By Bob Reid, Reid, Mcnally & Savage, LLC

NYSAFP Advocacy Report - 2014

By Bob Reid, Reid, McNally & Savage, LLC

As the calendar turns to fall and the leaves change to colors across our state, in Albany, thoughts of New York’s statewide officeholders (Governor, Lt. Governor, Attorney General and Comptroller and the entire State Legislature (150 Assemblypersons and 63 Senators) turn to the pending elections. As Family Doctor goes to print, the primary election is September 9th with the general election on November 4th. While we understand time is a valuable commodity in your lives, we urge you to take the time to reach out to the candidates in your local Assembly and Senate districts and let them know the importance of family medicine in New York! We will, of course, keep you updated on the election results both on the state and federal level.

Governor Cuomo and legislative leaders announced a number of big deals in the final days of the session. These include agreements on a measure to allow for the limited use of medical marijuana, a package of bills to address the State’s opioid/heroin addiction epidemic, changes to existing teacher evaluations and Common Core requirements which the head of the state teacher’s union call a “reset”, and an agreement on facility closures under the Office of Mental Health (OMH) and the Office for People with Developmental Disabilities (OPWDD) to set up community services before the facilities close.

While the Governor and state leaders hailed these and other successes including the fourth on-time state budget in a row as the session came to a close, there has been public criticism for leaving significant work undone. This includes failure to approve the package of bills included in the Women’s Equality Act, the Dream Act, reform of the state’s Brownfield tax credit program which expires next year, campaign finance reform, and others.

During the 2014 session, we worked with Academy leadership and members to pursue a number of NYSAFP priorities. Of particular interest to the Academy, we successfully secured changes to a bill that would have authorized long term antibiotics for "chronic Lyme disease" and provided blanket OPMC protection for such treatment and all related care. The bill that passed both houses provides a broader physician protection (not just for Lyme) which more narrowly focuses on treatment decisions only (as summarized in the Physician section below). Also together with others in organized medicine, we beat back a major push to require physician CME in pain management, ISTOP, palliative care and other areas with attempts to tie the proposal to the enacted heroin/opioid bill package. Also we successfully defeated a proposal to change the current statute of limitations in medical liability cases and working with other impacted physician specialties, we defeated a bill to create midwifery birthing centers without any physician oversight/involvement, among other initiatives.

Below, please find our sector-by-sector summary of legislation that passed both houses in the health and human services areas during the 2014 session. We would encourage you to closely review the bills summarized in the Physician, Public Health and Behavioral Health (for summary of the enacted heroin/opioid bill package) sections below for bills that would be of particular interest to NYSAFP.

Sections

Hospitals/ Health Care Facilities

Long Term Care

Physicians/ Other Health Care Practitioners

Pharmacy

Public Health

Behavioral Health

Developmental Disabilities

Education/Special Education

Insurance

Multiple Sectors

HOSPITALS/ HEALTH CARE FACILITIES

Limited Permits for Proteomics Testing S7199-A (Hannon)/A9517-A (Gottfried)

This bill allows individuals employed at National Cancer Institute (NCI)-designated cancer centers to obtain a restricted license to practice proteomics, including mass spectrometry. Proteomics is a branch of biotechnology used to analyze proteins produced by the genes of a particular cell, tissue, or organism. Proteomics, through the use of spectrometry, can be used to ensure that patients receive the appropriate doses of cancer treating drugs.

Signed Into Law

Autopsy Reports for Emergency Medical Trauma Care S7271 (Hannon)/A9611 (Gottfried)

This bill requires medical examiners and coroners to share their findings from autopsy reports following traumatic death with referring hospitals to facilitate the hospital’s quality improvement process.

Refinancing Financially Distressed Hospitals S7387-A (Golden)/A9021-A (Davila)

This bill allows financially distressed hospitals that refinanced debt through the Secured Hospital Loan Program which expired in 1998 to refinance their existing debt upon a demonstration that, satisfactory to the Commissioner of the State Department of Health (DOH), the refinancing is undertaken to sustain, maintain, or improve the hospital’s financial condition. A hospital may not claim additional Medicaid reimbursement due to interest payments and the refinancing of a mortgage loan shall not alter, affect or change Medicaid rates applicable to the depreciation of any assets. The Act expires on December 31, 2015.

