S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  9013--A
 
                           I N  A S S E M B L Y
 
                             January 10, 2020
                                ___________
 
 Introduced  by  M. of A. BARRETT, GOTTFRIED -- read once and referred to
   the Committee  on  Higher  Education  --  committee  discharged,  bill
   amended,  ordered reprinted as amended and recommitted to said commit-
   tee
 
 AN ACT to amend the education law, in relation  to  authorizing  pharma-
   cists to dispense HIV pre-exposure and post-exposure prophylaxis

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Subdivision 7-a of section 6527 of the  education  law,  as
 added by chapter 502 of the laws of 2016, is amended to read as follows:
   7-a.  A  licensed physician may prescribe and order a patient specific
 order or non-patient specific order to a licensed  pharmacist,  pursuant
 to  regulations promulgated by the commissioner in consultation with the
 commissioner of health, and consistent with the public health  law,  for
 dispensing  up  to a seven day starter pack of HIV post-exposure prophy-
 laxis  for  the  purpose  of  preventing  human  immunodeficiency  virus
 infection following a potential human immunodeficiency virus exposure. A
 LICENSED  PHYSICIAN  MAY  ALSO PRESCRIBE AND ORDER A PATIENT SPECIFIC OR
 NON-PATIENT SPECIFIC ORDER TO A LICENSED PHARMACIST, PURSUANT  TO  REGU-
 LATIONS PROMULGATED BY THE COMMISSIONER IN CONSULTATION WITH THE COMMIS-
 SIONER  OF HEALTH, AND CONSISTENT WITH THE PUBLIC HEALTH LAW AND SECTION
 SIXTY-EIGHT HUNDRED ONE OF THIS TITLE, FOR HIV PRE-EXPOSURE PROPHYLAXIS,
 PROVIDED, HOWEVER, THAT THE REGULATIONS  PROMULGATED  PURSUANT  TO  THIS
 SUBDIVISION  SHALL REQUIRE THAT THE HIV PRE-EXPOSURE PROPHYLAXIS AUTHOR-
 IZED TO BE DISPENSED BY A LICENSED PHARMACIST SHALL PROVIDE FOR AT LEAST
 A THIRTY-DAY, BUT NO MORE THAN A SIXTY-DAY, SUPPLY OF SUCH PROPHYLAXIS.
   § 2. Subdivision 8 of section 6909 of the education law, as  added  by
 chapter 502 of the laws of 2016, is amended to read as follows:
   8.  A  certified  nurse practitioner may prescribe and order a patient
 specific order or non-patient specific order to a  licensed  pharmacist,
 pursuant  to regulations promulgated by the commissioner in consultation
 with the commissioner of health, and consistent with the  public  health
 law,  for dispensing up to a seven day starter pack of HIV post-exposure
 prophylaxis for the purpose of preventing human  immunodeficiency  virus
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
              

                       [ ] is old law to be omitted.
                                                            LBD14442-06-0

