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

                                 420--A

                       2013-2014 Regular Sessions

                          I N  A S S E M B L Y

                               (PREFILED)

                             January 9, 2013
                               ___________

Introduced  by  M.  of  A. PAULIN, GOTTFRIED, ENGLEBRIGHT, GALEF, GLICK,
  ROSENTHAL, BOYLAND, SKOUFIS, LAVINE, TITONE, FAHY  --  Multi-Sponsored
  by  -- M. of A.  AUBRY, BRENNAN, CAHILL, CLARK, COOK, CROUCH, CYMBROW-
  ITZ, DINOWITZ, FARRELL,  GUNTHER,  HEASTIE,  HEVESI,  HOOPER,  JACOBS,
  JAFFEE,  KELLNER,  LIFTON,  LUPARDO, MILLMAN, MORELLE, PERRY, PRETLOW,
  THIELE, WEISENBERG, WRIGHT -- read once and referred to the  Committee
  on Health -- recommitted to the Committee on Health in accordance with
  Assembly Rule 3, sec. 2 -- committee discharged, bill amended, ordered
  reprinted as amended and recommitted to said committee

AN  ACT  to  amend  the  education law, the insurance law and the public
  health law, in relation to providing for dispensing emergency  contra-
  ception under certain conditions

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Short title. This act shall be known and may  be  cited  as
the "unintended pregnancy prevention act".
  S  2.  Legislative  findings. The United States Food and Drug Adminis-
tration (FDA) has declared emergency contraceptive pills to be safe  and
effective in preventing pregnancy when used within 72 hours after unpro-
tected  intercourse. The American College of Obstetricians and Gynecolo-
gists and the American College of Nurse-Midwives  state  that  emergency
contraception  (EC)  is  so  safe, and using it quickly is so important,
that it should be available over the counter,  without  a  prescription.
They also emphasize the need for unimpeded access to EC for all women of
reproductive  age.  However,  although  there  are no medical reasons to
limit provision of EC, the FDA only approved non-prescription access for
women 18 years and older. Additionally, the FDA imposed requirements for
proving the patient's  identity  with  government-issued  identification
documents.  The  need  remains,  however, to provide access to women who
have difficulty obtaining the required identification documents  and  to
women under the age of 17 years. Minors in New York State have long been
legally entitled to full access, without parental consent, to all repro-
ductive  health care and services, including EC. Providing direct access
              

