A00123 Summary:

BILL NOA00123B
 
SAME ASSAME AS S04739-A
 
SPONSORPaulin
 
COSPNSRGottfried, Gunther, Markey, Otis, Hooper, Simanowitz, Weprin, Fahy, McDonald, Buchwald, Stirpe, Lavine, Skoufis, Steck, Ortiz, Clark, Duprey, Linares
 
MLTSPNSRCeretto, Cook, DiPietro, Goodell, Hikind, Lupardo, Lupinacci, Magee, Moya, Perry, Schimel, Schimminger, Walter
 
Amd SS6527, 6909, 6801 & 6802, Ed L; amd S8, Chap 563 of 2008; amd SS5 & 6, Chap 116 of 2012
 
Relates to the administration of certain immunizations; requires immunizing agents be administered to adults by pharmacists; authorizes a licensed pharmacist and certified nurse practitioner to administer certain immunizing agents and meningococcal disease immunizing agents; makes provisions permanent.
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A00123 Actions:

BILL NOA00123B
 
01/07/2015referred to higher education
06/08/2015amend (t) and recommit to higher education
06/08/2015print number 123a
06/10/2015amend and recommit to higher education
06/10/2015print number 123b
06/16/2015reported referred to rules
06/17/2015reported
06/17/2015rules report cal.512
06/17/2015ordered to third reading rules cal.512
06/18/2015substituted by s4739a
 S04739 AMEND=A HANNON
 04/15/2015REFERRED TO HIGHER EDUCATION
 06/10/2015AMEND AND RECOMMIT TO HIGHER EDUCATION
 06/10/2015PRINT NUMBER 4739A
 06/15/2015COMMITTEE DISCHARGED AND COMMITTED TO RULES
 06/15/2015ORDERED TO THIRD READING CAL.1536
 06/15/2015PASSED SENATE
 06/15/2015DELIVERED TO ASSEMBLY
 06/15/2015referred to higher education
 06/18/2015substituted for a123b
 06/18/2015ordered to third reading rules cal.512
 06/18/2015passed assembly
 06/18/2015returned to senate
 06/29/2015DELIVERED TO GOVERNOR
 06/30/2015SIGNED CHAP.46
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A00123 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A123B
 
