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 [demonstration4program]. 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. LBD09687-01-7A. 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-27based 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 a34hospital licensed pursuant to article twenty-eight of the public health35law that is eligible to receive direct or indirect graduate medical36education payments pursuant to article twenty-eight of the public health37law.] 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 shallA. 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-19tive date when upon such date the provisions of this act shall be deemed20repealed]; 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.
