senate Bill S2361

Amended

Requires health care professional undergraduate, graduate and continuing education in chronic pain management and treatment

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Bill Status


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor
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actions

  • 16 / Jan / 2013
    • REFERRED TO HEALTH
  • 08 / Jan / 2014
    • REFERRED TO HEALTH
  • 06 / Feb / 2014
    • AMEND AND RECOMMIT TO HEALTH
  • 06 / Feb / 2014
    • PRINT NUMBER 2361A

Summary

Establishes standards to advance the management and treatment of chronic pain; incorporates continuing education programs for health care professionals that treat patients that have chronic pain.

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Bill Details

See Assembly Version of this Bill:
A2247
Versions:
S2361
S2361A
Legislative Cycle:
2013-2014
Current Committee:
Senate Health
Law Section:
Public Health Law
Laws Affected:
Add Art 28-F §2899-k, amd §2807-s, Pub Health L; amd §6507, Ed L
Versions Introduced in Previous Legislative Cycles:
2011-2012: A7124, A8894, A8894D, S2723C, A7124, A8894D
2009-2010: S4387, S4387

Sponsor Memo

BILL NUMBER:S2361

TITLE OF BILL: An act to amend the public health law and the
education law, in relation to chronic pain management

PURPOSE: To improve medical education and training in chronic pain
management and treatment by providing some funding support to medical
school and residency training program that train physicians in this
area of medicine. It also establishes the State Chronic Pain
Management Education and Training Council. This Council is to advise
the commissioners of Health and Education on establishing standards to
advance the management and treatment of chronic pain and to suggest
course materials that should be incorporated in continuing education
programs for the many health care professionals that treat patients
that have chronic pain.

SUMMARY OF PROVISIONS:

Section 1: Legislative Intent.

Section 2: Creates a new Article 28-F in the public Health law.
Provides grants for medical school education in chronic pain care
treatment and management that may be used for faculty development and
recruitment, and teaching at hospital based ambulatory care settings
and hospices, including personnel, administration, and student-related
expenses. Grants awarded through a competitive application process are
to be monitored by the newly created state Chronic Pain Management
Education and Training Council.

Provides grants for residency medical education in chronic pain care
treatment and management that may be used for faculty development and
recruitment, start-up costs and teaching at hospital based chronic
pain care settings and non-hospital based care sites, including
personnel, administration and trainee related costs. Grants are to be
awarded through a competitive application process monitored by the
Council.

Authorizes the commissioner of Health to designate Chronic Pain Health
Care professional practitioner Resource Centers which may be
state-wide or regional, to provide technical information and guidance
for practitioners on the treatment and management of chronic pain.
Such treatment and management can include new and advanced strategies,
therapies. and medications in this area of medicine. The resource
centers must be not-for-profit but they may charge fees to defray the
cost of the service.

Establishes a New York State Chronic Pain Management Education and
Training Council. The bill outlines the membership of this new council
and its duties on advising the Commissioner of Health on encouraging
medical schools and graduate medical educators to better highlight the
need to treat and manage chronic pain. Further, to help develop better
models of interdisciplinary cooperation between different health care
professionals who treat individuals that have chronic pain. Doing this
may be able to help increase the coordination of care, and thereby
benefit a patient's well-being and simultaneously help to reduce
health care costs by reducing the number of patient visits, diagnostic


tests conducted, and strong pain medications administered. The bill
further outlines public policies that should be considered, examined
and possibly advanced by the Council. In addition, the bill authorizes
the Council to make suggestions to the Departments of Health and
Education on how to better present course materials to health care
professionals in continuing education programs that educate such
professionals in the management and treatment of chronic pain.

Section 3: Amends Education Law section 6507 (3) to grant to the
Education Department the ability to accept the recommendations of the
Council in revising the continuing education requirements of certain
health care professionals that are licensed pursuant to the Education
Law. Such recommendations and alterations in the provision of such
continuing education shall be tailored to the specific health care
profession in question.

Section 4: Allocates up to $2.5 million in Health Care Reform Act
(HCRA) funds for grants for medical school education in chronic pain
care and up to $2.5 million in Health Care Reform Act (HCRA) funds for
grants for graduate medical education in palliative care.

JUSTIFICATION: Improving the management and treatment of chronic pain
in New York, especially the treatment of chronic pain, that leads to a
patient's decrease in physical activity, increased obesity rates,
higher rates of unemployment and higher rates of mental anguish are
important medical and patient wellbeing goals. Research in New York
and nationally has documented that there may be a general lack of
knowledge among many segments of health care practitioner community
concerning chronic pain care and the diagnosis and treatment of such
pain.

New York, being one of the centers for medical school education and
education for other health care professionals in the country, should
consider expanding education for physicians and others in chronic
care. The Council created by this bill should provide a focal point
for those interested in the treatment and management of chronic pain
both as an area of separate study and as an area for further advances
in interdisciplinary study among the various treating professions.

