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.
STATE OF NEW YORK
________________________________________________________________________
4739--A
2015-2016 Regular Sessions
IN SENATE
April 15, 2015
___________
Introduced by Sens. HANNON, ADDABBO, ESPAILLAT, FUNKE, GALLIVAN, HOYL-
MAN, LATIMER, RITCHIE, ROBACH -- read twice and ordered printed, and
when printed to be committed to the Committee on Higher Education --
committee discharged, bill amended, 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; 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, and to amend
chapter 274 of the laws of 2013, amending the education law relating
to authorizing a licensed pharmacist and certified nurse practitioner
to administer meningococcal disease immunizing agents, in relation to
making the provisions thereof permanent
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
11 authorize unlicensed persons to administer immunizations, vaccines or
12 other drugs.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD00891-11-5
S. 4739--A 2
1 [(b) A licensed physician may prescribe and order a patient specific
2 order to a licensed pharmacist, pursuant to regulations promulgated by
3 the commissioner, and consistent with the public health law, for admin-
4 istering immunizations to prevent acute herpes zoster.
5 (c) A licensed physician may prescribe and order a non-patient specif-
6 ic regimen to a licensed pharmacist, pursuant to regulations promulgated
7 by the commissioner, and consistent with the public health law, for
8 administering immunizations to prevent meningococcal disease.]
9 § 2. Subdivision 7 of section 6909 of the education law, as amended by
10 chapter 116 of the laws of 2012 and paragraph (c) as added by chapter
11 274 of the laws of 2013, is amended to read as follows:
12 7. [(a)] A certified nurse practitioner may prescribe and order a
13 patient specific order or non-patient specific regimen to a licensed
14 pharmacist, pursuant to regulations promulgated by the commissioner, and
15 consistent with the public health law, for administering immunizations
16 to prevent influenza [or], pneumococcal, acute herpes zoster, meningo-
17 coccal, tetanus, diphtheria or pertussis disease and medications
18 required for emergency treatment of anaphylaxis. Nothing in this subdi-
19 vision shall authorize unlicensed persons to administer immunizations,
20 vaccines or other drugs.
21 [(b) A certified nurse practitioner may prescribe and order a patient
22 specific regimen to a licensed pharmacist, pursuant to regulations
23 promulgated by the commissioner, and consistent with the public health
24 law, for administering immunizations to prevent acute herpes zoster.
25 (c) A certified nurse practitioner may prescribe and order a non-pa-
26 tient specific regimen to a licensed pharmacist, pursuant to regulations
27 promulgated by the commissioner, and consistent with the public health
28 law, for administering immunizations to prevent meningococcal disease.]
29 § 3. Subdivisions 2, 4 and 5 of section 6801 of the education law,
30 subdivisions 2 and 4 as added by chapter 563 of the laws of 2008 and
31 subdivision 5 as added by chapter 116 of the laws of 2012, are amended
32 to read as follows:
33 2. A licensed pharmacist may execute a non-patient specific regimen
34 prescribed or ordered by a [licensed] physician licensed in this state
35 or [certified] nurse practitioner certified in this state, pursuant to
36 rules and regulations promulgated by the commissioner. When a licensed
37 pharmacist administers an immunizing agent, he or she shall:
38 (a) report such administration by electronic transmission or fascimile
39 to the patient's attending primary health care practitioner or practi-
40 tioners, if any, [pursuant to rules and regulations of the commissioner]
41 and, to the extent practicable, make himself or herself available to
42 discuss the outcome of such immunization, including any adverse
43 reactions, with the attending primary health care practitioner, or to
44 the statewide immunization registry or the citywide immunization regis-
45 try, as established pursuant to section twenty-one hundred sixty-eight
46 of the public health law; and
47 (b) provide information to the patient on the importance of having a
48 primary health care practitioner, developed by the commissioner of
49 health; and
50 (c) report such administration, absent of any individually identifi-
51 able health information, to the department of health in a manner
52 required by the commissioner of health.