Collaborative Drug Therapy Management Extender S7435 (LaValle)/A9715 (Glick)

The bill extends for an additional year to September 2015 the collaborative drug therapy management program currently in place in teaching hospitals.

Signed Into Law

LONG TERM CARE

Continuing Care Retirement Community (CCRC) Long Term Care Services S2118-B (Ranzenhofer)/A4611 (Schimminger)

This bill would authorize a CCRC to establish a Continuing Care at Home Corporation as a not-for-profit entity affiliated with the CCRC for the provision of long term care services to an enrollee in an individual’s residence, affiliated community nursing facility, and an affiliated adult care facility. Corporations providing services in a nursing home are required to be licensed under Article 28 of the Public Health Law. Corporations providing home care as defined in Article 36 of the Public Health Law are subject to licensure and other provisions of Article 36.

Criminal History Background Checks Adult Care Facilities S4926-C (Hannon)/A5476-D (Cymbrowitz)

This bill will provide DOH with additional time to implement a law passed on April 1, 2014 to require adult care facilities to conduct criminal background checks on all prospective employees. Nursing homes and home care agencies have been required to conduct criminal background checks since 2005. The 2014-15 State Budget added this requirement for adult care facilities, effective April 1, 2014. This bill will extend the effective date until January 1, 2015 to allow for sufficient time for implementation of the new requirement.

Signed Into Law

Physical Therapy Assistants in Home Care Extender S6666 (LaValle)/S8659 (Glick)

This bill extends until June 30, 2018 the authority for physical therapy assistants to provide services in home care settings. Such services are authorized when a supervising physical therapist: establishes a program of care for a patient; has an initial joint visit with the patient; and provides a final evaluation of the treatment plan.

Signed Into Law

Information for Informal Caregivers S7255 (Valesky)/A8871 (Millman)

This bill requires county Area Agencies on Aging to provide “informal caregivers” with information and assistance to gain access to available services and referrals for counseling. “Informal caregivers” including spouses, children, grandchildren, and siblings are the largest source of care for elderly individuals. This bill will provide informal caregivers with additional assistance and resources to provide care to their family members. The bill was signed into law on June 30th, Chapter 47 of the Laws of 2014.

Signed Into Law

Workgroup on State Health Information Technology Infrastructure S7592 (Hannon)/ A9801 (Gottfried)

This bill adds two representatives of home care agencies to the Workgroup on State Health Information Technology Infrastructure. This Workgroup was established as part of the 2014-15 State Budget to examine and make recommendations on the State’s health information technology infrastructure. It currently includes representatives for hospitals, physicians and health centers. However, the enacting legislation did not include home care representatives.

Signed Into Law

PHYSICIANS/ OTHER HEALTH CARE PRACTIONERS

Hepatitis C Testing S6871 (Hannon)/A9124-A (Zebrowski)

This bill adds testing for the hepatitis C virus to the list of tests and services that registered nurses may currently do pursuant to a non-patient specific order issued by a physician or nurse practitioner.

Maternal Depression Education, Screening and Treatment S7234-B (Krueger)/A9610-B (Gottfried)

The bill defines maternal depression and maternal health care provider and requires the Commissioner of DOH to provide updated information and guidelines on maternal depression screening, follow-up support, referrals and treatment to health care providers, hospitals and OMH treatment providers, support groups and not-for-profit organizations. The bill also would require greater public education to promote awareness of and destigmatize maternal depression. The bill also states that no insurer shall limit a patient's direct access to maternal depression screening and referral, as covered by their policy in that patients should not be required to get a referral for such services from their primary care provider.

Signed Into Law

Expanded Users of Adult Immunization Registry S7253-A (Hannon)/A9561-A (Paulin)

The bill makes registered nurses and pharmacists, who are authorized to administer immunizations, authorized users of the statewide immunization information system and require that they report immunizations given to adults, upon oral consent within 14 days of administration to the state immunization registry. For patients in New York City such reporting shall be to the citywide immunization registry. The bill also states that other health care providers may report adult immunizations to the state and city registries, upon oral consent.

