Bill Text: NY A10196 | 2017-2018 | General Assembly | Introduced


Bill Title: Includes nurse practioners as a provider of services for purposes of collaborative drug therapy management and makes the authorization for pharmacists to perform such management permanent.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2018-03-22 - referred to higher education [A10196 Detail]

Download: New_York-2017-A10196-Introduced.html


                STATE OF NEW YORK
        ________________________________________________________________________
                                          10196
                   IN ASSEMBLY
                                     March 22, 2018
                                       ___________
        Introduced  by  M.  of  A.  SEAWRIGHT  --  read once and referred to the
          Committee on Higher Education
        AN ACT to amend the education law, in relation to including nurse  prac-
          titioners as a provider of services for purposes of collaborative drug
          therapy management; and to amend chapter 21 of the laws of 2011 amend-
          ing  the  education law relating to authorizing pharmacists to perform
          collaborative drug  therapy  management  with  physicians  in  certain
          settings,  in  relation to making the authorization for pharmacists to
          perform collaborative drug therapy management permanent
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
     1    Section  1. Section 6801-a of the education law, as amended by chapter
     2  238 of the laws of 2015, is amended to read as follows:
     3    §  6801-a.  Collaborative  drug  therapy   management   [demonstration
     4  program].    1.  As used in this section, the following terms shall have
     5  the following meanings:
     6    a. "Board" shall mean the state board of pharmacy  as  established  by
     7  section sixty-eight hundred four of this article.
     8    b. "Clinical services" shall mean the collection and interpretation of
     9  patient  data  for  the  purpose of initiating, modifying and monitoring
    10  drug therapy  with  associated  accountability  and  responsibility  for
    11  outcomes in a direct patient care setting.
    12    c.  "Collaborative drug therapy management" shall mean the performance
    13  of clinical services by a pharmacist relating to the review,  evaluation
    14  and  management  of drug therapy to a patient, who is being treated by a
    15  physician or nurse practitioner for a  specific  disease  or  associated
    16  disease  states, in accordance with a written agreement or protocol with
    17  a voluntarily participating  physician  or  nurse  practitioner  and  in
    18  accordance with the policies, procedures, and protocols of the facility.
    19  Such  agreement  or  protocol  as entered into by the physician or nurse
    20  practitioner and a pharmacist, may include, and shall be limited to:
    21    (i) adjusting or managing a drug regimen of a patient, pursuant  to  a
    22  patient  specific  order  or protocol made by the patient's physician or
    23  nurse practitioner, which may include adjusting drug strength, frequency
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD09687-01-7

