Bill Text: NY S00060 | 2021-2022 | General Assembly | Introduced


Bill Title: Directs the commissioner of health, in consultation with the commissioner of education, the commissioner of mental health, and the state board of pharmacy, to promulgate and implement rules and regulations authorizing the use of automated patient dispensing and storage systems for distribution of prescription and non-prescription drugs and medical devices at pharmacies.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2022-01-05 - REFERRED TO HIGHER EDUCATION [S00060 Detail]

Download: New_York-2021-S00060-Introduced.html



                STATE OF NEW YORK
        ________________________________________________________________________

                                           60

                               2021-2022 Regular Sessions

                    IN SENATE

                                       (Prefiled)

                                     January 6, 2021
                                       ___________

        Introduced  by  Sen. PERSAUD -- read twice and ordered printed, and when
          printed to be committed to the Committee on Higher Education

        AN ACT to amend the education law and the public health law, in relation
          to directing the commissioner of health,   in  consultation  with  the
          commissioner  of education, the commissioner of mental health, and the
          state board of pharmacy, to promulgate and implement rules  and  regu-
          lations  authorizing the use of automated patient dispensing and stor-
          age systems for  distribution  of  prescription  and  non-prescription
          drugs  and  medical  devices  directly to patients at certain pharmacy
          locations

          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:

     1    Section  1.  Subdivision  1  of  section 6808 of the education law, as
     2  amended by section 2 of part D of chapter 60 of the  laws  of  2014,  is
     3  amended to read as follows:
     4    1.  No  person,  firm, corporation or association shall possess drugs,
     5  prescriptions or poisons for the  purpose  of  compounding,  dispensing,
     6  retailing,   wholesaling,   or  manufacturing,  or  shall  offer  drugs,
     7  prescriptions or poisons for sale at retail or wholesale  unless  regis-
     8  tered  by  the  department  as  a  pharmacy, wholesaler, manufacturer or
     9  outsourcing facility; provided, however, that  the  provisions  of  this
    10  section   shall   not   prohibit   the   dispensing  and/or  storage  of
    11  prescriptions, drugs or medical devices through the use of an  automated
    12  patient dispensing and storage system as provided in section two hundred
    13  eighty-d  of the public health law and rules and regulations promulgated
    14  pursuant to such section.
    15    § 2. The public health law is amended by adding a new section 280-d to
    16  read as follows:
    17    § 280-d. Automated patient dispensing and storage systems  at  pharma-
    18  cies.  1.  The  commissioner,  in  consultation with the commissioner of

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD02963-01-1

        S. 60                               2

     1  education, the commissioner of mental health, and  the  state  board  of
     2  pharmacy,  shall  promulgate  rules  and  regulations  to  authorize the
     3  licensing and use of automated patient dispensing and storage systems as
     4  provided  in  this  section  which shall include, but not be limited to,
     5  requiring that the operator of an automated patient dispensing and stor-
     6  age system holds a registration from the federal drug enforcement agency
     7  for the distribution of controlled substances.
     8    2. Definitions. As used in this section:
     9    (a) "Automated drug delivery system"  or  "ADDS"  means  a  mechanical
    10  system that performs operations or activities, other than compounding or
    11  administration,  relative to the storage, dispensing, or distribution of
    12  drugs. An ADDS shall collect,  control,  and  maintain  all  transaction
    13  information  to  accurately  track the movement of drugs into and out of
    14  the system for security, accuracy, and accountability.
    15    (b) "Automated patient dispensing and storage system" or "APDSS" means
    16  an ADDS for storage and dispensing of drugs directly to patients  pursu-
    17  ant to prior authorization by a pharmacist.
    18    (c) "Drug" means a prescription drug, a non-prescription drug or over-
    19  the-counter medication or supply, and/or a medical device.
    20    (d)  "Patient"  means  an  individual  for  whom  medication  has been
    21  prescribed by any person authorized to prescribe medication pursuant  to
    22  article  one hundred thirty-one, one hundred thirty-one-b or one hundred
    23  forty-one of the education law.
    24    (e) "Pharmacy" means a pharmacy which holds a  registration  from  the
    25  federal  drug  enforcement  agency  for  the  distribution of controlled
    26  substances.
    27    3. Pursuant to the rules and regulations authorized by subdivision one
    28  of this section, if all of the following conditions are met, a  pharmacy
    29  located in the state may provide pharmacy services through the use of an
    30  automated  patient dispensing system to individual patients as described
    31  in subdivision five of this section:
    32    (a) The pharmacy obtains a license from the state board of pharmacy to
    33  operate the APDSS at or adjacent to the pharmacy, as applicable. As part
    34  of the application, the pharmacy shall provide the address at which  the
    35  APDSS  shall  be  placed.  A separate license shall be required for each
    36  location and shall be renewed  annually  concurrent  with  the  pharmacy
    37  license.  The application and renewal fee shall be three hundred dollars
    38  and may be increased to five hundred dollars.  The state board of  phar-
    39  macy is authorized to lower the renewal fee to not less than two hundred
    40  dollars  if  a  lower  fee  level  will  provide sufficient resources to
    41  support the regulatory activities.
    42    (b) Drugs stored in an APDSS shall be part of  the  inventory  of  the
    43  pharmacy  providing  pharmacy  services  to patients and drugs dispensed
    44  from the APDSS shall be considered to have been dispensed by that  phar-
    45  macy.
    46    (c)  The pharmacy shall maintain records of the acquisition and dispo-
    47  sition of drugs  stored  in  the  APDSS  separate  from  other  pharmacy
    48  records.
    49    (d)  The pharmacy shall be solely responsible for the security, opera-
    50  tion, and maintenance of the APDSS.
    51    (e) The pharmacy shall provide training regarding  the  operation  and
    52  use of the APDSS to pharmacy personnel using the system.
    53    (f)  The  operation  of  the APDSS shall be under the supervision of a
    54  pharmacist licensed pursuant to article one hundred thirty-seven of  the
    55  education  law acting on behalf of the pharmacy. The pharmacist need not