NYS Palliative Care and Education and Training Council S7601-B (Hannon)/A9966 (Rules) Gottfried

The bill expands the membership of the state Palliative Care Education and Training Council to add individuals that are representative of home care and social work. It also directs the Council, within its mission, to examine and make recommendations to DOH, the State Education Department (SED) and the Legislature with regard to the need, approaches and resources to provide for palliative care education and training in state certified schools of nursing and social work, as well as in practice settings at the health care facility or agency level. In doing so, the Council would solicit and consider the input of nursing and social work schools.

Signed Into Law

Medical Professional Misconduct S7854 (Hannon)/A7558-B (Barrett)

The bill prohibits investigation and professional disciplinary actions by the State Board for Professional Medical Conduct or Office of Professional Medical Conduct based solely on the recommendation or provision of a treatment modality by a licensee that is not universally accepted by the medical profession, including that used in the treatment of Lyme disease. It does not exonerate the licensee from otherwise applicable professional requirements.

*Please also see summary of enacted heroin/opioid bill package under Behavioral Health section below.

PHARMACY

Drug Disposal Demonstration Program S3985-A (Grisanti)/A5465-A (Sweeney)

The bill would requires the Department of Environmental Conservation (DEC), in consultation with the State Police, to establish a one-year demonstration drug disposal program in at least three publicly-available State Police facilities located in urban, suburban and rural areas. DEC would also be required to maintain on its website a list of State Police facilities participating in such demonstration drug disposal program, any information regarding drug disposal procedures for such facilities as well as any existing information concerning drug disposal. Also the bill requires DEC at the end of the demonstration program to prepare a report detailing:

· the quantities of drugs collected;

· the effectiveness of each facility location;

· information detailing the acceptance methods made available; and

· recommendations for any legislative action.

Prescription Delivery Off Premises S6449-A (Hannon)/A8612-A (McDonald)

The bill requires that a prescription (new or refill) may not be delivered off premises without the consent of the patient or individual authorized to consent on the patient's behalf. Consent includes one of the following:

· Patient or authorized individual's signature of acceptance of each prescription delivered;

· Pharmacy contacting the patient or authorized individual for consent and documenting such consent in the patient record; or

· Pharmacies administering refill reminder adherence programs that deliver off premises shall make such programs opt-in by the patient and update with patient consent every 180 days (6 months) accompanied by a documented patient record review between a licensed pharmacist and the patient before continuation of medication delivery.

The bill also states that pharmacies that deliver medication without patient or authorized individual consent will be required to accept the return of the medication from the patient, provide the patient credit for any charges paid and destroy such returned medications, in accordance with applicable state and federal laws. The bill does not apply to long-term care pharmacy dispensing and delivery.

Drug Disposal Promotion S6691 (Boyle)/A1609 (Cymbrowitz)

The bill requires the Office of Alcoholism and Substance Abuse Services (OASAS) in cooperation with DEC to post on its agency website information related to conducting a pharmaceutical collection event. This would include steps and guidelines for any municipality, pharmacy, local law enforcement agency, or community group to conduct a household pharmaceutical collection event. The bill would also allow OASAS to assist DEC in the development of a public information program on the proper disposal of drugs and drug disposal sites. Signed Into Law

Expanded Users of Adult Immunization Registry S7253-A (Hannon)/A9561-A (Paulin)

Collaborative Drug Therapy Management Extender S7435 (LaValle)/A9715 (Glick)

The bill extends for an additional year to September 2015 the collaborative drug therapy management program currently in place in teaching hospitals.

Signed Into Law

*Please also see summary of enacted heroin/opioid bill package under Behavioral Health section below.

PUBLIC HEALTH

Eating Disorders Awareness and Prevention Program S2530-A (Hannon)/A5294-A (Gunther)

This bill establishes an Eating Disorders Awareness and Prevention program in DOH for the purpose of promoting the awareness of eating disorders and available services and to prevent and reduce the incidence and prevalence of eating disorders among children and adolescents.

Women’s Health Website S3817 (Hannon)/A4465-A (Galef)

The bill directs DOH to establish and maintain an Internet website for the purpose of advancing women's health initiatives. Information shall be provided for the purposes of educating the public and raising awareness of women's health issues. Information and links to useful resources shall be provided to encourage use of services now made more widely available to women in the state. The website shall include information detailing the 22 preventative services now covered pursuant to federal law and regulations. Also the bill requires DOH to consider making use of social media networks for the purposes of further advancing women's health initiatives.