S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  8664--A
 
                        2017-2018 Regular Sessions
 
                           I N  A S S E M B L Y
 
                            September 11, 2017
                                ___________
 
 Introduced by M. of A. McDONALD -- read once and referred to the Commit-
   tee on Higher Education -- committee discharged, bill amended, ordered
   reprinted as amended and recommitted to said committee
 
 AN ACT to amend the public health law and the education law, in relation
   to comprehensive medication management; and to amend chapter 21 of the
   laws  of 2011 amending the education law relating to authorizing phar-
   macists to perform collaborative drug therapy management  with  physi-
   cians  in  certain  settings,  in relation to making the provisions of
   such chapter permanent
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  The  public health law is amended by adding a new article
 29-H to read as follows:
                               ARTICLE 29-H
                    COMPREHENSIVE MEDICATION MANAGEMENT
 SECTION 2999-EE. COMPREHENSIVE MEDICATION MANAGEMENT.
   § 2999-EE. COMPREHENSIVE MEDICATION  MANAGEMENT.  1.  DEFINITIONS.  AS
 USED IN THIS ARTICLE, THE FOLLOWING TERMS SHALL HAVE THE FOLLOWING MEAN-
 INGS:
   (A) QUALIFIED PHARMACIST. THE TERM "QUALIFIED PHARMACIST" SHALL MEAN A
 PHARMACIST  WHO  MAINTAINS  A  CURRENT  UNRESTRICTED LICENSE PURSUANT TO
 ARTICLE ONE HUNDRED THIRTY-SEVEN OF THE EDUCATION LAW, WHO HAS A MINIMUM
 OF TWO YEARS OF EXPERIENCE IN PATIENT CARE AS  A  PRACTICING  PHARMACIST
 WITHIN  THE  LAST FIVE YEARS, AND WHO HAS DEMONSTRATED COMPETENCY IN THE
 MEDICATION MANAGEMENT OF PATIENTS WITH A CHRONIC  DISEASE  OR  DISEASES,
 INCLUDING,  BUT  NOT  LIMITED TO, THE COMPLETION OF ONE OR MORE PROGRAMS
 WHICH ARE ACCREDITED BY THE ACCREDITATION COUNCIL  FOR  PHARMACY  EDUCA-
 TION,  RECOGNIZED  BY  THE  EDUCATION  DEPARTMENT  AND ACCEPTABLE TO THE
 PATIENT'S TREATING PHYSICIAN.
   (B) PATIENT CARE. THE TERM "PATIENT CARE"  SHALL  MEAN  ASSESSING  THE
 APPROPRIATENESS  OF PRESCRIPTION AND NON-PRESCRIPTION DRUGS FOR INDIVID-
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD13456-04-7