        S. 60                               3

     1  be physically present at the site of the APDSS  and  may  supervise  the
     2  system electronically.
     3    (g)  The state board of pharmacy may issue a license for the operation
     4  of an APDSS at an address for which it has issued another site  license,
     5  including  but  not  limited  to  drive-through pharmacy areas and other
     6  areas adjacent to the physical location occupied by a pharmacy.
     7    (h) The state board of pharmacy, within thirty days after  receipt  of
     8  an  application  for  an  APDSS  license,  shall conduct a pre-licensure
     9  inspection at the proposed location of  the  APDSS.  Relocation  of  the
    10  APDSS  shall require a new application for licensure.  Replacement of an
    11  APDSS shall require notice to such board within thirty days.
    12    (i) The APDSS license shall be canceled by operation  of  law  if  the
    13  underlying  pharmacy  license  is  not  current, valid, and active. Upon
    14  reissuance or reinstatement of the underlying pharmacy  license,  a  new
    15  application  for  an APDSS license shall be submitted to the state board
    16  of pharmacy, if so required by such board.
    17    (j) A pharmacy that holds an APDSS  license  shall  advise  the  state
    18  board  of  pharmacy in writing within thirty days if use of the APDSS is
    19  discontinued.
    20    4. (a) An  automated  patient  dispensing  and  storage  system  shall
    21  collect, control, and maintain all transaction information to accurately
    22  track  the  movement  of  drugs into and out of the system for security,
    23  accuracy, and accountability.
    24    (b) Transaction information shall be made readily available in a down-
    25  loadable format for review and inspection by individuals  authorized  by
    26  law to review such information. These records shall be maintained by the
    27  pharmacy for a minimum of three years.
    28    5.  Drugs  from an automated patient dispensing and storage system may
    29  be dispensed directly to a patient from a drive-through  pharmacy  aisle
    30  or  other  location  adjacent  to  the physical location occupied by the
    31  pharmacy, if all of the following requirements are met:
    32    (a) The pharmacy develops, implements, and  annually  reviews  written
    33  policies and procedures with respect to all of the following:
    34    (i)  the  pharmacy  maintains  the security of the APDSS and the drugs
    35  within that APDSS;
    36    (ii) the pharmacy determines and applies inclusion criteria  regarding
    37  which  drugs  are  appropriate  for placement in the APDSS and for which
    38  patients;
    39    (iii) the pharmacy ensures that patients are aware  that  consultation
    40  with  a pharmacist is available for any prescription medication, includ-
    41  ing those delivered via the APDSS;
    42    (iv) the pharmacy describes the assignment of responsibilities to, and
    43  training of pharmacy personnel regarding maintenance and filling  proce-
    44  dures for the APDSS;
    45    (v)  the  pharmacy  orients  participating  patients on the use of the
    46  APDSS, notifying patients when expected prescription medications are not
    47  available in the APDSS, and ensuring that patient use of the APDSS  does
    48  not interfere with delivery of drugs; and
    49    (vi)  the  pharmacy ensures delivery of drugs to patients expecting to
    50  receive them from the APDSS in the event the automated patient  dispens-
    51  ing and storage system is disabled or malfunctions.
    52    (b)  The automated patient dispensing and storage system shall only be
    53  used for patients who have signed a written consent demonstrating  their
    54  informed consent to receive prescribed drugs from an APDSS and whose use
    55  of  the APDSS meet the criteria pursuant to paragraph (a) of this subdi-
    56  vision.