SPONSOR: Paulin (MS)
  TITLE OF BILL: An act to amend the education law, in relation to the administration of certain immunizations; to amend chapter 563 of the laws of 2008, amending the education law and the public health law relating to immunizing agents to be administered to adults by pharma- cists; and to amend chapter 116 of the laws of 2012, amending the educa- tion law relating to authorizing a licensed pharmacist and certified nurse practitioner to administer certain immunizing agents, in relation to the effectiveness thereof   PURPOSE OR GENERAL IDEA OF BILL: To authorize pharmacists to administer immunizations to prevent acute herpes zoster pursuant to a non-patient specific regimen; to authorize pharmacists to administer immunizations to prevent tetanus, diphtheria and pertussis pursuant to a patient specific or non-patient specific order; to amend the county restriction that applies to the physician or nurse practitioner issuing patient-specific or non-patient specific order to a licensed pharmacist certified to immunize; and to extend the sunset provisions by 3 years.   SUMMARY OF SPECIFIC PROVISIONS: Section 1 of the bill amends S 6527(7) of the Education Law to allow a licensed physician to issue a patient specific or non-patient specific regimen to a licensed pharmacist for immunizations to prevent acute herpes zoster, tetanus, diphtheria, or pertussis. Section 2 of the bill amends S 6909(7) of the Education Law to allow a certified nurse practitioner to issue a patient specific or non-patient specific regimen to a licensed pharmacist for immunizations to prevent acute herpes zoster, tetanus, diphtheria, or pertussis. Section 3 of the bill amends S 6801 of the Education Law to amend approved methods of notifying primary care practitioners, require the pharmacist to inform the patient of cost prior to administering an immunization, and to administer immunizations according to recommenda- tions by the advisory committee for immunization practices (ACIP), to make technical amendments and removes a requirement for a report that was issued in 2011. Section 4 of the bill amends S 6802 of the Education Law to authorize pharmacists to administer immunizations to prevent acute herpes zoster, tetanus, diphtheria, or pertussis pursuant to a patient specific or non-patient specific regimen. It also authorizes a non-patient specific regimen statewide in the event of a disease outbreak or the imminent threat of a disease outbreak, as determined by the commissioner of health. The requirement that standing orders be issued by a physician or nurse practitioner practicing in the same county in which the immuniza- tion is administered is amended to allow orders to be issued by a physi- cian or nurse practitioner in an adjoining county. Section 5 extends by 3 years the sunset provision that applies to phar- macists' authority to administer immunizations to prevent influenza and pneumococcal disease. Section 6 eliminates the requirement that a report be issued to the governor and legislature regarding the rates of health insurance plan coverage for immunizations to prevent acute herpes zoster. It also extends by 3 years the sunset provision that applies to pharmacists' authority to administer immunizations to prevent influenza and pneumo- coccal disease. Section 7 adds a required report be issued to the governor and the legislature regarding rates of health insurance plan coverage to replace a report that was never completed Section 8 provides the effective date.   JUSTIFICATION: New York State, like the United States as a whole, has experienced a surge in the number of cases of pertussis in recent years. The Tdap vaccine is recommended by the CDC for adults 19 years and older who have not received a dose of Tdap, especially those who have contact with infants. Allowing pharmacists to administer the Tdap vaccine will provide more opportunities for people to get vaccinated and help reduce the cases of pertussis in New York. Importantly, this bill also makes it easier for people to get the shin- gles vaccine, by authorizing pharmacists to administer that vaccine pursuant to a non-patient specific regimen when following ACIP recommen- dations. Currently, pharmacists may only administer this immunization pursuant to a patient-specific prescription, so an individual must first go to their doctor and obtain the prescription, then go to the pharmacy to receive the immunization. This bill also eases the requirement that standing orders be issued by a physician practicing in the same county in which the immunization is administered, which has proven difficult to obtain in some rural areas. Pharmacists were first authorized to administer immunizations to prevent influenza or pneumococcal in 2008, and that authority has already been extended for an additional period due to the safety and success of that program. This bill will eliminate that sunset provision, as well as the sunsets that apply to immunizations to prevent herpes zoster and menin- gococcal disease.   PRIOR LEGISLATIVE HISTORY: A.9211-A, 2014 held for consideration in higher education. Same as S.5688-A, 2014 referred to higher education.   FISCAL IMPLICATIONS: None   EFFECTIVE DATE: This act shall take effect immediately
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A00123 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         123--B
 
                               2015-2016 Regular Sessions
 
                   IN ASSEMBLY
 
                                       (Prefiled)
 
                                     January 7, 2015
                                       ___________
 
        Introduced by M. of A. PAULIN, GOTTFRIED, GUNTHER, MARKEY, OTIS, HOOPER,
          SIMANOWITZ, WEPRIN, FAHY, McDONALD, BUCHWALD, STIRPE, LAVINE, SKOUFIS,
          BROOK-KRASNY,  STECK, ORTIZ, CLARK, DUPREY, LINARES -- Multi-Sponsored
          by -- M. of A.   CERETTO, COOK, DiPIETRO,  GOODELL,  HIKIND,  LUPARDO,
          LUPINACCI,  MAGEE,  MOYA,  PERRY, SCHIMEL, SCHIMMINGER, WALTER -- read
          once and referred to the Committee on Higher  Education  --  committee
          discharged, bill amended, ordered reprinted as amended and recommitted
          to  said  committee  -- again reported from said committee with amend-
          ments, ordered reprinted as amended and recommitted to said committee
 
        AN ACT to amend the education law, in relation to the administration  of
          certain  immunizations;  to  amend  chapter  563  of the laws of 2008,
          amending the education law and  the  public  health  law  relating  to
          immunizing  agents to be administered to adults by pharmacists; and to
          amend chapter 116 of the laws of  2012,  amending  the  education  law
          relating  to  authorizing  a  licensed  pharmacist and certified nurse
          practitioner to administer certain immunizing agents, in  relation  to
          the effectiveness thereof
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 
     1    Section 1. Subdivision 7 of section 6527  of  the  education  law,  as
     2  amended by chapter 116 of the laws of 2012 and paragraph (c) as added by
     3  chapter 274 of the laws of 2013, is amended to read as follows:
     4    7.  [(a)]  A  licensed  physician  may  prescribe  and order a patient
     5  specific order or non-patient specific regimen to a licensed pharmacist,
     6  pursuant to regulations promulgated by the commissioner, and  consistent
     7  with  the  public health law, for administering immunizations to prevent
     8  influenza [or], pneumococcal, acute herpes zoster, meningococcal,  teta-
     9  nus,  diphtheria or pertussis disease and medications required for emer-
    10  gency treatment  of  anaphylaxis.  Nothing  in  this  subdivision  shall
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD00891-10-5