 A. 8664--A                          2
 
 UAL PATIENTS BASED ON AN ASSESSMENT OF THE PATIENT'S MEDICATION HISTORY,
 MEDICATION EXPERIENCE INCLUDING  BELIEFS,  CONCERNS,  UNDERSTANDING  AND
 EXPECTATIONS,  THE  CLINICAL  GOALS  OF  THERAPY, POTENTIAL DRUG-TO-DRUG
 INTERACTIONS  OR  OTHER  MEDICATION SAFETY CONCERNS, RECOMMENDATIONS FOR
 ADHERENCE AND CONSULTING WITH A PATIENT OR CAREGIVER.
   (C) COMPREHENSIVE MEDICATION MANAGEMENT. THE TERM "COMPREHENSIVE MEDI-
 CATION MANAGEMENT" SHALL MEAN A PROGRAM CONDUCTED BY A QUALIFIED PHARMA-
 CIST THAT ENSURES  A  PATIENT'S  MEDICATIONS,  WHETHER  PRESCRIPTION  OR
 NONPRESCRIPTION,  ARE INDIVIDUALLY ASSESSED TO DETERMINE THAT EACH MEDI-
 CATION IS APPROPRIATE FOR THE PATIENT, EFFECTIVE FOR THE MEDICAL  CONDI-
 TION,  SAFE  GIVEN  THE COMORBIDITIES AND OTHER MEDICATIONS BEING TAKEN,
 AND ABLE TO BE TAKEN BY THE PATIENT AS INTENDED.  COMPREHENSIVE  MEDICA-
 TION  MANAGEMENT CONDUCTED BY A QUALIFIED PHARMACIST SHALL INCLUDE SHAR-
 ING OF APPLICABLE PATIENT CLINICAL INFORMATION WITH THE TREATING  PHYSI-
 CIAN AS SPECIFIED IN A COMPREHENSIVE MEDICATION MANAGEMENT PROTOCOL.
   (D) COMPREHENSIVE MEDICATION MANAGEMENT PROTOCOL. THE TERM "COMPREHEN-
 SIVE  MEDICATION  MANAGEMENT  PROTOCOL"  SHALL  MEAN  A WRITTEN DOCUMENT
 PURSUANT TO  AND  CONSISTENT  WITH  ANY  APPLICABLE  STATE  AND  FEDERAL
 REQUIREMENTS,  THAT  IS ENTERED INTO VOLUNTARILY BY A PHYSICIAN LICENSED
 PURSUANT TO ARTICLE ONE HUNDRED THIRTY-ONE OF THE EDUCATION  LAW  AND  A
 QUALIFIED  PHARMACIST  WHICH  ADDRESSES A CHRONIC DISEASE OR DISEASES AS
 DETERMINED BY THE TREATING PHYSICIAN AND THAT DESCRIBES THE  NATURE  AND
 SCOPE   OF  THE  COMPREHENSIVE  MEDICATION  MANAGEMENT  SERVICES  TO  BE
 PERFORMED BY THE QUALIFIED PHARMACIST, IN ACCORDANCE WITH THE PROVISIONS
 OF THIS ARTICLE.  COMPREHENSIVE MEDICATION MANAGEMENT PROTOCOLS  BETWEEN
 LICENSED PHYSICIANS AND QUALIFIED PHARMACISTS SHALL BE MADE AVAILABLE TO
