. This issue has lead to an increase in the
prescribing of prescription medications to help ease patients
suffering, which has resulted in and increase of prescription drug
abuse throughout the state. This bill will require health care
professionals who prescribe controlled substances to take a continuing
medical education (CME) course regarding pain management. This
training in pain management will assist in curbing the prescription
drug crisis the state currently faces by educating practitioners on
proper practices. This bill will ensure that health care practitioners
stay current on pain management and palliative care techniques, and
not over or under prescribing pain medications.

LEGISLATIVE HISTORY: New bill.

FISCAL IMPLICATIONS: None.

EFFECTIVE DATE: This bill shall take effect one year after it becomes
law.
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A01124 Text:

                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________

                                        1124--A
                                                                Cal. No. 68

                              2013-2014 Regular Sessions

                                 I N  A S S E M B L Y

                                      (PREFILED)

                                    January 9, 2013
                                      ___________

       Introduced  by  M. of A. ROSENTHAL, GOTTFRIED, ORTIZ, KELLNER, HOOPER --
         Multi-Sponsored by -- M. of A. CLARK, DINOWITZ, PERRY, RIVERA --  read
         once  and  referred  to the Committee on Health -- advanced to a third
         reading, amended and ordered reprinted, retaining  its  place  on  the
         order of third reading

       AN  ACT  to amend the public health law, in relation to the prescription
         pain medication awareness program and providing for the repeal of such
         provisions upon expiration thereof

         THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
       BLY, DO ENACT AS FOLLOWS:

    1    Section  1.  Section  3309-a  of  the  public  health law, as added by
    2  section 52 of part D of chapter 56 of the laws  of  2012,  subparagraphs
    3  (i),  (ii)  and  (iii)  of paragraph (b) of subdivision 2 as amended and
    4  subparagraph (iv) of paragraph (b) of subdivision 2 as added by  section
    5  1  and subdivisions 3 and 4 as amended by section 2 of part D of chapter
    6  447 of the laws of 2012, is amended to read as follows:
    7    S 3309-a. Prescription pain medication awareness program. 1. There  is
    8  hereby  established within the department a prescription pain medication
    9  awareness program to educate the public and  health  care  practitioners
   10  about  the  risks  associated  with  prescribing  and  taking controlled
   11  substance pain medications.
   12    2. Within the amounts appropriated, the commissioner, in  consultation
   13  with  the  commissioner  of the office of alcoholism and substance abuse
   14  services, shall[:
   15    (a) Develop] DEVELOP and  conduct  a  public  health  education  media
   16  campaign  designed  to  alert  youth, parents and the general population
   17  about the risks associated with prescription pain  medications  and  the
   18  need  to  properly  dispose of any unused medication. In developing this
   19  campaign, the  commissioner  shall  consult  with  and  use  information
   20  provided  by  the  work  group established pursuant to subdivision [(b)]
   21  FOUR of this section and other relevant professional organizations.  The
   22  campaign  shall  include  an  internet website providing information for
   23  parents, children and health care professionals on the risks  associated

        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD05030-03-4
       A. 1124--A                          2