53 (d) prior to administering the immunization, inform the patient of the
54 total cost of the immunization or immunizations, subtracting any health
55 insurance subsidization, if applicable. In the case the immunization is
56 not covered, the pharmacist must inform the patient of the possibility
S. 4739--A 3
1 that the immunization may be covered when administered by a primary care
2 physician or practitioner; and
3 (e) administer the immunization or immunizations according to the most
4 current recommendations by the advisory committee for immunization prac-
5 tices (ACIP), provided however, that a pharmacist may administer any
6 immunization authorized under this section when specified by a patient
7 specific order.
8 4. [The commissioner of health, in consultation with the commissioner,
9 shall prepare and submit a report to the governor and the legislature,
10 on or before December thirty-first, two thousand eleven, reporting the
11 results and evaluating the effectiveness and impact, if any, of imple-
12 mentation of subdivision two of this section upon the supply of such
13 immunizing agents for the prevention of influenza and pneumococcal
14 disease, upon the geographical distribution of such agents, and upon the
15 distribution of such agents among health care providers, including
16 physicians, and pharmacies in New York state.
17 5.] When administering an immunization in a pharmacy, the licensed
18 pharmacist shall provide an area for the immunization that provides for
19 a patient's privacy. The privacy area should include a clearly visible
20 posting of the most current "Recommended Adult Immunization Schedule"
21 published by the advisory committee for immunization practices (ACIP).
22 § 4. Subdivision 22 of section 6802 of the education law, as amended
23 by chapter 274 of the laws of 2013, is amended to read as follows:
24 22. "Administer", for the purpose of section sixty-eight hundred one
25 of this article, means the direct application of an immunizing agent to
26 adults, whether by injection, ingestion or any other means, pursuant to
27 [a.] a patient specific order or non-patient specific regimen prescribed
28 or ordered by a physician or certified nurse practitioner, who has a
29 practice site in the county or adjoining county in which the immuniza-
30 tion is administered, for immunizations to prevent influenza [or], pneu-
31 mococcal, acute herpes zoster, meningococcal, tetanus, diphtheria or
32 pertussis disease and medications required for emergency treatment of
33 anaphylaxis [or b. a patient specific order prescribed or ordered by a
34 physician or certified nurse practitioner for immunizations to prevent
35 acute herpes zoster or meningococcal disease or c. a patient specific
36 order or non-patient specific regimen prescribed or ordered by a physi-
37 cian or certified nurse practitioner for immunizations to prevent menin-
38 gococcal disease. If the county where the immunization is to be adminis-
39 tered has a population of seventy-five thousand or less, then the
40 licensed physician or certified nurse practitioner may be in an adjoin-
41 ing county. Such administration shall be limited to immunizing agents to
42 prevent influenza or pneumococcal disease and medications required for
43 emergency treatment of anaphylaxis]. If the commissioner of health
44 determines that there is an outbreak of disease, or that there is the
45 imminent threat of an outbreak of disease, then the commissioner of
46 health may issue a non-patient specific regimen applicable statewide.
47 § 5. Section 8 of chapter 563 of the laws of 2008, amending the educa-
48 tion law and the public health law relating to immunizing agents to be
49 administered to adults by pharmacists, as amended by chapter 316 of the
50 laws of 2011, is amended to read as follows:
51 § 8. This act shall take effect on the ninetieth day after it shall
52 have become a law and shall expire and be deemed repealed [March 31,
53 2016] July 1, 2019.