 THE  DEPARTMENT  FOR  REVIEW AND TO ENSURE COMPLIANCE WITH THIS ARTICLE,
 UPON REQUEST.
   2. AUTHORIZATION  TO  ESTABLISH  COMPREHENSIVE  MEDICATION  MANAGEMENT
 PROTOCOLS.  A PHYSICIAN LICENSED PURSUANT TO ARTICLE ONE HUNDRED THIRTY-
 ONE OF THE EDUCATION LAW SHALL BE AUTHORIZED TO VOLUNTARILY ESTABLISH  A
 COMPREHENSIVE MEDICATION MANAGEMENT PROTOCOL WITH A QUALIFIED PHARMACIST
 TO  PROVIDE  COMPREHENSIVE  MEDICATION MANAGEMENT SERVICES FOR A PATIENT
 WHO HAS NOT MET CLINICAL GOALS OF THERAPY, IS AT RISK  FOR  HOSPITALIZA-
 TION  OR FOR WHOM THE PHYSICIAN DEEMS IT IS NECESSARY TO RECEIVE COMPRE-
 HENSIVE MEDICATION MANAGEMENT SERVICES.  PARTICIPATION BY THE PATIENT IN
 COMPREHENSIVE MEDICATION MANAGEMENT SERVICES SHALL BE VOLUNTARY.
   3. SCOPE OF COMPREHENSIVE MEDICATION  MANAGEMENT  PROTOCOLS.  UNDER  A
 COMPREHENSIVE  MEDICATION  MANAGEMENT  PROTOCOL,  A QUALIFIED PHARMACIST
 SHALL BE PERMITTED TO:
   (A) ADJUST OR MANAGE A DRUG REGIMEN OF  A  PATIENT,  PURSUANT  TO  THE
 PATIENT SPECIFIC ORDER OR PROTOCOL ESTABLISHED BY THE PATIENT'S TREATING
 PHYSICIAN,  WHICH  MAY  INCLUDE  ADJUSTING  DRUG  STRENGTH, FREQUENCY OF
 ADMINISTRATION OR ROUTE OF ADMINISTRATION.  ADJUSTING THE  DRUG  REGIMEN
 SHALL  NOT  INCLUDE  SUBSTITUTING  OR  SELECTING  A DIFFERENT DRUG WHICH
 DIFFERS FROM THAT INITIALLY PRESCRIBED BY THE PATIENT'S TREATING  PHYSI-
 CIAN  UNLESS  SUCH  SUBSTITUTION  IS EXPRESSLY AUTHORIZED IN THE WRITTEN
 ORDER OR PROTOCOL. THE QUALIFIED PHARMACIST SHALL BE REQUIRED  TO  IMME-
 DIATELY  DOCUMENT  IN  THE  PATIENT'S MEDICAL RECORD CHANGES MADE TO THE
 PATIENT'S DRUG THERAPY. THE PATIENT'S TREATING PHYSICIAN  MAY  PROHIBIT,
 BY  WRITTEN  INSTRUCTION, ANY ADJUSTMENT OR CHANGE IN THE PATIENT'S DRUG
 REGIMEN BY THE QUALIFIED PHARMACIST;
   (B) EVALUATE AND, ONLY IF SPECIFICALLY AUTHORIZED BY THE PROTOCOL  AND
 ONLY TO THE EXTENT NECESSARY TO DISCHARGE THE RESPONSIBILITIES SET FORTH
 IN  THIS  ARTICLE,  ORDER  DISEASE STATE LABORATORY TESTS RELATED TO THE