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD00945-03-4

A. 420--A                           2

to EC for younger women will also make it more  likely  that  they  will
receive  appropriate  and  timely  professional  attention,  support and
assistance.
  The legislature deems it necessary to create a structure for simplify-
ing  access  to  EC for these women, while respecting and preserving the
prescribing scopes of practice of physicians, nurse  practitioners,  and
midwives,  the treating and case-finding scope of practice of registered
professional nurses, and the dispensing scope  of  practice  of  pharma-
cists.  This act does not alter the scopes of such professions, nor does
this legislation interfere with non-prescription access to EC  where  it
is otherwise lawful.
  The  legislature  also  finds  that  this  legislation is necessary to
ensure that women do not lose insurance coverage for EC  solely  because
it has become available without a prescription. Losing coverage would be
a  major  obstacle to access, which would undermine the important health
objectives of the FDA and the legislature.
  S 3. Subdivision 6 of section 6527 of the education law, as  added  by
chapter  573  of the laws of 1999, paragraph (c) as added by chapter 221
of the laws of 2002 and paragraph (d) as added by  chapter  429  of  the
laws of 2005, is amended to read as follows:
  6. A licensed physician may prescribe and order a non-patient specific
regimen  [to  a  registered professional nurse], pursuant to regulations
promulgated by the commissioner, and consistent with the  public  health
law, [for] TO:
  (a) A REGISTERED PROFESSIONAL NURSE FOR:
  (I) administering immunizations[.];
  [(b)] (II) the emergency treatment of anaphylaxis[.];
  [(c)] (III) administering purified protein derivative (PPD) tests[.];
  [(d)]  (IV) administering tests to determine the presence of the human
immunodeficiency virus[.];
  (V) EMERGENCY CONTRACEPTION, TO BE ADMINISTERED TO OR DISPENSED TO  BE
SELF-ADMINISTERED  BY  THE  PATIENT,  UNDER  SECTION SIXTY-EIGHT HUNDRED
THIRTY-ONE OF THIS TITLE; OR
  (B) A LICENSED PHARMACIST, FOR DISPENSING EMERGENCY CONTRACEPTION,  TO
BE  SELF-ADMINISTERED  BY THE PATIENT, UNDER SECTION SIXTY-EIGHT HUNDRED
THIRTY-ONE OF THIS TITLE.
  S 4. Subdivision 3 of section 6807 of the education law, as  added  by
chapter  573  of the laws of 1999, is amended and a new subdivision 4 is
added to read as follows:
  3. A pharmacist may dispense drugs and devices to a registered profes-
sional nurse, and a registered professional nurse may possess and admin-
ister, drugs and devices, pursuant to  a  non-patient  specific  regimen
prescribed  or  ordered  by  a  licensed physician, LICENSED MIDWIFE, or
certified nurse practitioner, pursuant to regulations promulgated by the
commissioner and the public health law.
  4. A LICENSED PHARMACIST MAY DISPENSE A NON-PATIENT  SPECIFIC  REGIMEN
OF  EMERGENCY  CONTRACEPTION,  TO  BE  SELF-ADMINISTERED BY THE PATIENT,
PRESCRIBED OR ORDERED BY A LICENSED PHYSICIAN, CERTIFIED  NURSE  PRACTI-
TIONER,   OR   LICENSED   MIDWIFE,  UNDER  SECTION  SIXTY-EIGHT  HUNDRED
THIRTY-ONE OF THIS ARTICLE.
  S 5. The education law is amended by adding a new section 6831 to read
as follows:
  S 6831. EMERGENCY CONTRACEPTION; NON-PATIENT SPECIFIC PRESCRIPTION  OR
ORDER.  1.  AS  USED IN THIS SECTION, THE FOLLOWING TERMS SHALL HAVE THE
FOLLOWING MEANINGS, UNLESS THE CONTEXT REQUIRES OTHERWISE:

