BILL NUMBER:S1494

TITLE OF BILL:
An act
to amend the education law, the insurance law and the
public health law, in
relation to providing for dispensing emergency contraception under
certain conditions

PURPOSE OR GENERAL IDEA OF BILL:
This legislation will help to reduce the number of unintended
pregnancies by increasing access to emergency contraception for women
in New York. State.

SUMMARY OF SPECIFIC PROVISIONS:

Section one provides that this act shall be cited as the "unintended
pregnancy prevention act."

Section two describes legislative findings.

Section three three amends subdivision six of section 6527 of the
education law and provides that a licensed physician may prescribe
and order a non-patient specific regimen to a registered professional
nurse for emergency contraception, to be administered to or dispense
to be self-administered by the patient. Section three also provides
              

that a licensed physician may prescribe and order a non-patient
specific regimen to a licensed pharmacist, for dispensing emergency
contraception, to be self-administered by the patient.

Section four amends subdivision three of section 6807 of the education
law by adding licensed midwife to the list of practitioners who may
prescribe or order a non-patient specific regimen which allows a
pharmacist to dispense drugs and devices to a registered professional
nurse who may possess and administer such drugs and devices. Current
law only allows a licensed physician or certified nurse practitioner
to prescribe and order a non-patient specific regimen. A new
subdivision four is also added to section 6807 of the education law
and provides that a licensed pharmacist may dispense a non-patient
specific regimen of emergency contraception, to be self-administered
by the patient, which was prescribed or ordered by a licensed
physician, certified nurse practitioner, or licensed midwife.

Section five amends the education law by adding a new section 6831:
emergency contraception; non-patient specific prescription or order.
Subdivision one defines the terms "emergency contraception" and
"prescriber." Subdivision two provides that section 5831 of the
education law applies to the administering or dispensing of emergency
contraception by a registered professional nurse or licensed
pharmacist pursuant to a prescription or non-patient specific regimen
made by prescribers as outlined in three sections of the education

law. Subdivision three
provides that the administering or dispensing of emergency
contraception by a registered professional nurse or licensed
pharmacist shall be done in accordance with professional standards of
practice and in accordance with written procedures and protocols.
Subdivision four outlines the contents of written material that must
be provided to the patient. Such written material shall be developed
or approved by the commissioner in consultation with the Department
of Health (DOH) and the American College of Obstetricians and
Gynecologists (ACOG).

Section six amends paragraphs (a) and (b) of subdivision four of
section 6909 of the education law. Paragraph (a) provides that
emergency contraception is added to the list for which a certified
nurse.practitioner may already prescribe and order a non-patient
specific regimen to a registered professional nurse. Paragraph (b)
provides that, in addition to a registered professional nurse, a
certified nurse practitioner may also prescribe or order a
non-patient specific regimen to a licensed pharmacist, for dispensing
emergency contraception.

Section seven amends subdivision five of section 6909 of the education
law by adding a licensed midwife to those practitioners who may
already prescribe and order a non-patient specific regimen to a
registered professional nurse.

Section eight amends section 6951 of the education law by adding a new
subdivision four which provides that a licensed midwife may prescribe
and order a non-patient specific regimen to: a registered
professional nurse for emergency contraception to be administered to
or dispensed to be self-administered by the patient and; a licensed
pharmacist for dispensing emergency contraception, to be
self-administered by the patient..

Sections nine, ten, and eleven amend three sections of the insurance
law to mandate that under these articles any insurance policy that
covers emergency contraception shall also cover emergency
contraception when provided by a non-patient-specific prescription.

Section twelve adds a new paragraph (i) to subdivision one of section
207 of the public health law to broaden the education and outreach
program to include information on emergency contraception and its
safety, efficacy, appropriate use and availability.

Section thirteen provides that this act shall take effect on the 180th
day after it shall have become law, provided that the commissioner of
education is authorized to promulgate any and all rules and
regulations and take any other measures necessary to implement this
act.

