S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 4739--A

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                             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:

  Section 1. Subdivision 7 of section 6527  of  the  education  law,  as
amended by chapter 116 of the laws of 2012 and paragraph (c) as added by
chapter 274 of the laws of 2013, is amended to read as follows:
  7.  [(a)]  A  licensed  physician  may  prescribe  and order a PATIENT
SPECIFIC ORDER OR non-patient specific regimen to a licensed pharmacist,
pursuant to regulations promulgated by the commissioner, and  consistent
with  the  public health law, for administering immunizations to prevent
influenza [or], pneumococcal, ACUTE HERPES ZOSTER, MENINGOCOCCAL,  TETA-
NUS,  DIPHTHERIA OR PERTUSSIS disease and medications required for emer-
gency treatment  of  anaphylaxis.  Nothing  in  this  subdivision  shall
authorize  unlicensed  persons  to administer immunizations, vaccines or
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

  [(b) A licensed physician may prescribe and order a  patient  specific
order  to  a licensed pharmacist, pursuant to regulations promulgated by
the commissioner, and consistent with the public health law, for  admin-
istering immunizations to prevent acute herpes zoster.
  (c) A licensed physician may prescribe and order a non-patient specif-
ic regimen to a licensed pharmacist, pursuant to regulations promulgated
by  the  commissioner,  and  consistent  with the public health law, for
administering immunizations to prevent meningococcal disease.]
  S 2. Subdivision 7 of section 6909 of the education law, as amended by
chapter 116 of the laws of 2012 and paragraph (c) as  added  by  chapter
274 of the laws of 2013, is amended to read as follows:
  7.  [(a)]  A  certified  nurse  practitioner may prescribe and order a
PATIENT SPECIFIC ORDER OR non-patient specific  regimen  to  a  licensed
pharmacist, pursuant to regulations promulgated by the commissioner, and
consistent  with  the public health law, for administering immunizations
to prevent influenza [or], pneumococcal, ACUTE HERPES  ZOSTER,  MENINGO-
COCCAL,   TETANUS,  DIPHTHERIA  OR  PERTUSSIS  disease  and  medications
required for emergency treatment of anaphylaxis. Nothing in this  subdi-
vision  shall  authorize unlicensed persons to administer immunizations,
vaccines or other drugs.
  [(b) A certified nurse practitioner may prescribe and order a  patient
specific  regimen  to  a  licensed  pharmacist,  pursuant to regulations
promulgated by the commissioner, and consistent with the  public  health
law, for administering immunizations to prevent acute herpes zoster.
  (c)  A  certified nurse practitioner may prescribe and order a non-pa-
tient specific regimen to a licensed pharmacist, pursuant to regulations
promulgated by the commissioner, and consistent with the  public  health
law, for administering immunizations to prevent meningococcal disease.]
  S  3.  Subdivisions  2,  4 and 5 of section 6801 of the education law,
subdivisions 2 and 4 as added by chapter 563 of the  laws  of  2008  and
subdivision  5  as added by chapter 116 of the laws of 2012, are amended
to read as follows:
  2. A licensed pharmacist may execute a  non-patient  specific  regimen
prescribed  or  ordered by a [licensed] physician LICENSED IN THIS STATE
or [certified] nurse practitioner CERTIFIED IN THIS STATE,  pursuant  to
rules  and  regulations promulgated by the commissioner. When a licensed
pharmacist administers an immunizing agent, he or she shall:
  (a) report such administration BY ELECTRONIC TRANSMISSION OR FASCIMILE
to the patient's attending primary health care practitioner  or  practi-
tioners, if any, [pursuant to rules and regulations of the commissioner]
AND,  TO  THE  EXTENT  PRACTICABLE, MAKE HIMSELF OR HERSELF AVAILABLE TO
DISCUSS  THE  OUTCOME  OF  SUCH  IMMUNIZATION,  INCLUDING  ANY   ADVERSE
REACTIONS,  WITH  THE  ATTENDING PRIMARY HEALTH CARE PRACTITIONER, OR TO
THE STATEWIDE IMMUNIZATION REGISTRY OR THE CITYWIDE IMMUNIZATION  REGIS-
TRY,  AS  ESTABLISHED PURSUANT TO SECTION TWENTY-ONE HUNDRED SIXTY-EIGHT
OF THE PUBLIC HEALTH LAW; AND
  (b) provide information to the patient on the importance of  having  a
primary  health  care  practitioner,  developed  by  the commissioner of
health; and
  (c) report such administration, absent of any  individually  identifi-
able  health  information,  to  the  department  of  health  in a manner
required by the commissioner of health.
  (D) PRIOR TO ADMINISTERING THE IMMUNIZATION, INFORM THE PATIENT OF THE
TOTAL COST OF THE IMMUNIZATION OR IMMUNIZATIONS, SUBTRACTING ANY  HEALTH
INSURANCE  SUBSIDIZATION, IF APPLICABLE. IN THE CASE THE IMMUNIZATION IS
NOT COVERED, THE PHARMACIST MUST INFORM THE PATIENT OF  THE  POSSIBILITY