A. 420--A                           3

  (A) "EMERGENCY  CONTRACEPTION"  MEANS  ONE  OR  MORE  PRESCRIPTION  OR
NON-PRESCRIPTION  DRUGS,  USED SEPARATELY OR IN COMBINATION, IN A DOSAGE
AND MANNER FOR PREVENTING PREGNANCY WHEN USED AFTER  INTERCOURSE,  FOUND
SAFE  AND  EFFECTIVE  FOR  THAT  USE  BY THE UNITED STATES FOOD AND DRUG
ADMINISTRATION, AND DISPENSED OR ADMINISTERED FOR THAT PURPOSE.
  (B)  "PRESCRIBER"  MEANS A LICENSED PHYSICIAN, CERTIFIED NURSE PRACTI-
TIONER OR LICENSED MIDWIFE.
  2. THIS SECTION APPLIES TO THE ADMINISTERING OR DISPENSING OF EMERGEN-
CY CONTRACEPTION BY A REGISTERED PROFESSIONAL NURSE OR LICENSED  PHARMA-
CIST  PURSUANT  TO  A  PRESCRIPTION  OR ORDER FOR A NON-PATIENT SPECIFIC
REGIMEN  MADE  BY  A  PRESCRIBER  UNDER   SECTION   SIXTY-FIVE   HUNDRED
TWENTY-SEVEN, SIXTY-NINE HUNDRED NINE OR SIXTY-NINE HUNDRED FIFTY-ONE OF
THIS  TITLE.  THIS SECTION DOES NOT APPLY TO ADMINISTERING OR DISPENSING
EMERGENCY CONTRACEPTION WHEN LAWFULLY DONE WITHOUT SUCH  A  PRESCRIPTION
OR ORDER.
  3.  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  AGREED  TO  BY  THE  REGISTERED
PROFESSIONAL NURSE OR LICENSED PHARMACIST AND THE PRESCRIBER OR A HOSPI-
TAL  (LICENSED UNDER ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW) THAT
PROVIDES GYNECOLOGICAL OR FAMILY PLANNING SERVICES.
  4. (A) WHEN EMERGENCY CONTRACEPTION IS ADMINISTERED OR DISPENSED,  THE
REGISTERED  PROFESSIONAL  NURSE  OR LICENSED PHARMACIST SHALL PROVIDE TO
THE PATIENT WRITTEN MATERIAL THAT INCLUDES: (I) THE  CLINICAL  CONSIDER-
ATIONS  AND  RECOMMENDATIONS  FOR  USE OF THE DRUG; (II) THE APPROPRIATE
METHOD FOR USING THE  DRUG;  (III)  INFORMATION  ON  THE  IMPORTANCE  OF
FOLLOW-UP  HEALTH  CARE;  (IV) INFORMATION ON THE HEALTH RISKS AND OTHER
DANGERS OF UNPROTECTED INTERCOURSE; AND (V) REFERRAL INFORMATION  RELAT-
ING  TO  HEALTH  CARE AND SERVICES RELATING TO SEXUAL ABUSE AND DOMESTIC
VIOLENCE.
  (B) SUCH WRITTEN MATERIAL  SHALL  BE  DEVELOPED  OR  APPROVED  BY  THE
COMMISSIONER IN CONSULTATION WITH THE DEPARTMENT OF HEALTH AND THE AMER-
ICAN COLLEGE OF OBSTETRICIANS AND GYNECOLOGISTS.
  S  6.  Subdivision 4 of section 6909 of the education law, as added by
chapter 573 of the laws of 1999, paragraph (a) as amended and  paragraph
(c)  as  added  by  chapter 221 of the laws of 2002 and paragraph (d) as
added by chapter 429 of the laws of 2005, is amended to read as follows:
  4. A certified nurse practitioner may prescribe and  order  a  non-pa-
tient specific regimen [to a registered professional nurse], pursuant to
regulations promulgated by the commissioner, consistent with subdivision
three  of  section  [six  thousand  nine] SIXTY-NINE hundred two of this
article, and consistent with the public health law, [for] TO:
  (a) A REGISTERED PROFESSIONAL NURSE FOR:
  (I) administering immunizations[.];
  [(b)] (II) the emergency treatment of anaphylaxis[.];
  [(c)] (III) administering purified protein derivative (PPD) tests[.];
  [(d)] (IV) administering tests to determine the presence of the  human
immunodeficiency virus[.];
  (V)  EMERGENCY CONTRACEPTION, TO BE ADMINISTERED TO OR DISPENSED TO BE
SELF-ADMINISTERED BY THE  PATIENT,  UNDER  SECTION  SIXTY-EIGHT  HUNDRED
THIRTY-ONE OF THIS TITLE; OR
  (B)  A LICENSED PHARMACIST, FOR DISPENSING EMERGENCY CONTRACEPTION, TO
BE SELF-ADMINISTERED BY THE PATIENT, UNDER SECTION  SIXTY-EIGHT  HUNDRED
THIRTY-ONE OF THIS TITLE.