        A. 123--B                           2
 
     1  authorize  unlicensed  persons  to administer immunizations, vaccines or
     2  other drugs.
     3    [(b)  A  licensed physician may prescribe and order a patient specific
     4  order to a licensed pharmacist, pursuant to regulations  promulgated  by
     5  the  commissioner, and consistent with the public health law, for admin-
     6  istering immunizations to prevent acute herpes zoster.
     7    (c) A licensed physician may prescribe and order a non-patient specif-
     8  ic regimen to a licensed pharmacist, pursuant to regulations promulgated
     9  by the commissioner, and consistent with  the  public  health  law,  for
    10  administering immunizations to prevent meningococcal disease.]
    11    § 2. Subdivision 7 of section 6909 of the education law, as amended by
    12  chapter  116  of  the laws of 2012 and paragraph (c) as added by chapter
    13  274 of the laws of 2013, is amended to read as follows:
    14    7. [(a)] A certified nurse practitioner  may  prescribe  and  order  a
    15  patient  specific  order  or  non-patient specific regimen to a licensed
    16  pharmacist, pursuant to regulations promulgated by the commissioner, and
    17  consistent with the public health law, for  administering  immunizations
    18  to  prevent  influenza [or], pneumococcal, acute herpes zoster, meningo-
    19  coccal,  tetanus,  diphtheria  or  pertussis  disease  and   medications
    20  required  for emergency treatment of anaphylaxis. Nothing in this subdi-
    21  vision shall authorize unlicensed persons to  administer  immunizations,
    22  vaccines or other drugs.
    23    [(b)  A certified nurse practitioner may prescribe and order a patient
    24  specific regimen to  a  licensed  pharmacist,  pursuant  to  regulations
    25  promulgated  by  the commissioner, and consistent with the public health
    26  law, for administering immunizations to prevent acute herpes zoster.
    27    (c) A certified nurse practitioner may prescribe and order  a  non-pa-
    28  tient specific regimen to a licensed pharmacist, pursuant to regulations
    29  promulgated  by  the commissioner, and consistent with the public health
    30  law, for administering immunizations to prevent meningococcal disease.]
    31    § 3. Subdivisions 2, 4 and 5 of section 6801  of  the  education  law,
    32  subdivisions  2  and  4  as added by chapter 563 of the laws of 2008 and
    33  subdivision 5 as added by chapter 116 of the laws of 2012,  are  amended
    34  to read as follows:
    35    2.  A  licensed  pharmacist may execute a non-patient specific regimen
    36  prescribed or ordered by a [licensed] physician licensed in  this  state
    37  or  [certified]  nurse practitioner certified in this state, pursuant to
    38  rules and regulations promulgated by the commissioner. When  a  licensed
    39  pharmacist administers an immunizing agent, he or she shall:
    40    (a) report such administration by electronic transmission or fascimile
    41  to  the  patient's attending primary health care practitioner or practi-
    42  tioners, if any, [pursuant to rules and regulations of the commissioner]
    43  and, to the extent practicable, make himself  or  herself  available  to
    44  discuss   the  outcome  of  such  immunization,  including  any  adverse
    45  reactions, with the attending primary health care  practitioner,  or  to
    46  the  statewide immunization registry or the citywide immunization regis-
    47  try, as established pursuant to section twenty-one  hundred  sixty-eight
    48  of the public health law; and
    49    (b)  provide  information to the patient on the importance of having a
    50  primary health care  practitioner,  developed  by  the  commissioner  of
    51  health; and
    52    (c)  report  such administration, absent of any individually identifi-
    53  able health information,  to  the  department  of  health  in  a  manner
    54  required by the commissioner of health.
    55    (d) prior to administering the immunization, inform the patient of the
    56  total  cost of the immunization or immunizations, subtracting any health