 A. 9013--A                          2
 
 infection following a potential human immunodeficiency virus exposure. A
 CERTIFIED  NURSE  PRACTITIONER  MAY  ALSO  PRESCRIBE AND ORDER A PATIENT
 SPECIFIC OR NON-PATIENT SPECIFIC ORDER TO A LICENSED PHARMACIST,  PURSU-
 ANT  TO REGULATIONS PROMULGATED BY THE COMMISSIONER IN CONSULTATION WITH
 THE COMMISSIONER OF HEALTH, AND CONSISTENT WITH THE  PUBLIC  HEALTH  LAW
 AND  SECTION SIXTY-EIGHT HUNDRED ONE OF THIS TITLE, FOR HIV PRE-EXPOSURE
 PROPHYLAXIS, PROVIDED, HOWEVER, THAT THE REGULATIONS PROMULGATED  PURSU-
 ANT  TO THIS SUBDIVISION SHALL REQUIRE THAT THE HIV PRE-EXPOSURE PROPHY-
 LAXIS AUTHORIZED TO BE DISPENSED BY A LICENSED PHARMACIST SHALL  PROVIDE
 FOR  AT LEAST A THIRTY-DAY, BUT NO MORE THAN A SIXTY-DAY, SUPPLY OF SUCH
 PROPHYLAXIS.
   § 3. Subdivision 5 of section 6801 of the education law, as  added  by
 chapter  502  of the laws of 2016, is amended and a new subdivision 6 is
 added to read as follows:
   5. A licensed pharmacist may execute a non-patient specific order, for
 dispensing up to a seven day starter pack of HIV  post-exposure  prophy-
 laxis  medications  for the purpose of preventing human immunodeficiency
 virus infection, by a physician licensed in this state or nurse  practi-
 tioner  certified  in  this  state,  pursuant  to  rules and regulations
 promulgated by the commissioner in consultation with the commissioner of
 health following a potential human immunodeficiency virus exposure.  THE
 PHARMACIST  SHALL ALSO INFORM THE PATIENT OF THE AVAILABILITY OF PRE-EX-
 POSURE PROPHYLAXIS FOR PERSONS WHO ARE AT SUBSTANTIAL RISK OF  ACQUIRING
 HIV.
   6. A LICENSED PHARMACIST MAY EXECUTE A NON-PATIENT SPECIFIC ORDER, FOR
 DISPENSING  HIV  PRE-EXPOSURE  PROPHYLAXIS,  PURSUANT TO RULES AND REGU-
 LATIONS PROMULGATED BY THE COMMISSIONER IN CONSULTATION WITH THE COMMIS-
 SIONER OF HEALTH PROVIDED,  HOWEVER,  THAT  THE  RULES  AND  REGULATIONS
 PROMULGATED  PURSUANT  TO  THIS  SUBDIVISION  SHALL REQUIRE THAT THE HIV
 PRE-EXPOSURE PROPHYLAXIS AUTHORIZED TO BE DISPENSED BY A LICENSED  PHAR-
 MACIST  SHALL  PROVIDE  FOR  AT  LEAST  A THIRTY-DAY, BUT NO MORE THAN A
 SIXTY-DAY, SUPPLY OF SUCH PROPHYLAXIS. AND PROVIDED, FURTHER,  THAT  THE
 FOLLOWING  CONDITIONS SHALL BE MET BEFORE A PHARMACIST MAY DISPENSE PRE-
 EXPOSURE PROPHYLAXIS:
   (A) THE PHARMACIST HAS COMPLETED A TRAINING  PROGRAM  CREATED  BY  THE
 DEPARTMENT  OF HEALTH ON THE USE OF PRE-EXPOSURE PROPHYLAXIS. THE TRAIN-
 ING PROGRAM SHALL EDUCATE PHARMACISTS ABOUT  THE  REQUIREMENTS  OF  THIS
 SUBDIVISION,  THE  RISKS  AND  SIDE  EFFECTS  OF THE MEDICATION, PATIENT
 INSURANCE AND COST BURDENS, AND ANY OTHER  INFORMATION  SUCH  DEPARTMENT
 DEEMS NECESSARY OR IMPORTANT;
   (B)  THE PATIENT IS HIV NEGATIVE, AS DOCUMENTED BY A NEGATIVE HIV TEST
 RESULT  OBTAINED  WITHIN  THE  PREVIOUS   SEVEN   DAYS   FROM   AN   HIV
 ANTIGEN/ANTIBODY  TEST  OR ANTIBODY-ONLY TEST OR FROM A RAPID, POINT-OF-
 CARE FINGERSTICK BLOOD TEST APPROVED BY THE FEDERAL FOOD AND DRUG ADMIN-
 ISTRATION. IF THE PATIENT DOES NOT PROVIDE EVIDENCE OF  A  NEGATIVE  HIV
 TEST  IN ACCORDANCE WITH THIS PARAGRAPH, THE PHARMACIST MAY RECOMMEND AN
 HIV TEST. IF THE PATIENT TESTS POSITIVE FOR HIV INFECTION,  THE  PHARMA-
 CIST  SHALL  DIRECT  THE PATIENT TO A LICENSED PHYSICIAN AND PROVIDE THE
 PATIENT WITH A LIST OF HEALTH CARE SERVICE PROVIDERS AND CLINICS  WITHIN
 THE COUNTY WHERE THE PHARMACIST IS LOCATED OR ADJACENT COUNTIES;
   (C)  THE  PATIENT  DOES  NOT REPORT ANY SIGNS OR SYMPTOMS OF ACUTE HIV
 INFECTION ON A SELF-REPORTED CHECKLIST OF ACUTE HIV INFECTION SIGNS  AND
 SYMPTOMS;
   (D)  THE  PATIENT  DOES  NOT REPORT TAKING ANY CONTRAINDICATED MEDICA-
 TIONS;