        A. 10196                            2
     1  of administration or route of administration. Adjusting the drug regimen
     2  shall not include substituting  or  selecting  a  different  drug  which
     3  differs  from  that  initially  prescribed by the patient's physician or
     4  nurse  practitioner  unless such substitution is expressly authorized in
     5  the written order or protocol. The pharmacist shall be required to imme-
     6  diately document in the patient record changes  made  to  the  patient's
     7  drug therapy and shall use any reasonable means or method established by
     8  the  facility to notify the patient's other treating physicians or nurse
     9  practitioners with whom he or she does not have a written  agreement  or
    10  protocol  regarding such changes. The patient's physician or nurse prac-
    11  titioner may prohibit, by written instruction, any adjustment or  change
    12  in the patient's drug regimen by the pharmacist;
    13    (ii)  evaluating  and, only if specifically authorized by the protocol
    14  and only to the extent necessary to discharge the  responsibilities  set
    15  forth  in  this section, ordering disease state laboratory tests related
    16  to the drug therapy management for the specific disease or disease state
    17  specified within the written agreement or protocol; and
    18    (iii) only if specifically authorized  by  the  written  agreement  or
    19  protocol  and only to the extent necessary to discharge the responsibil-
    20  ities set forth in this section, ordering or performing routine  patient
    21  monitoring functions as may be necessary in the drug therapy management,
    22  including  the collecting and reviewing of patient histories, and order-
    23  ing or checking patient vital signs, including pulse, temperature, blood
    24  pressure and respiration.
    25    d. "Facility" shall mean: (i) a [teaching hospital or general]  hospi-
    26  tal,  [including  any  diagnostic center, treatment center, or hospital-
    27  based outpatient department] as defined in subdivision  one  of  section
    28  twenty-eight  hundred  one  of  the public health law; or (ii) a nursing
    29  home  with  an  on-site  pharmacy  staffed  by  a  licensed  pharmacist;
    30  provided,  however, for the purposes of this section the term "facility"
    31  shall not  include  dental  clinics,  dental  dispensaries,  residential
    32  health care facilities and rehabilitation centers.
    33    [For  the purposes of this section, a "teaching hospital" shall mean a
    34  hospital licensed pursuant to article twenty-eight of the public  health
    35  law  that  is  eligible  to  receive direct or indirect graduate medical
    36  education payments pursuant to article twenty-eight of the public health
    37  law.] In addition, a facility may also include up to fifteen  community-
    38  practice  sites,  selected  by  the  department in consultation with the
    39  department of health, where pharmacists and physicians or nurse  practi-
    40  tioners  may  propose to enter into collaborative arrangements, pursuant
    41  to the provisions of this section. Such sites shall  be  selected  based
    42  upon  a review of applications submitted to the department by such phar-
    43  macists and physicians or nurse practitioners,  which  demonstrate  that
    44  the applicants can satisfy the requirements of this section.
    45    e.  "Physician"  or  "nurse  practitioner" shall mean the physician or
    46  nurse practitioner selected by or assigned to a patient, who has primary
    47  responsibility for the treatment and care of the patient for the disease
    48  and associated disease states that are the subject of the  collaborative
    49  drug therapy management.
    50    f.  "Written  agreement  or  protocol"  shall mean a written document,
    51  pursuant to and consistent with any applicable state or federal require-
    52  ments, that addresses a specific disease or  associated  disease  states
    53  and  that  describes  the nature and scope of collaborative drug therapy
    54  management to be undertaken by the pharmacists,  in  collaboration  with
    55  the participating physician or nurse practitioner in accordance with the
    56  provisions of this section.