 A. 8664--A                          3
 
 DRUG THERAPY MANAGEMENT FOR THE SPECIFIC  CHRONIC  DISEASE  OR  DISEASES
 SPECIFIED WITHIN THE WRITTEN AGREEMENT OR PROTOCOL;
   (C)  ONLY  IF SPECIFICALLY AUTHORIZED BY THE WRITTEN ORDER OR PROTOCOL
 AND ONLY TO THE EXTENT NECESSARY TO DISCHARGE THE  RESPONSIBILITIES  SET
 FORTH IN THIS ARTICLE, ORDER OR PERFORM ROUTINE PATIENT MONITORING FUNC-
 TIONS  AS MAY BE NECESSARY IN THE DRUG THERAPY MANAGEMENT, INCLUDING THE
 COLLECTING AND REVIEWING OF PATIENT HISTORIES, AND ORDERING OR  CHECKING
 PATIENT  VITAL  SIGNS,  INCLUDING  PULSE,  TEMPERATURE,  BLOOD PRESSURE,
 WEIGHT AND RESPIRATION; AND
   (D) ACCESS THE COMPLETE  PATIENT  MEDICAL  RECORD  MAINTAINED  BY  THE
 TREATING PHYSICIAN WITH WHOM THE QUALIFIED PHARMACIST HAS THE COMPREHEN-
 SIVE  MEDICATION  MANAGEMENT  PROTOCOL AND DOCUMENT ANY ADJUSTMENTS MADE
 PURSUANT TO THE PROTOCOL IN THE PATIENT'S MEDICAL RECORD AND SHALL NOTI-
 FY THE PATIENT'S TREATING PHYSICIAN  OF  ANY  ADJUSTMENTS  IN  A  TIMELY
 MANNER ELECTRONICALLY OR BY OTHER MEANS.
   (E)  UNDER NO CIRCUMSTANCES, SHALL THE QUALIFIED PHARMACIST BE PERMIT-
 TED TO DELEGATE COMPREHENSIVE  MEDICATION  MANAGEMENT  SERVICES  TO  ANY
 OTHER LICENSED PHARMACIST OR OTHER PHARMACY PERSONNEL.
   4.  MEDICATION  ADJUSTMENTS.  ANY  MEDICATION  ADJUSTMENTS MADE BY THE
 QUALIFIED PHARMACIST PURSUANT TO THE COMPREHENSIVE MEDICATION MANAGEMENT
 PROTOCOL INCLUDING ADJUSTMENTS IN DRUG STRENGTH, FREQUENCY OR  ROUTE  OF
 ADMINISTRATION, OR INITIATION OF A DRUG WHICH DIFFERS FROM THAT INITIAL-
 LY PRESCRIBED AND AS DOCUMENTED IN THE PATIENT'S MEDICAL RECORD SHALL BE
 DEEMED  AN  ORAL  PRESCRIPTION  AUTHORIZED  BY AN AGENT OF THE PATIENT'S
 TREATING PHYSICIAN  AND  SHALL  BE  DISPENSED  CONSISTENT  WITH  SECTION
 SIXTY-EIGHT  HUNDRED  TEN OF THE EDUCATION LAW. FOR THE PURPOSES OF THIS
 ARTICLE, A PHARMACIST WHO IS NOT AN EMPLOYEE OF  THE  PHYSICIAN  MAY  BE
 AUTHORIZED TO SERVE AS AN AGENT OF THE PHYSICIAN.
   5.  REFERRALS.  A  PHYSICIAN  LICENSED PURSUANT TO ARTICLE ONE HUNDRED
 THIRTY-ONE OF THE EDUCATION LAW WHO HAS RESPONSIBILITY FOR THE TREATMENT
 AND CARE OF A PATIENT FOR A CHRONIC DISEASE OR DISEASES AS DETERMINED BY
 THE PHYSICIAN MAY REFER  THE  PATIENT  TO  A  QUALIFIED  PHARMACIST  FOR
 COMPREHENSIVE MEDICATION MANAGEMENT SERVICES, PURSUANT TO THE COMPREHEN-
 SIVE  MEDICATION  MANAGEMENT PROTOCOL THAT THE PHYSICIAN HAS ESTABLISHED
 WITH THE QUALIFIED PHARMACIST. THE PROTOCOL  AGREEMENT  SHALL  AUTHORIZE
 THE  PHARMACIST  TO SERVE AS AN AGENT OF THE PHYSICIAN AS DEFINED BY THE
 PROTOCOL. SUCH REFERRAL SHALL BE DOCUMENTED  IN  THE  PATIENT'S  MEDICAL
 RECORD.
   6.  PATIENT  PARTICIPATION.  PARTICIPATION IN COMPREHENSIVE MEDICATION
 MANAGEMENT SERVICES SHALL BE VOLUNTARY, AND  NO  PATIENT,  PHYSICIAN  OR
 PHARMACIST  SHALL  BE REQUIRED TO PARTICIPATE. THE REFERRAL OF A PATIENT
 FOR COMPREHENSIVE MEDICATION MANAGEMENT SERVICES AND THE PATIENT'S RIGHT
 TO CHOOSE TO NOT PARTICIPATE SHALL BE DISCLOSED TO THE PATIENT.  COMPRE-
 HENSIVE MEDICATION MANAGEMENT SERVICES SHALL NOT BE UTILIZED UNLESS  THE
 PATIENT OR THE PATIENT'S AUTHORIZED REPRESENTATIVE CONSENTS, IN WRITING,
 TO  SUCH  SERVICES. SUCH CONSENT SHALL BE NOTED IN THE PATIENT'S MEDICAL
 RECORD. IF THE PATIENT OR THE PATIENT'S  AUTHORIZED  REPRESENTATIVE  WHO
 CONSENTED  CHOOSES  TO  NO  LONGER  PARTICIPATE IN SUCH SERVICES, AT ANY
 TIME, THE SERVICES SHALL BE DISCONTINUED AND IT SHALL BE  NOTED  IN  THE
 PATIENT'S MEDICAL RECORD.
   §  2.  The  education law is amended by adding a new section 6801-b to
 read as follows:
   § 6801-B. COMPREHENSIVE MEDICATION MANAGEMENT.  1.  AS  USED  IN  THIS
 SECTION:
   (A) "COMPREHENSIVE MEDICATION MANAGEMENT" SHALL MEAN A PROGRAM FOR THE
 MANAGEMENT OF CHRONIC DISEASE OR DISEASES THAT ENSURES A PATIENT'S MEDI-