S. 4739--A                          3

THAT THE IMMUNIZATION MAY BE COVERED WHEN ADMINISTERED BY A PRIMARY CARE
PHYSICIAN OR PRACTITIONER; AND
  (E) ADMINISTER THE IMMUNIZATION OR IMMUNIZATIONS ACCORDING TO THE MOST
CURRENT RECOMMENDATIONS BY THE ADVISORY COMMITTEE FOR IMMUNIZATION PRAC-
TICES  (ACIP),  PROVIDED  HOWEVER,  THAT A PHARMACIST MAY ADMINISTER ANY
IMMUNIZATION AUTHORIZED UNDER THIS SECTION WHEN SPECIFIED BY  A  PATIENT
SPECIFIC ORDER.
  4. [The commissioner of health, in consultation with the commissioner,
shall  prepare  and submit a report to the governor and the legislature,
on or before December thirty-first, two thousand eleven,  reporting  the
results  and  evaluating the effectiveness and impact, if any, of imple-
mentation of subdivision two of this section upon  the  supply  of  such
immunizing  agents  for  the  prevention  of  influenza and pneumococcal
disease, upon the geographical distribution of such agents, and upon the
distribution of such  agents  among  health  care  providers,  including
physicians, and pharmacies in New York state.
  5.]  When  administering  an  immunization in a pharmacy, the licensed
pharmacist shall provide an area for the immunization that provides  for
a  patient's  privacy. THE PRIVACY AREA SHOULD INCLUDE A CLEARLY VISIBLE
POSTING OF THE MOST CURRENT "RECOMMENDED  ADULT  IMMUNIZATION  SCHEDULE"
PUBLISHED BY THE ADVISORY COMMITTEE FOR IMMUNIZATION PRACTICES (ACIP).
  S  4.  Subdivision 22 of section 6802 of the education law, as amended
by chapter 274 of the laws of 2013, is amended to read as follows:
  22. "Administer", for the purpose of section sixty-eight  hundred  one
of  this article, means the direct application of an immunizing agent to
adults, whether by injection, ingestion or any other means, pursuant  to
[a.] a patient specific order or non-patient specific regimen prescribed
or  ordered  by  a  physician or certified nurse practitioner, who has a
practice site in the county OR ADJOINING COUNTY in which  the  immuniza-
tion is administered, for immunizations to prevent influenza [or], pneu-
mococcal,  ACUTE  HERPES  ZOSTER,  MENINGOCOCCAL, TETANUS, DIPHTHERIA OR
PERTUSSIS disease and medications required for  emergency  treatment  of
anaphylaxis  [or  b. a patient specific order prescribed or ordered by a
physician or certified nurse practitioner for immunizations  to  prevent
acute  herpes  zoster  or meningococcal disease or c. a patient specific
order or non-patient specific regimen prescribed or ordered by a  physi-
cian or certified nurse practitioner for immunizations to prevent menin-
gococcal disease. If the county where the immunization is to be adminis-
tered  has  a  population  of  seventy-five  thousand  or less, then the
licensed physician or certified nurse practitioner may be in an  adjoin-
ing county. Such administration shall be limited to immunizing agents to
prevent  influenza  or pneumococcal disease and medications required for
emergency treatment of  anaphylaxis].  IF  THE  COMMISSIONER  OF  HEALTH
DETERMINES  THAT  THERE  IS AN OUTBREAK OF DISEASE, OR THAT THERE IS THE
IMMINENT THREAT OF AN OUTBREAK OF  DISEASE,  THEN  THE  COMMISSIONER  OF
HEALTH MAY ISSUE A NON-PATIENT SPECIFIC REGIMEN APPLICABLE STATEWIDE.
  S 5. Section 8 of chapter 563 of the laws of 2008, amending the educa-
tion  law  and the public health law relating to immunizing agents to be
administered to adults by pharmacists, as amended by chapter 316 of  the
laws of 2011, is amended to read as follows:
  S  8.  This  act shall take effect on the ninetieth day after it shall
have become a law and shall expire and be  deemed  repealed  [March  31,
2016] JULY 1, 2019.
  S 6. Sections 5 and 6 of chapter 116 of the laws of 2012, amending the
education  law  relating to authorizing a licensed pharmacist and certi-