        A. 123--B                           3
 
     1  insurance subsidization, if applicable. In the case the immunization  is
     2  not  covered,  the pharmacist must inform the patient of the possibility
     3  that the immunization may be covered when administered by a primary care
     4  physician or practitioner; and
     5    (e) administer the immunization or immunizations according to the most
     6  current recommendations by the advisory committee for immunization prac-
     7  tices  (ACIP),  provided  however,  that a pharmacist may administer any
     8  immunization authorized under this section when specified by  a  patient
     9  specific order.
    10    4. [The commissioner of health, in consultation with the commissioner,
    11  shall  prepare  and submit a report to the governor and the legislature,
    12  on or before December thirty-first, two thousand eleven,  reporting  the
    13  results  and  evaluating the effectiveness and impact, if any, of imple-
    14  mentation of subdivision two of this section upon  the  supply  of  such
    15  immunizing  agents  for  the  prevention  of  influenza and pneumococcal
    16  disease, upon the geographical distribution of such agents, and upon the
    17  distribution of such  agents  among  health  care  providers,  including
    18  physicians, and pharmacies in New York state.
    19    5.]  When  administering  an  immunization in a pharmacy, the licensed
    20  pharmacist shall provide an area for the immunization that provides  for
    21  a  patient's  privacy. The privacy area should include a clearly visible
    22  posting of the most current "Recommended  Adult  Immunization  Schedule"
    23  published by the advisory committee for immunization practices (ACIP).
    24    §  4.  Subdivision 22 of section 6802 of the education law, as amended
    25  by chapter 274 of the laws of 2013, is amended to read as follows:
    26    22. "Administer", for the purpose of section sixty-eight  hundred  one
    27  of  this article, means the direct application of an immunizing agent to
    28  adults, whether by injection, ingestion or any other means, pursuant  to
    29  [a.] a patient specific order or non-patient specific regimen prescribed
    30  or  ordered  by  a  physician or certified nurse practitioner, who has a
    31  practice site in the county or adjoining county in which  the  immuniza-
    32  tion is administered, for immunizations to prevent influenza [or], pneu-
    33  mococcal,  acute  herpes  zoster,  meningococcal, tetanus, diphtheria or
    34  pertussis disease and medications required for  emergency  treatment  of
    35  anaphylaxis  [or  b. a patient specific order prescribed or ordered by a
    36  physician or certified nurse practitioner for immunizations  to  prevent
    37  acute  herpes  zoster  or meningococcal disease or c. a patient specific
    38  order or non-patient specific regimen prescribed or ordered by a  physi-
    39  cian or certified nurse practitioner for immunizations to prevent menin-
    40  gococcal disease. If the county where the immunization is to be adminis-
    41  tered  has  a  population  of  seventy-five  thousand  or less, then the
    42  licensed physician or certified nurse practitioner may be in an  adjoin-
    43  ing county. Such administration shall be limited to immunizing agents to
    44  prevent  influenza  or pneumococcal disease and medications required for
    45  emergency treatment of  anaphylaxis].  If  the  commissioner  of  health
    46  determines  that  there  is an outbreak of disease, or that there is the
    47  imminent threat of an outbreak of  disease,  then  the  commissioner  of
    48  health may issue a non-patient specific regimen applicable statewide.
    49    § 5. Section 8 of chapter 563 of the laws of 2008, amending the educa-
    50  tion  law  and the public health law relating to immunizing agents to be
    51  administered to adults by pharmacists, as amended by chapter 316 of  the
    52  laws of 2011, is amended to read as follows:
    53    §  8.  This  act shall take effect on the ninetieth day after it shall
    54  have become a law and shall expire and be  deemed  repealed  [March  31,
    55  2016] July 1, 2019.