    1  with  taking opioids and resources available to those needing assistance
    2  with prescription pain medication addiction.  Such  website  shall  also
    3  provide  information regarding where individuals may properly dispose of
    4  controlled  substances  in  their  community and include active links to
    5  further information and resources. The campaign  shall  begin  no  later
    6  than September first, two thousand twelve.
    7    3.  THE  COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER OF EDUCA-
    8  TION, SHALL ESTABLISH STANDARDS, AND REVIEW AND  IMPLEMENT  REQUIREMENTS
    9  FOR  THE PERFORMANCE OF CONTINUING MEDICAL EDUCATION ON PAIN MANAGEMENT,
   10  PALLIATIVE CARE AND ADDICTION.  EVERY HEALTH CARE PROFESSIONAL LICENSED,
   11  REGISTERED OR CERTIFIED UNDER TITLE EIGHT OF THE EDUCATION LAW TO  TREAT
   12  HUMANS AND REGISTERED UNDER THE FEDERAL CONTROLLED SUBSTANCES ACT AND IN
   13  POSSESSION  OF  A REGISTRATION NUMBER FROM THE DRUG ENFORCEMENT ADMINIS-
   14  TRATION, UNITED STATES DEPARTMENT OF JUSTICE, OR ITS  SUCCESSOR  AGENCY,
   15  SHALL, EVERY TWO YEARS, COMPLETE THREE HOURS OF COURSE WORK AS SET FORTH
   16  IN  THIS  SECTION; PROVIDED, HOWEVER, THAT SAID HOURS SHALL BE DEEMED TO
   17  COUNT TOWARD THE PROFESSIONAL'S OBLIGATION FOR BOARD CERTIFICATION.
   18    (A) EXISTING CURRICULA, INCLUDING CURRICULA DEVELOPED BY A  NATIONALLY
   19  RECOGNIZED HEALTH CARE PROFESSIONAL, SPECIALTY, OR PROVIDER ASSOCIATION,
   20  OR  NATIONALLY RECOGNIZED PAIN MANAGEMENT ASSOCIATION, MAY BE CONSIDERED
   21  IN IMPLEMENTING THIS SECTION.
   22    (B) CURRICULA SHALL INCLUDE, BUT NOT BE LIMITED TO:  I-STOP  AND  DRUG
   23  ENFORCEMENT   ADMINISTRATION  REQUIREMENTS  FOR  PRESCRIBING  CONTROLLED
   24  SUBSTANCES; PAIN MANAGEMENT;  APPROPRIATE  PRESCRIBING;  MANAGING  ACUTE
   25  PAIN; PALLIATIVE MEDICINE; PREVENTION, SCREENING AND SIGNS OF ADDICTION;
   26  RESPONSES TO ABUSE AND ADDICTION; AND END OF LIFE CARE.
   27    (C)  THE COMMISSIONER SHALL PROVIDE AN EXEMPTION FROM THIS REQUIREMENT
   28  TO ANYONE WHO REQUESTS SUCH AN EXEMPTION AND  WHO  DEMONSTRATES  TO  THE
   29  COMMISSIONER'S SATISFACTION THAT:
   30    (I) THERE WOULD BE NO NEED FOR HIM OR HER TO COMPLETE SUCH COURSE WORK
   31  OR TRAINING BECAUSE OF THE NATURE, AREA OR SPECIALTY OF HIS OR HER PRAC-
   32  TICE; OR
   33    (II)  HE  OR  SHE  HAS COMPLETED COURSE WORK OR TRAINING DEEMED BY THE
   34  COMMISSIONER TO BE EQUIVALENT TO THE STANDARDS FOR COURSE WORK OR TRAIN-
   35  ING APPROVED UNDER THIS SECTION.
   36    (D) THE COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER OF  EDUCA-
   37  TION  AND  STAKEHOLDERS  SHALL  REPORT TO THE TEMPORARY PRESIDENT OF THE
   38  SENATE, THE SPEAKER OF THE ASSEMBLY AND THE CHAIRS  OF  THE  HEALTH  AND
   39  HIGHER  EDUCATION  COMMITTEES NO LATER THAN THREE YEARS AFTER THE EFFEC-
   40  TIVE DATE OF THIS SUBDIVISION ON THE SUCCESS AND IMPACT OF THIS  SECTION
   41  AND ANY RECOMMENDATIONS.
   42    [(b)]  4.  Establish a work group, no later than June first, two thou-
   43  sand twelve, which shall be composed of experts in the fields of pallia-
   44  tive and chronic care pain management and addiction medicine. Members of
   45  the work group shall receive no compensation  for  their  services,  but
   46  shall  be  allowed  actual  and necessary expenses in the performance of
   47  their duties pursuant to this section. The work group shall:
   48    [(i)] (A) Report to the  commissioner  regarding  the  development  of
   49  recommendations  and  model  courses  for  continuing medical education,
   50  refresher courses and other training materials for licensed health  care
   51  professionals  on  appropriate use of prescription pain medication. Such
   52  recommendations, model courses and other  training  materials  shall  be
   53  submitted to the commissioner, who shall make such information available
   54  for  the  use  in  medical  education,  residency  programs,  fellowship
   55  programs, and for use in continuing  medication  education  programs  no
   56  later  than  January  first, two thousand thirteen. Such recommendations
       A. 1124--A                          3