        S. 60                               4

     1    (c) The automated patient dispensing and storage system shall  have  a
     2  means to identify each patient and only release the identified patient's
     3  drugs to the patient or the patient's agent.
     4    (d) A pharmacist shall perform all clinical services conducted as part
     5  of  the dispensing process, including, but not limited to, drug utiliza-
     6  tion review and consultation.
     7    (e) Drugs shall be dispensed from the automated patient dispensing and
     8  storage system only upon authorization from a pharmacist after the phar-
     9  macist has reviewed the  prescription  and  the  patient's  profile  for
    10  potential contraindications and adverse drug reactions.
    11    (f)  All  drugs  dispensed  from  the automated patient dispensing and
    12  storage system for the first time shall be accompanied by a consultation
    13  conducted by a pharmacist licensed pursuant to article one hundred thir-
    14  ty-seven of the education law in one of the following  manners:  (i)  in
    15  person;  (ii)  through  a  drive-through prescription dispensing window;
    16  (iii) via a telecommunications link that has two-way audio and video; or
    17  (iv) through a telephone call between the pharmacist and the patient  or
    18  the  patient's  appointed  representative with the prescribing physician
    19  present for the duration of the call.
    20    (g) The automated patient dispensing and storage system shall  include
    21  a  notice,  prominently  posted  on the automated patient dispensing and
    22  storage system, that provides the name, address, and telephone number of
    23  the pharmacy that holds the automated  patient  dispensing  and  storage
    24  system license for that APDSS.
    25    (h)  The  labels  on  all  drugs  dispensed  by  the automated patient
    26  dispensing and storage system shall comply with all New York  state  and
    27  federal  requirements for labelling of drugs prescribed and dispensed in
    28  this state.
    29    (i) Any complaint, error, or omission involving the automated  patient
    30  dispensing  and  storage system shall be reviewed as part of the pharma-
    31  cy's quality assurance program.
    32    (j) The state board of pharmacy shall not issue a pharmacy  more  than
    33  fifteen  licenses  for  automated  patient dispensing and storage system
    34  units under this section. The state board of pharmacy  may  adopt  regu-
    35  lations  to  reduce the number of APDSS licenses that may be issued to a
    36  pharmacy.
    37    (k) The  pharmacy  holding  the  license  for  the  automated  patient
    38  dispensing and storage system shall maintain the policies and procedures
    39  developed  pursuant to paragraph (a) of this subdivision for three years
    40  after the last date of use of that APDSS.
    41    6. Access to the automated patient dispensing and storage system shall
    42  be controlled and tracked using an identification or password system  or
    43  biosensor. A system that is accessed via a password system shall include
    44  a camera that records a picture of the individual accessing the machine.
    45  Picture  records shall be maintained for a minimum of one hundred eighty
    46  days.
    47    7. The automated patient dispensing and storage system  shall  make  a
    48  complete  and  accurate record of all transactions that will include all
    49  users accessing the APDSS and all drugs added to, or removed  from,  the
    50  APDSS.
    51    8.  The stocking of an automated patient dispensing and storage system
    52  shall be performed by a pharmacist.  If  the  APDSS  utilizes  removable
    53  pockets,  cards,  drawers,  similar technology, or unit of use or single
    54  dose containers as defined by the United States Pharmacopeia, the stock-
    55  ing system may be done outside of the APDSS  and  be  delivered  to  the
    56  APDSS if all of the following conditions are met:

        S. 60                               5

     1    (a) The task of placing drugs into the removable pockets, cards, draw-
     2  ers,  similar  technology,  or  unit of use or single dose containers is
     3  performed by a pharmacist, or by an  intern  pharmacist  or  a  pharmacy
     4  technician working under the direct supervision of a pharmacist licensed
     5  pursuant to article one hundred thirty-seven of the education law.
     6    (b) The removable pockets, cards, drawers, similar technology, or unit
     7  of  use  or  single dose containers are transported between the pharmacy
     8  and the APDSS in a secure tamper-evidence container.
     9    (c) The pharmacy, in conjunction with the covered entity,  has  devel-
    10  oped  policies  and  procedures  to  ensure  that the removable pockets,
    11  cards, drawers, similar technology,  or  unit  of  use  or  single  dose
    12  containers are properly placed into the automated patient dispensing and
    13  storage system.
    14    9. Review of the drugs contained within, and the operation and mainte-
    15  nance  of,  the automated patient dispensing and storage system shall be
    16  done in accordance with law and shall be the responsibility of the phar-
    17  macy. The review shall be conducted on a monthly basis by  a  pharmacist
    18  and  shall  include  a physical inspection of the drugs in the APDSS, an
    19  inspection of the APDSS machine for cleanliness, and  a  review  of  all
    20  transaction  records  in order to verify the security and accountability
    21  of the APDSS.
    22    10. A pharmacy holding an automated  patient  dispensing  and  storage
    23  system  license  shall  complete  an  annual  self-assessment, performed
    24  pursuant to rules and regulations promulgated pursuant to this  section,
    25  evaluating  the  pharmacy's  compliance  with  the education law and all
    26  applicable rules and regulations relating to the use  of  the  automated
    27  patient  dispensing and storage system. All information regarding opera-
    28  tion, maintenance, compliance, error, omissions, or complaints  pertain-
    29  ing to the APDSS shall be included in the self-assessment.
    30    11.  The  pharmacy  shall  comply  with  all recordkeeping and quality
    31  assurance requirements pursuant to this section and article one  hundred
    32  thirty-seven  of  the  education  law and all applicable rules and regu-
    33  lations and shall maintain those records within the pharmacy holding the
    34  APDSS license and separately from other pharmacy records.
    35    12. Rules and regulations providing  for  the  implementation  of  the
    36  provisions  of  this  section  shall be implemented within three hundred
    37  sixty-five days of the effective date of this section.
    38    § 3. This act shall take effect immediately.
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