Further the bill helps to provide technical support for practicing
physicians and other health care professionals who are faced with
complex or unfamiliar pain-related conditions. To develop these
resources, experts in chronic pain care management from New York's
medical community should be engaged in the process, thus ensuring that
vital clinical and educational expertise is available.

Developing residency programs for physicians and other health care
professionals will improve the training of new health care
professionals. Further, it will generally improve the awareness and
quality of chronic pain care among all health care professionals who
practice at the residency program sites.

LEGISLATIVE HISTORY: This bill is similar in format to S.581,
sponsored by Senator Hannon in 2006 and 2007, which related to
establishing a Council for palliative Care. This bill ultimately
became law and was integrated into the Health Care Reform Act (HCRA)
by Chapter 58 of the Laws of 2007.


This bill is different from S.581 because it concentrates on chronic
pain treatment and management and takes a more interdisciplinary
approach to coordinating care among all health care professionals that
treat persons with chronic pain conditions. The approach taken in this
bill was suggested to the sponsor by Senator Hannon to address chronic
pain management. Further, this bill expands the concept of encouraging
graduate medical education centers to teach and research palliative
care (in this bill's case chronic pain) to include other health care
professionals that treat or monitor individuals with chronic pain such
as acupuncturists, chiropractors, nurses, physical therapists,
podiatrists, drug manufacturers, health care plan payors, and others
health care practitioners. The bill hopes to encourage better
cooperation between the various health care professions both in the
graduate training of such professionals and in the continuing
education forum after graduating from such health care professional
school.

2012 - S. 2723-C - Referred to Health

FISCAL IMPLICATIONS: Authorizes the allocation of up to $5 million in
existing HCPA funds, upon the appropriation of such funds and the
Commissioner of Health authorizing the disbursement of such funds.

EFFECTIVE DATE: Immediately.

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

                                  2361

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                            January 16, 2013
                               ___________

Introduced  by  Sens.  KLEIN, CARLUCCI, HANNON, MAZIARZ, VALESKY -- read
  twice and ordered printed, and when printed to  be  committed  to  the
  Committee on Health

AN ACT to amend the public health law and the education law, in relation
  to chronic pain management

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

  Section 1. Legislative  intent:  The  legislature  hereby  finds  that
medical  treatment  of chronic pain in this state needs to be reexamined
to enhance the ability to assess  such  condition,  increase  access  to
appropriate  care  to  treat  and mitigate chronic pain, and improve the
quality of life for  those  afflicted  with  this  condition.  Currently
chronic  pain  is  most  often treated by primary care providers who may
have little training in the assessment and proper treatment  of  complex
chronic  pain  conditions.  This,  in  turn, has led, in certain circum-
stances, to patients seeing multiple health care providers  and  experi-
encing  multiple  and repeated diagnostic tests, that lead to inadequate
or unproven surgeries, prescription of unneeded or strong  pain  medica-
tions, with its consequential heightened possibility to lead to the long
term  addiction  to such strong pain medications, and the performance of
procedures or treatment regimens that are not able to successfully treat
or mitigate such chronic pain.
  Further, the current practice of the repeated utilization of different
health practitioners, tests and unnecessary medical procedures to  treat
such  chronic  pain  is  resulting  in higher health care costs.   These
increased costs come from unnecessary visits to health care  practition-
ers, more and longer hospital stays, performing unnecessary surgeries or
other  medical  procedures,  and  unnecessary prescription of costly and
dangerous drugs. This inefficient use of valuable health care  resources
is contributing to the rapidly increasing cost of providing health care.
With  the  continuing aging of New York's general population, this trend