JUSTIFICATION:
EC is Safe: In February of 1997, the Food and Drug Administration

(FDA) announced that certain combinations of estrogen and progestin
were safe and effective for use as postcoital emergency contraception
(Be). Administered in pill form, EC is a higher dosage of standard
birth control pills that serve to prevent pregnancy after unprotected
intercourse, including when birth control fails or in cases of sexual
assault. EC can reduce the risk of pregnancy from 75% to 89% if the
first dose is taken within 72 hours of unprotected intercourse. EC is
almost seven times more effective if taken within the first 24 hours
of unprotected inter-
course. "EC will not cause an abortion; it is not the same as RU-486
(also known as Mifepristone or the medical abortion pill). In 1999,
the FDA prescription use Plan B (which is Levonorgestrel, a form of
progesterone) is, currently, the only brand of emergency
contraception packaged for that use. In 2007, Plan B was approved by
the FDA for over the counter sale if a person is eighteen years or
older. However, young women in New York State currently face barriers
to accessing EC, as current law requires that a traditionally
licensed source, such as a physician, prescribe EC. This bill would
allow New York State pharmacists and registered professional nurses
to dispense EC from a non-patient specific order, written by either a
licensed physician, certified nurse practitioner or licensed midwife,
bypassing the frequent difficulties encountered in obtaining medical
appointments at offices with limited hours, long waits, or
inconvenient locations. By accessing EC in this manner, young women
will have the opportunity to ask questions and have them answered by
a healthcare professional who will also provide a fact sheet and a
verbal explanation about EC. Currently, a pharmacist may refuse to
dispense any medication if he or she reasonably
feels that it would endanger someone. This same discretion would
apply to EC.

EC Will Significantly Lower the Number of Abortions: In New York
State, there were 111,212 induced abortions in 2010, of which 6,355
were performed on girls ages seventeen and under, according to the
New York Stare Department of Health (NYSDOH). Medical experts,
including the American College of Obstetricians and Gynecologists
(AGOG), believe that increased access to EC will reduce the number of
abortions in New York by at least one half. Increased access to EC
will not only reduce the number of abortions young women have, but
reduce the cost and health risks associated with pregnancy,
childbirth and abortion. A commonsense, risk-benefit analysis
indicates that increased access to EC will enable young women to
pursue a better, healthier future by preventing an unintended
pregnancy in a safe and timely fashion.

EC Will Positively Impact the Lives of Young Women: Victims of sexual
assault are most often younger women and adolescents. According to
Tjaden and Thoennes, researchers from the National institute of
Justice, "Rape is primarily a crime against youth," A study conducted
by National Violence Against Women reported 54% of rape victims were
between the ages of 12 and 17. Similarly, the National Women's Study
found that 62% of sexual assault victims were under seventeen years

of age. Every two years, Youth Risk Behavior Survey (YRES) conducts a
study of high school students in grades nine through twelve
throughout the entire country. In 1997 and in 1999, a question was
added to the Massachusetts survey regarding teen violence_ One in
five girls reported being sexually or physically abused by a dating
partner and of those females, one in ten was sexually abused. The
statistics support the fact that there is a tremendous need for
prevention of unintended pregnancies in very young women. A
misconception about EC is that by giving women, especially young
women, access to EC the rate of sexually transmitted infections.

(STIs) will increase and it will lead to more risky sexual behavior.
However, a study providing EC to 2,117 young women ages 15 to 24,
reported in the January 5, 2005 issue of the Journal of the American
Medical Association (JAMA), concludes that giving young women access
to EC does not negate the ability of women to act responsibly. The
study confirmed that EC does not increase promiscuity or unprotected
sex among women, nor does it cause women to abandon their regular
birth control
methods. Moreover, other methods of birth control such as condoms and
spermicides may already be purchased over the counter in pharmacies,
grocery stores, or convenience stores.

EC Will be Covered by Insurance: This legislation provides that if an
insurance Policy covers contraception when it is provided pursuant to
a prescription, that same policy shall cover emergency contraception.

Education and Outreach Programs are Effective: In 1998, Washington
State began to conduct public relations and promotional activities to
increase public awareness of emergency contraception and of the
national emergency contraception hotline (1-888-NOT-2-LATE). Calls
from Washington State to the hotline increased ten-fold, an average
of 1,160 per month, after
the campaign was launched, indicating that outreach programs are
effective. This legislation adds emergency contraception to the list
of health related issues for which the Commissioner of Health shall
conduct education and outreach programs. Making the public aware of
the safety, efficacy, appropriate use, and availability of EC is
important to the health and safety of women in New York.

Conclusion: EC is designed to be just that: emergency contraception,
to be used when other methods of contraception fail or in cases of
rape, incest, or human error. Many pregnancies, births and abortions
are far more dangerous to a woman's health, especially a young
woman's health, than EC. By allowing women the chance to prevent an
unintended pregnancy, the abortion rate will drop, healthcare costs
will decrease and young women will not have to start their adult
lives with the difficult decision of whether to have a baby (often as
a single mother), have an abortion, or give a baby up for adoption.
By allowing young women access to EC, they will have the opportunity
to have a healthier and more promising future.

LEGISLATIVE HISTORY:
2011-2012: S.592/A.85
2009-2010: S.1410-A (Schneiderman) A.627-A (Paulin)
2008 - Referred to Higher Education
2007 - Referred to Higher Education

FISCAL IMPLICATIONS: None.

EFFECTIVE DATE:
This act shall take effect 180 days after it becomes law provided the
commissioner of education is authorized to promulgate any and all
rules, regulations and measures necessary for implementation on or
before such date.