A. 420--A                           4

  S  7.  Subdivision 5 of section 6909 of the education law, as added by
chapter 573 of the laws of 1999, is amended to read as follows:
  5.  A registered professional nurse may execute a non-patient specific
regimen prescribed or ordered by a licensed physician, LICENSED MIDWIFE,
or certified nurse practitioner, pursuant to regulations promulgated  by
the commissioner.
  S  8.  Section  6951  of  the education law is amended by adding a new
subdivision 4 to read as follows:
  4. A LICENSED MIDWIFE MAY PRESCRIBE AND ORDER A  NON-PATIENT  SPECIFIC
REGIMEN  PURSUANT  TO  REGULATIONS  OF THE COMMISSIONER, CONSISTENT WITH
THIS SECTION AND THE PUBLIC HEALTH LAW, TO:
  (A) A REGISTERED PROFESSIONAL NURSE FOR EMERGENCY CONTRACEPTION, TO BE
ADMINISTERED TO OR DISPENSED TO BE  SELF-ADMINISTERED  BY  THE  PATIENT,
UNDER SECTION SIXTY-EIGHT HUNDRED THIRTY-ONE OF THIS TITLE; OR
  (B)  A LICENSED PHARMACIST, FOR DISPENSING EMERGENCY CONTRACEPTION, TO
BE SELF-ADMINISTERED BY THE PATIENT, UNDER SECTION  SIXTY-EIGHT  HUNDRED
THIRTY-ONE OF THIS TITLE.
  S  9.  Section  3216  of  the insurance law is amended by adding a new
subsection (n) to read as follows:
  (N) ANY POLICY UNDER  THIS  ARTICLE  THAT  COVERS  CONTRACEPTION  WHEN
PROVIDED  PURSUANT TO A PRESCRIPTION SHALL COVER EMERGENCY CONTRACEPTION
AS DEFINED IN PARAGRAPH (A) OF SUBDIVISION ONE  OF  SECTION  SIXTY-EIGHT
HUNDRED  THIRTY-ONE  OF  THE EDUCATION LAW, WHEN PROVIDED PURSUANT TO AN
ORDINARY PRESCRIPTION OR ORDER UNDER SECTION SIXTY-EIGHT  HUNDRED  THIR-
TY-ONE  OF  THE  EDUCATION  LAW  AND  WHEN  LAWFULLY PROVIDED OTHER THAN
THROUGH A PRESCRIPTION OR ORDER.
  S 10. Section 3221 of the insurance law is amended  by  adding  a  new
subsection (t) to read as follows:
  (T)  ANY  POLICY  UNDER  THIS  ARTICLE  THAT COVERS CONTRACEPTION WHEN
PROVIDED PURSUANT TO A PRESCRIPTION, SHALL COVER EMERGENCY CONTRACEPTION
AS DEFINED IN PARAGRAPH (A) OF SUBDIVISION ONE  OF  SECTION  SIXTY-EIGHT
HUNDRED  THIRTY-ONE  OF  THE EDUCATION LAW, WHEN PROVIDED PURSUANT TO AN
ORDINARY PRESCRIPTION OR ORDER UNDER SECTION SIXTY-EIGHT  HUNDRED  THIR-
TY-ONE  OF  THE  EDUCATION  LAW  AND  WHEN  LAWFULLY PROVIDED OTHER THAN
THROUGH A PRESCRIPTION OR ORDER.
  S 11. Section 4304 of the insurance law is amended  by  adding  a  new
subsection (n) to read as follows:
  (N)  ANY  POLICY  UNDER  THIS  ARTICLE  THAT COVERS CONTRACEPTION WHEN
PROVIDED PURSUANT TO A PRESCRIPTION, SHALL COVER EMERGENCY CONTRACEPTION
AS DEFINED IN PARAGRAPH (A) OF SUBDIVISION ONE  OF  SECTION  SIXTY-EIGHT
HUNDRED  THIRTY-ONE  OF  THE EDUCATION LAW, WHEN PROVIDED PURSUANT TO AN
ORDINARY PRESCRIPTION OR ORDER UNDER SECTION SIXTY-EIGHT  HUNDRED  THIR-
TY-ONE  OF  THE  EDUCATION  LAW  AND  WHEN  LAWFULLY PROVIDED OTHER THAN
THROUGH A PRESCRIPTION OR ORDER.
  S 12. Subdivision 1 of section 207 of the public health law is amended
by adding a new paragraph (j) to read as follows:
  (J) EMERGENCY CONTRACEPTION, INCLUDING INFORMATION ABOUT  ITS  SAFETY,
EFFICACY, APPROPRIATE USE AND AVAILABILITY.
  S  13.  This  act  shall  take effect on the one hundred eightieth day
after it shall have become a law; and sections nine, ten and  eleven  of
this  act  shall  apply to policies and contracts issued, renewed, modi-
fied, altered or amended on  or after such effective date.  The  commis-
sioner  of  education  is authorized to promulgate any and all rules and
regulations and take any other measures necessary to implement this  act
on its effective date on or before such effective date.