NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A5805A
SPONSOR: McDonald TITLE OF BILL: An act to amend the education law, in relation to
authorizing pharmacists to perform collaborative drug therapy manage-
ment, and to amend chapter 21 of the laws of 2011 amending the education
law relating to authorizing pharmacists to perform collaborative drug
therapy management with physicians in certain settings, in relation to
extending such provisions
PURPOSE OF THE BILL:
To extend and expand provisions enacted in 2011 that permit pharmacists
to collaborate with physicians in the provision of collaborative drug
therapy management.
SUMMARY OF SPECIFIC PROVISIONS:
The bill would extend the Collaborative Drug Therapy Demonstration
Project for an additional three years and expand the scope of the
authorization for collaborative drug therapy management (CDTM) as
follows:
Section one of the bill would amend section 6801-a of the Education Law,
as follows:
*Authorizes pharmacists who have entered into a written agreement with a
physician to adjust or manage, evaluate and review drug regimens of a
patient including ordering or performing routine patient monitoring
functions as necessary;
*Authorizes CDTM to occur in teaching hospitals, general hospitals
including any diagnostic center, treatment center, or hospital-based
outpatient department as defined in section 2801 of the public health
law or a nursing home with an onsite pharmacy;
*Defines the eligibility process for pharmacists to enter into CDTM
agreements; and
*Requires the department of education and the department of health to
prepare a report that reviews the contributions of the expansion and
extension of CDMT including recommendations regarding such provisions
including recommendations for addressing barriers to further implementa-
tion of CDTM.
Section two of the bill would repeal the expiration date of the prior
statute and make the provisions permanent.
Section three provides the effective date.
JUSTIFICATION:
Collaborative Drug Therapy Management (CDTM) will further enhance the
quality of healthcare for individuals with chronic medical conditions in
three measurable areas: (1) improved clinical outcomes; (2) greater
patient satisfaction; and (3) more efficient delivery of care.
This bill creates a new certification that will qualify licensed pharma-
cists to enter into written voluntary Collaborative Drug Therapy Manage-
ment (CDTM) agreements with physicians. These CDTM protocols will speci-
fy the actions that New York State Education Department
(SED)-credentialed CDTM pharmacists are to follow when managing patients
who are assigned to their care by the authorizing practitioner, main-
taining the established lines of responsibility for patient care. Diag-
nosis and oversight remain the purview of physicians and other primary
care providers, while managing the drug therapy would be the responsi-
bility of the CDTM-certified collaborating pharmacist. Given the rigor-
ous requirements outlined in the bill for pharmacists to achieve the
CDTM certification, it is clear that patient safety and high standards
of healthcare are preserved. In fact, most states allow qualified phar-
macists to collaborate with primary care providers to provide comprehen-
sive drug therapy management and, since the passage of the demonstration
legislation, pharmacists have been successfully collaborating with
physicians across New York State in managing drug therapies for patients
with a broad range of disease states.
Introduction of this legislation follows the May 2014 release of a
comprehensive report to the legislature that presents detailed, positive
results of the CDTM demonstration programs that were initiated in
several of the state's teaching hospitals as authorized by the 2011 law.
The state-based, site-specific and disease-specific results in the
Report to the Legislature corroborate findings in a substantial volume
of peer-reviewed studies measuring evidence-based outcomes, perfor-
mance-based criteria and the economic benefits of pharmacist-provided
CDTM. Against every measurement, results were consistently better when
pharmacists managed patients' drug therapies in collaboration with the
treating practitioner. The report highlights results from patients being
treated by pharmacists in anti-coagulation clinics as well as patients
with diabetes, asthma, heart failure, cancer and HIV. The exhaustive
report prepared by the New York State Board of Pharmacy is consistent
with recommendations made in the 2011 Report to the U.S. Surgeon General
that pharmacists should be recognized as health care providers. Consist-
ent with the triple aim of improving healthcare quality and patient
satisfaction while controlling overall healthcare costs, the evidence is
clear and compelling that Collaborative Drug Therapy Management prac-
ticed by qualified pharmacists represents sound value and solid public
policy.
As the health care system continues to evolve, programs such as the
Delivery System Reform Incentive Program (DSRIP) and Value Based Care
call out for members of the pharmacy profession to be more engaged with
medical providers. CDTM is a path not for all pharmacists but for a
subset of the population who meet the rigorous standards established by
this legislation and overseen by the NYS BOP can lead to achieve better
patient care and outcomes.
PRIOR LEGISLATIVE HISTORY:
A7521-A (2013-14); referred to higher education
FISCAL IMPLICATIONS:
None.
EFFECTIVE DATE:
This act shall take effect immediately, provided that section one of
this act shall take effect on the ninetieth day after it shall have
become law; provided that the amendments to section 6801-a of the educa-
tion law, made by section one of this act, shall not affect the repeal
of such section and shall be deemed repealed therewith; provided,
further, that, effective immediately, the addition, amendment and/or
repeal of any rile or regulation necessary for the implementation of
this act on its effective date is authorized and directed to be made and
completed on or before such effective date.