        A. 123--B                           4
 
     1    § 6. Sections 5 and 6 of chapter 116 of the laws of 2012, amending the
     2  education  law  relating to authorizing a licensed pharmacist and certi-
     3  fied nurse practitioner to administer  certain  immunizing  agents,  are
     4  amended to read as follows:
     5    § 5. [The commissioner of health, in consultation with the superinten-
     6  dent  of  financial  services  and  the commissioner of education, shall
     7  prepare and submit a report to the governor and the legislature,  on  or
     8  before  October  first,  two  thousand  fourteen, regarding the rates of
     9  health insurance plan coverage for immunizations to prevent acute herpes
    10  zoster in New York state. This information shall  include,  but  not  be
    11  limited  to,  the  total  number  of  people  receiving immunizations to
    12  prevent acute herpes zoster from health care providers  as  compared  to
    13  pharmacies  in  New York state; the rates of coverage from health insur-
    14  ance plans, including Medicare, for people  receiving  immunizations  to
    15  prevent  acute  herpes  zoster from health care providers as compared to
    16  pharmacies in New York state; the  amount  of  co-pays  and  other  fees
    17  required  by  health  insurance  plans,  including  Medicare, for people
    18  receiving immunizations to prevent acute herpes zoster from health  care
    19  providers  as  compared  to  pharmacies in New York state; and a list of
    20  health insurance plans that do not provide coverage for people receiving
    21  immunizations to prevent acute herpes zoster from health care  providers
    22  as  compared  to  pharmacies  in New York state as well as the amount or
    23  amounts that are charges to an  individual  receiving  immunizations  to
    24  prevent herpes zoster without any health insurance coverage.
    25    §  6.]  This act shall take effect on the ninetieth day after it shall
    26  have become a law and shall expire and be deemed repealed July 1, [2015]
    27  2019 provided, that:
    28    (a) the amendments to subdivision 7 of section 6527 of  the  education
    29  law  made by section one of this act shall not affect the repeal of such
    30  subdivision and shall be deemed to be repealed therewith;
    31    (b) the amendments to subdivision 7 of section 6909 of  the  education
    32  law, made by section two of this act shall not affect the repeal of such
    33  subdivision and shall be deemed to be repealed therewith;
    34    (c)  the amendments to subdivision 22 of section 6802 of the education
    35  law made by section three of this act shall not  affect  the  repeal  of
    36  such subdivision and shall be deemed to be repealed therewith; and
    37    (d)  the  amendments  to  section  6801  of  the education law made by
    38  section four of this act shall not affect the expiration of such section
    39  and shall be deemed to expire therewith.
    40    § 7. The commissioner of health, in consultation with the  superinten-
    41  dent  of  financial  services  and  the commissioner of education, shall
    42  prepare and submit a report to the governor and to the temporary  presi-
    43  dent of the senate and the speaker of the assembly, on or before October
    44  first,  two  thousand nineteen, regarding rates of health insurance plan
    45  coverage for immunizations administered at pharmacies in New York  state
    46  and  any other subjects deemed relevant and necessary.  This information
    47  shall include, but not be limited to, the total number of people receiv-
    48  ing immunizations at pharmacies in New York state; the number  of  indi-
    49  viduals  reporting  being  under the care of a primary care physician or
    50  practitioner when receiving an immunization at a pharmacy; the rates  of
    51  coverage  from  health  insurance  plans, including medicare, for people
    52  receiving immunizations from pharmacies  in  New  York  state;  and  the
    53  amount  or amounts that are charges to an individual receiving immuniza-
    54  tions without any  health  insurance  coverage.    The  commissioner  of
    55  health,  superintendent  of  financial  services and the commissioner of

        A. 123--B                           5
 
     1  education may require pharmacists, private insurers, public insurers and
     2  others to submit information necessary to the completion of the report.
     3    § 8. This act shall take effect immediately; provided, however, that:
     4    (a)  the  amendments to subdivision 7 of section 6527 of the education
     5  law made by section one of this act shall not affect the  expiration  of
     6  such subdivision and shall be deemed to be expired therewith;
     7    (b)  the  amendments to subdivision 7 of section 6909 of the education
     8  law, made by section two of this act shall not affect the expiration  of
     9  such subdivision and shall be deemed to be expired therewith;
    10    (c)  the  amendments  to  subdivisions  2 and 4 of section 6801 of the
    11  education law, made by section three of this act shall  not  affect  the
    12  expiration of such section and shall be deemed to expire therewith;
    13    (d)  the  amendments to subdivision 5 of section 6801 of the education
    14  law, made by section three of this act shall not affect  the  repeal  of
    15  such subdivision and shall be deemed repealed therewith;
    16    (e)  the amendments to subdivision 22 of section 6802 of the education
    17  law, made by section four of this act shall not affect the expiration of
    18  such subdivision and shall be deemed to be expired therewith; and
    19    (f) the amendments to paragraph (a) of subdivision 2 of  section  6801
    20  of the education law made by section three of this act shall take effect
    21  on  the  one  hundred  eightieth  day  after it shall have become a law,
    22  provided, however, that effective immediately, any rules and regulations
    23  necessary to implement the provisions of this act on its effective  date
    24  are  authorized  to  be added, amended and/or repealed on or before such
    25  effective date.
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