S. 4739--A                          4

fied nurse practitioner to administer  certain  immunizing  agents,  are
amended to read as follows:
  S 5. [The commissioner of health, in consultation with the superinten-
dent  of  financial  services  and  the commissioner of education, shall
prepare and submit a report to the governor and the legislature,  on  or
before  October  first,  two  thousand  fourteen, regarding the rates of
health insurance plan coverage for immunizations to prevent acute herpes
zoster in New York state. This information shall  include,  but  not  be
limited  to,  the  total  number  of  people  receiving immunizations to
prevent acute herpes zoster from health care providers  as  compared  to
pharmacies  in  New York state; the rates of coverage from health insur-
ance plans, including Medicare, for people  receiving  immunizations  to
prevent  acute  herpes  zoster from health care providers as compared to
pharmacies in New York state; the  amount  of  co-pays  and  other  fees
required  by  health  insurance  plans,  including  Medicare, for people
receiving immunizations to prevent acute herpes zoster from health  care
providers  as  compared  to  pharmacies in New York state; and a list of
health insurance plans that do not provide coverage for people receiving
immunizations to prevent acute herpes zoster from health care  providers
as  compared  to  pharmacies  in New York state as well as the amount or
amounts that are charges to an  individual  receiving  immunizations  to
prevent herpes zoster without any health insurance coverage.
  S  6.]  This act shall take effect on the ninetieth day after it shall
have become a law and shall expire and be deemed repealed July 1, [2015]
2019 provided, that:
  (a) the amendments to subdivision 7 of section 6527 of  the  education
law  made by section one of this act shall not affect the repeal of such
subdivision and shall be deemed to be repealed therewith;
  (b) the amendments to subdivision 7 of section 6909 of  the  education
law, made by section two of this act shall not affect the repeal of such
subdivision and shall be deemed to be repealed therewith;
  (c)  the amendments to subdivision 22 of section 6802 of the education
law made by section three of this act shall not  affect  the  repeal  of
such subdivision and shall be deemed to be repealed therewith; and
  (d)  the  amendments  to  section  6801  of  the education law made by
section four of this act shall not affect the expiration of such section
and shall be deemed to expire therewith.
  S 7. The commissioner of health, in consultation with the  superinten-
dent  of  financial  services  and  the commissioner of education, shall
prepare and submit a report to the governor and to the temporary  presi-
dent of the senate and the speaker of the assembly, on or before October
first,  two  thousand nineteen, regarding rates of health insurance plan
coverage for immunizations administered at pharmacies in New York  state
and  any other subjects deemed relevant and necessary.  This information
shall include, but not be limited to, the total number of people receiv-
ing immunizations at pharmacies in New York state; the number  of  indi-
viduals  reporting  being  under the care of a primary care physician or
practitioner when receiving an immunization at a pharmacy; the rates  of
coverage  from  health  insurance  plans, including medicare, for people
receiving immunizations from pharmacies  in  New  York  state;  and  the
amount  or amounts that are charges to an individual receiving immuniza-
tions without any  health  insurance  coverage.    The  commissioner  of
health,  superintendent  of  financial  services and the commissioner of
education may require pharmacists, private insurers, public insurers and
others to submit information necessary to the completion of the report.
  S 8. This act shall take effect immediately; provided, however, that:

S. 4739--A                          5

  (a) the amendments to subdivision 7 of section 6527 of  the  education
law  made  by section one of this act shall not affect the expiration of
such subdivision and shall be deemed to be expired therewith;
  (b)  the  amendments to subdivision 7 of section 6909 of the education
law, made by section two of this act shall not affect the expiration  of
such subdivision and shall be deemed to be expired therewith;
  (c)  the  amendments  to  subdivisions  2 and 4 of section 6801 of the
education law, made by section three of this act shall  not  affect  the
expiration of such section and shall be deemed to expire therewith;
  (d)  the  amendments to subdivision 5 of section 6801 of the education
law, made by section three of this act shall not affect  the  repeal  of
such subdivision and shall be deemed repealed therewith;
  (e)  the amendments to subdivision 22 of section 6802 of the education
law, made by section four of this act shall not affect the expiration of
such subdivision and shall be deemed to be expired therewith; and
  (f) the amendments to paragraph (a) of subdivision 2 of  section  6801
of the education law made by section three of this act shall take effect
on  the  one  hundred  eightieth  day  after it shall have become a law,
provided, however, that effective immediately, any rules and regulations
necessary to implement the provisions of this act on its effective  date
are  authorized  to  be added, amended and/or repealed on or before such
effective date.