 A. 9013--A                          3
 
   (E) THE PHARMACIST DOES NOT FURNISH MORE THAN A  SIXTY-DAY  SUPPLY  OF
 PRE-EXPOSURE  PROPHYLAXIS  TO  A SINGLE PATIENT MORE THAN ONCE EVERY TWO
 YEARS, UNLESS DIRECTED OTHERWISE BY A PRESCRIBER.
   (F)  THE  PHARMACIST  PROVIDES  WRITTEN  INFORMATION, PUBLISHED BY THE
 DEPARTMENT OF HEALTH, TO THE PATIENT ON THE ONGOING USE OF  PRE-EXPOSURE
 PROPHYLAXIS,  WHICH  MAY  INCLUDE  EDUCATION  ABOUT SIDE EFFECTS, SAFETY
 DURING PREGNANCY AND BREASTFEEDING, ADHERENCE TO RECOMMENDED DOSING, AND
 THE IMPORTANCE OF TIMELY TESTING AND TREATMENT, AS APPLICABLE, FOR  HIV,
 RENAL FUNCTION, HEPATITIS B, HEPATITIS C, SEXUALLY TRANSMITTED DISEASES,
 AND  PREGNANCY FOR INDIVIDUALS OF CHILD-BEARING CAPACITY. THE PHARMACIST
 SHALL NOTIFY THE PATIENT THAT THE PATIENT MUST BE  SEEN  BY  A  LICENSED
 PHYSICIAN  TO  RECEIVE SUBSEQUENT PRESCRIPTIONS FOR PRE-EXPOSURE PROPHY-
 LAXIS; AND
   (G) THE PHARMACIST PROVIDES INFORMATION, WITH THE  PATIENT'S  CONSENT,
 TO  THE PATIENT OR, WHEN THE PATIENT LACKS CAPACITY TO CONSENT, A PERSON
 AUTHORIZED TO CONSENT TO HEALTH CARE FOR SUCH INDIVIDUAL, ON THE  IMPOR-
 TANCE OF HAVING A HEALTH CARE PROVIDER, DEVELOPED BY THE COMMISSIONER OF
 HEALTH,  AND  IF  THE  PATIENT  DOES NOT HAVE A HEALTH CARE PROVIDER THE
 PHARMACIST SHALL PROVIDE THE PATIENT  A  LIST  OF  LICENSED  PHYSICIANS,
 CLINICS,  OR OTHER HEALTH CARE SERVICE PROVIDERS WITHIN THE COUNTY WHERE
 THE PHARMACIST IS LOCATED OR ADJACENT COUNTIES.
   § 4. This act shall take effect on the one hundred eightieth day after
 it shall have become a law; provided, however, the amendments to 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. Effective  immediately,  the  commissioner  of  education  is
 authorized  to promulgate any and all rules and regulations and take any
 other measures necessary to implement this act on or before such  effec-
 tive date.