 A. 8664--A                          4

 CATIONS,  WHETHER  PRESCRIPTION  OR  NONPRESCRIPTION,  ARE  INDIVIDUALLY
 ASSESSED TO DETERMINE  THAT  EACH  MEDICATION  IS  APPROPRIATE  FOR  THE
 PATIENT,  EFFECTIVE FOR THE MEDICAL CONDITION, SAFE GIVEN THE COMORBIDI-
 TIES  AND  OTHER  MEDICATIONS  BEING  TAKEN, AND ABLE TO BE TAKEN BY THE
 PATIENT AS INTENDED; AND
   (B) "COMPREHENSIVE MEDICATION MANAGEMENT PROTOCOL" SHALL MEAN A  WRIT-
 TEN  DOCUMENT,  PURSUANT  TO AND CONSISTENT WITH ANY APPLICABLE STATE OR
 FEDERAL REQUIREMENTS, THAT IS ENTERED INTO VOLUNTARILY  BY  A  PHYSICIAN
 LICENSED  PURSUANT TO ARTICLE ONE HUNDRED THIRTY-ONE OF THIS TITLE AND A
 LICENSED PHARMACIST WHO MEETS THE QUALIFICATION  REQUIREMENTS  SPECIFIED
 IN  ARTICLE  TWENTY-NINE-H  OF  THE  PUBLIC HEALTH LAW WHICH ADDRESSES A
 CHRONIC DISEASE OR DISEASES AS DETERMINED  BY  THE  PHYSICIAN  AND  THAT
 DESCRIBES  THE  NATURE AND SCOPE OF THE COMPREHENSIVE MEDICATION MANAGE-
 MENT SERVICE TO BE PERFORMED BY THE QUALIFIED PHARMACIST.  COMPREHENSIVE
 MEDICATION  MANAGEMENT  PROTOCOLS BETWEEN LICENSED PHYSICIANS AND QUALI-
 FIED PHARMACISTS SHALL BE MADE AVAILABLE TO THE  DEPARTMENT  FOR  REVIEW
 AND TO ENSURE COMPLIANCE WITH THIS ARTICLE, UPON REQUEST.
   2.  A  LICENSED PHARMACIST QUALIFIED PURSUANT TO ARTICLE TWENTY-NINE-H
 OF THE PUBLIC HEALTH LAW IS AUTHORIZED TO  SERVE  AS  AN  AGENT  OF  THE
 PHYSICIAN  WHEN EXECUTING THE TERMS OF THE WRITTEN COMPREHENSIVE MEDICA-
 TION MANAGEMENT PROTOCOL AS ESTABLISHED BY THE  LICENSED  PHYSICIAN  FOR
 THE MANAGEMENT OF PATIENTS WITH A CHRONIC DISEASE OR DISEASES.
   §  3. Section 5 of chapter 21 of the laws of 2011, amending the educa-
 tion law relating to authorizing pharmacists  to  perform  collaborative
 drug  therapy management with physicians in certain settings, as amended
 by chapter 238 of the laws of 2015, is amended to read as follows:
   § 5. This act shall take effect on the one hundred twentieth day after
 it shall have become a law [and shall expire 7 years after  such  effec-
 tive date when upon such date the provisions of this act shall be deemed
 repealed];  provided,  however,  that the amendments to subdivision 1 of
 section 6801 of the education law made by section one of this act  shall
 be  subject to the expiration and reversion of such subdivision pursuant
 to section 8 of chapter 563 of the laws of 2008, when upon such date the
 provisions of section one-a of this act  shall  take  effect;  provided,
 further,  that  effective  immediately,  the  addition, amendment and/or
 repeal of any rule or regulation necessary  for  the  implementation  of
 this act on its effective date is authorized and directed to be made and
 completed on or before such effective date.
   §  4.  This  act shall take effect immediately, provided that sections
 one and two of this act shall take effect on the one  hundred  eightieth
 day  after  it  shall  have become a law, provided that, effective imme-
 diately, the addition, amendment and/or repeal of any rule or regulation
 necessary for the implementation of this act on its effective  date  are
 authorized  and  directed  to  be  made  and completed on or before such
 effective date.