    1  also shall include recommendations on: [(A)] (I) educational and contin-
    2  uing medical education requirements  for  practitioners  appropriate  to
    3  address prescription pain medication awareness among health care profes-
    4  sionals;  [(B)]  (II)  continuing education requirements for pharmacists
    5  related to prescription  pain  medication  awareness;  and  [(C)]  (III)
    6  continuing  education  in  palliative care as it relates to pain manage-
    7  ment, for which purpose the work group shall consult the New York  state
    8  palliative care education and training council;
    9    [(ii)] (B) No later than January first, two thousand thirteen, provide
   10  outreach  and  assistance  to  health care professional organizations to
   11  encourage and facilitate continuing medical education training  programs
   12  for  their  members  regarding appropriate prescribing practices for the
   13  best patient care and the  risks  associated  with  overprescribing  and
   14  underprescribing pain medication;
   15    [(iii)]  (C)  Provide  information  to the commissioner for use in the
   16  development and continued  update  of  the  public  awareness  campaign,
   17  including  information,  resources,  and active web links that should be
   18  included on the website; and
   19    [(iv)] (D) Consider other issues deemed relevant by the  commissioner,
   20  including  how  to  protect  and  promote  the access of patients with a
   21  legitimate need  for  controlled  substances,  particularly  medications
   22  needed  for pain management by oncology patients, and whether and how to
   23  encourage or require the use or substitution of opioid drugs that employ
   24  tamper-resistance technology as  a  mechanism  for  reducing  abuse  and
   25  diversion of opioid drugs.
   26    [3.] 5. On or before September first, two thousand twelve, the commis-
   27  sioner,  in consultation with the commissioner of the office of alcohol-
   28  ism and substance abuse services, the commissioner of education, and the
   29  executive secretary of the state board of pharmacy,  shall  add  to  the
   30  workgroup  such  additional members as appropriate so that the workgroup
   31  may provide guidance in furtherance of the implementation of the  I-STOP
   32  act.  For  such purposes, the workgroup shall include but not be limited
   33  to  consumer  advisory  organizations,  health  care  practitioners  and
   34  providers,  oncologists,  addiction  treatment  providers, practitioners
   35  with experience in pain  management,  pharmacists  and  pharmacies,  and
   36  representatives of law enforcement agencies.
   37    [4.]  6.  The commissioner shall report to the governor, the temporary
   38  president of the senate and the speaker of the assembly  no  later  than
   39  March first, two thousand thirteen, and annually thereafter, on the work
   40  group's  findings.  The report shall include information on opioid over-
   41  dose deaths, emergency room utilization  for  the  treatment  of  opioid
   42  overdose,  the utilization of pre-hospital addiction services and recom-
   43  mendations to reduce opioid addiction and the consequences thereof.  The
   44  report shall also include a recommendation as to whether subdivision two
   45  of section thirty-three hundred forty-three-a of this article should  be
   46  amended to require practitioners prescribing or dispensing certain iden-
   47  tified  schedule V controlled substances to comply with the consultation
   48  requirements of such subdivision.
   49    S 2. This act shall take effect one year after it shall have become  a
   50  law  and  shall  expire  and be deemed repealed 4 years after such date.
   51  Provided, however, that effective immediately, the  addition,  amendment
   52  and/or repeal of any rule or regulation necessary for the implementation
   53  of  this act on its effective date is authorized and directed to be made
   54  and completed on or before such effective date.
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