54 § 6. Sections 5 and 6 of chapter 116 of the laws of 2012, amending the
55 education law relating to authorizing a licensed pharmacist and certi-
S. 4739--A 4
1 fied nurse practitioner to administer certain immunizing agents, are
2 amended to read as follows:
3 § 5. [The commissioner of health, in consultation with the superinten-
4 dent of financial services and the commissioner of education, shall
5 prepare and submit a report to the governor and the legislature, on or
6 before October first, two thousand fourteen, regarding the rates of
7 health insurance plan coverage for immunizations to prevent acute herpes
8 zoster in New York state. This information shall include, but not be
9 limited to, the total number of people receiving immunizations to
10 prevent acute herpes zoster from health care providers as compared to
11 pharmacies in New York state; the rates of coverage from health insur-
12 ance plans, including Medicare, for people receiving immunizations to
13 prevent acute herpes zoster from health care providers as compared to
14 pharmacies in New York state; the amount of co-pays and other fees
15 required by health insurance plans, including Medicare, for people
16 receiving immunizations to prevent acute herpes zoster from health care
17 providers as compared to pharmacies in New York state; and a list of
18 health insurance plans that do not provide coverage for people receiving
19 immunizations to prevent acute herpes zoster from health care providers
20 as compared to pharmacies in New York state as well as the amount or
21 amounts that are charges to an individual receiving immunizations to
22 prevent herpes zoster without any health insurance coverage.
23 § 6.] This act shall take effect on the ninetieth day after it shall
24 have become a law and shall expire and be deemed repealed July 1, [2015]
25 2019 provided, that:
26 (a) the amendments to subdivision 7 of section 6527 of the education
27 law made by section one of this act shall not affect the repeal of such
28 subdivision and shall be deemed to be repealed therewith;
29 (b) the amendments to subdivision 7 of section 6909 of the education
30 law, made by section two of this act shall not affect the repeal of such
31 subdivision and shall be deemed to be repealed therewith;
32 (c) the amendments to subdivision 22 of section 6802 of the education
33 law made by section three of this act shall not affect the repeal of
34 such subdivision and shall be deemed to be repealed therewith; and
35 (d) the amendments to section 6801 of the education law made by
36 section four of this act shall not affect the expiration of such section
37 and shall be deemed to expire therewith.
38 § 7. The commissioner of health, in consultation with the superinten-
39 dent of financial services and the commissioner of education, shall
40 prepare and submit a report to the governor and to the temporary presi-
41 dent of the senate and the speaker of the assembly, on or before October
42 first, two thousand nineteen, regarding rates of health insurance plan
43 coverage for immunizations administered at pharmacies in New York state
44 and any other subjects deemed relevant and necessary. This information
45 shall include, but not be limited to, the total number of people receiv-
46 ing immunizations at pharmacies in New York state; the number of indi-
47 viduals reporting being under the care of a primary care physician or
48 practitioner when receiving an immunization at a pharmacy; the rates of
49 coverage from health insurance plans, including medicare, for people
50 receiving immunizations from pharmacies in New York state; and the
51 amount or amounts that are charges to an individual receiving immuniza-
52 tions without any health insurance coverage. The commissioner of
53 health, superintendent of financial services and the commissioner of
54 education may require pharmacists, private insurers, public insurers and
55 others to submit information necessary to the completion of the report.
56 § 8. This act shall take effect immediately; provided, however, that:
S. 4739--A 5
1 (a) the amendments to subdivision 7 of section 6527 of the education
2 law made by section one of this act shall not affect the expiration of
3 such subdivision and shall be deemed to be expired therewith;
4 (b) the amendments to subdivision 7 of section 6909 of the education
5 law, made by section two of this act shall not affect the expiration of
6 such subdivision and shall be deemed to be expired therewith;
7 (c) the amendments to subdivisions 2 and 4 of section 6801 of the
8 education law, made by section three of this act shall not affect the
9 expiration of such section and shall be deemed to expire therewith;
10 (d) the amendments to subdivision 5 of section 6801 of the education
11 law, made by section three of this act shall not affect the repeal of
12 such subdivision and shall be deemed repealed therewith;
13 (e) the amendments to subdivision 22 of section 6802 of the education
14 law, made by section four of this act shall not affect the expiration of
15 such subdivision and shall be deemed to be expired therewith; and
16 (f) the amendments to paragraph (a) of subdivision 2 of section 6801
17 of the education law made by section three of this act shall take effect
18 on the one hundred eightieth day after it shall have become a law,
19 provided, however, that effective immediately, any rules and regulations
20 necessary to implement the provisions of this act on its effective date
21 are authorized to be added, amended and/or repealed on or before such
22 effective date.