        A. 10196                            3
     1    2.  a. A pharmacist who meets the experience requirements of paragraph
     2  b of this subdivision and who is either employed by or otherwise  affil-
     3  iated with a facility or is participating with a community-practice site
     4  selected  pursuant  to  paragraph  d  of subdivision one of this section
     5  shall  be permitted to enter into a written agreement or protocol with a
     6  physician or nurse practitioner authorizing collaborative  drug  therapy
     7  management, subject to the limitations set forth in this section, within
     8  the scope of such employment [or], affiliation or participation.
     9    b. A participating pharmacist must:
    10    (i)(A)  have been awarded either a master of science in clinical phar-
    11  macy or a doctor of pharmacy degree;
    12    (B) maintain a current unrestricted license; and
    13    (C) have a minimum of two years experience, of which at least one year
    14  of such experience shall include clinical experience in a health facili-
    15  ty, which involves consultation with physicians or  nurse  practitioners
    16  with  respect  to drug therapy and may include a residency at a facility
    17  involving such consultation; or
    18    (ii)(A) have been awarded a bachelor of science in pharmacy;
    19    (B) maintain a current unrestricted license; and
    20    (C) within the last seven years, have a minimum of three years experi-
    21  ence, of which at least one year of such experience shall include  clin-
    22  ical  experience  in a health facility, which involves consultation with
    23  physicians with respect to drug therapy and may include a residency at a
    24  facility involving such consultation; and
    25    (iii) meet any additional education, experience, or other requirements
    26  set forth by the department in consultation with the board.
    27    c. Notwithstanding any provision of law, nothing in this section shall
    28  prohibit a licensed pharmacist from engaging in clinical services  asso-
    29  ciated  with  collaborative  drug  therapy  management, in order to gain
    30  experience necessary to qualify under clause (C) of subparagraph (i)  or
    31  (ii)  of paragraph b of this subdivision, provided that such practice is
    32  under the supervision of a pharmacist that currently  meets  the  refer-
    33  enced  requirement, and that such practice is authorized under the writ-
    34  ten agreement or protocol with the physician or nurse practitioner.
    35    d. Notwithstanding any provision of this section, nothing herein shall
    36  authorize the pharmacist to diagnose disease. In the event that a treat-
    37  ing physician or nurse practitioner may disagree with  the  exercise  of
    38  professional  judgment  by  a  pharmacist,  the judgment of the treating
    39  physician or nurse practitioner shall prevail.
    40    3. The physician or nurse practitioner who is a  party  to  a  written
    41  agreement  or protocol authorizing collaborative drug therapy management
    42  shall be employed by or otherwise affiliated with the same facility with
    43  which the pharmacist is also employed or affiliated.
    44    4. The existence of a written agreement or protocol  on  collaborative
    45  drug therapy management and the patient's right to choose to not partic-
    46  ipate in collaborative drug therapy management shall be disclosed to any
    47  patient  who  is  eligible to receive collaborative drug therapy manage-
    48  ment. Collaborative drug therapy management shall not be utilized unless
    49  the patient or the  patient's  authorized  representative  consents,  in
    50  writing,  to such management. If the patient or the patient's authorized
    51  representative consents, it shall be  noted  on  the  patient's  medical
    52  record.  If  the  patient or the patient's authorized representative who
    53  consented to collaborative drug therapy management chooses to no  longer
    54  participate  in  such  management, at any time, it shall be noted on the
    55  patient's medical record. In addition,  the  existence  of  the  written
    56  agreement or protocol and the patient's consent to such management shall

        A. 10196                            4
     1  be  disclosed  to  the patient's primary physician or nurse practitioner
     2  and any other treating physician or  nurse  practitioner  or  healthcare
     3  provider.
     4    5. Participation in a written agreement or protocol authorizing colla-
     5  borative  drug  therapy  management  shall be voluntary, and no patient,
     6  physician or  nurse  practitioner,  pharmacist,  or  facility  shall  be
     7  required to participate.
     8    6. Nothing in this section shall be deemed to limit the scope of prac-
     9  tice of pharmacy nor be deemed to limit the authority of pharmacists and
    10  physicians  or  nurse  practitioners  to engage in medication management
    11  prior to the effective date of this section and to the extent authorized
    12  by law.
    13    § 2. Section 5 of chapter 21 of the laws of 2011 amending  the  educa-
    14  tion  law  relating  to authorizing pharmacists to perform collaborative
    15  drug therapy management with physicians in certain settings, as  amended
    16  by chapter 238 of the laws of 2015, is amended to read as follows:
    17    § 5. This act shall take effect on the one hundred twentieth day after
    18  it  shall  have become a law [and shall expire 7 years after such effec-
    19  tive date when upon such date the provisions of this act shall be deemed
    20  repealed]; provided, however, that the amendments to  subdivision  1  of
    21  section  6801 of the education law made by section one of this act shall
    22  be subject to the expiration and reversion of such subdivision  pursuant
    23  to section 8 of chapter 563 of the laws of 2008, when upon such date the
    24  provisions  of  section  one-a  of this act shall take effect; provided,
    25  further, that effective  immediately,  the  addition,  amendment  and/or
    26  repeal  of  any  rule  or regulation necessary for the implementation of
    27  this act on its effective date is authorized and directed to be made and
    28  completed on or before such effective date.
    29    § 3. This act shall take effect on the one hundred twentieth day after
    30  it shall have become a law; provided that,  effective  immediately,  the
    31  addition,  amendment  and/or  repeal of any rule or regulation necessary
    32  for the implementation of this act on its effective date are  authorized
    33  and directed to be made and completed on or before such effective date.
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