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD02105-02-3

S. 2361                             2

may only  continue  to  grow.  Further,  the  consequences  to  patients
afflicted  with  chronic  pain  will continue to undermine the physical,
social, economic and psychological well being of  such  patients,  their
families and loved ones.
  The  current  health  care delivery system both over treats and under-
treats those afflicted with chronic pain. Ideally, all patients  subject
to  chronic  pain  should be able to obtain an appropriate assessment of
the underlying conditions that cause such pain, followed by an appropri-
ate plan of care that reflects the best practices currently available to
prevent the adverse effects of pain. Such care should be provided  in  a
coordinated  manner  that minimizes such chronic pain and is cost effec-
tive for the patient, health care delivery system, and for employers  of
such  persons.  In sum, the provision of chronic pain treatments needs a
major reassessment to enhance assessment capabilities,  increase  access
to  appropriate care, improve the quality of care, and do so in a manner
that minimizes the cost of providing such care.
  S 2. The public health law is amended by adding a new article 28-F  to
read as follows:
                              ARTICLE 28-F
                         CHRONIC PAIN MANAGEMENT
SECTION 2899-K. CHRONIC PAIN MANAGEMENT.
  S 2899-K. CHRONIC PAIN MANAGEMENT. 1. DEFINITIONS. THE FOLLOWING WORDS
OR PHRASES AS USED IN THIS ARTICLE SHALL HAVE THE FOLLOWING MEANINGS:
  (A) "CHRONIC PAIN" SHALL MEAN CONSISTENT AND SIGNIFICANT PHYSICAL PAIN
OR  DISCOMFORT THAT LASTS FOR AN EXTENDED PERIOD OF TIME BEYOND AN ACUTE
PHYSICAL INJURY OR PAINFUL STIMULUS, AND PERSISTS UNABATED FOR A  PERIOD
OF  TIME  GREATER  THAN  SIX  MONTHS. FURTHER SUCH CONDITION IMPEDES THE
ABILITY OF SUCH PERSON FROM CONDUCTING MANY NORMAL LIFE  ACTIVITIES,  OR
IMPEDES  OR  LEADS TO THE LOSS OF EMPLOYMENT, OR CURTAILS THE ABILITY TO
PERFORM A NUMBER OF PREVIOUSLY EXECUTED PHYSICAL EMPLOYMENT TASKS.  SUCH
CHRONIC  PAIN  MAY  BE ASSOCIATED WITH CANCER PAIN, PAIN FROM CHRONIC OR
DEGENERATIVE DISEASES OR CONDITIONS, OR FROM AN UNIDENTIFIED CAUSE.
  (B) "CHRONIC PAIN CARE CERTIFIED MEDICAL SCHOOL" SHALL MEAN A  MEDICAL
SCHOOL  IN  THE  STATE  WHICH IS AN INSTITUTION WHICH GRANTS A DEGREE OF
DOCTOR OF MEDICINE OR DOCTOR OF OSTEOPATHIC MEDICINE IN ACCORDANCE  WITH
REGULATIONS  PROMULGATED  BY  THE  COMMISSIONER OF EDUCATION PURSUANT TO
SUBDIVISION TWO OF SECTION SIXTY-FIVE HUNDRED TWENTY-FOUR OF THE  EDUCA-
TION  LAW,  AND  WHICH MEETS THE STANDARDS ESTABLISHED PURSUANT TO REGU-
LATIONS PROMULGATED BY THE COMMISSIONER,  AFTER  CONSULTATION  WITH  THE
COUNCIL, THAT ARE USED TO DETERMINE WHETHER A MEDICAL SCHOOL IS ELIGIBLE
FOR FUNDING PURSUANT TO THIS SECTION.
  (C) "CHRONIC PAIN CARE CERTIFIED RESIDENCY PROGRAM" SHALL MEAN A GRAD-
UATE  MEDICAL EDUCATION PROGRAM IN THE STATE WHICH HAS RECEIVED ACCREDI-
TATION FROM A NATIONALLY RECOGNIZED ACCREDITATION BODY  FOR  MEDICAL  OR
OSTEOPATHIC  RESIDENCY  PROGRAMS,  AND  WHICH MEETS THE STANDARDS ESTAB-
LISHED PURSUANT TO REGULATIONS PROMULGATED BY  THE  COMMISSIONER,  AFTER
CONSULTATION  WITH  THE  COUNCIL,  THAT  ARE USED TO DETERMINE WHETHER A
RESIDENCY TRAINING PROGRAM IS ELIGIBLE  FOR  FUNDING  PURSUANT  TO  THIS
SECTION.
  (D)  "COUNCIL"  SHALL MEAN THE STATE CHRONIC PAIN MANAGEMENT EDUCATION
AND TRAINING COUNCIL ESTABLISHED BY SUBDIVISION TWO OF THIS SECTION.
  (E) "HEALTH CARE PROFESSIONALS" SHALL MEAN AND  INCLUDE  THOSE  HEALTH
CARE  PROFESSIONALS WHO REGULARLY TREAT PATIENTS THAT HAVE CHRONIC PAIN,
AND INCLUDES, BUT IS  NOT  LIMITED  TO,  ACUPUNCTURISTS,  CHIROPRACTORS,
DENTISTS,  NURSE  PRACTITIONERS,  REGISTERED PROFESSIONAL NURSES, PODIA-

S. 2361                             3

TRISTS, PHARMACISTS, PHYSICIANS, PHYSICAL THERAPISTS, PHYSICIAN  ASSIST-
ANTS, PSYCHIATRISTS AND OCCUPATIONAL THERAPISTS.
  (F)  "PROFESSIONAL  CONTINUING  EDUCATION"  OR  "CONTINUING EDUCATION"
SHALL MEAN  ALL  PROFESSIONAL  CONTINUING  EDUCATION  PROGRAMS  REQUIRED
EITHER  BY  STATE  LAW OR BY PROFESSIONAL ASSOCIATIONS AUTHORIZED BY THE
EDUCATION DEPARTMENT TO MONITOR THE REQUIREMENTS OF  LICENSURE,  AND  TO
CONDUCT AND APPROVE PROFESSIONAL CONTINUING EDUCATION REQUIREMENTS FOR A
HEALTH  CARE  PROFESSION.    SUCH  PROFESSIONS SHALL INCLUDE, BUT NOT BE
LIMITED TO, ACUPUNCTURE,  CHIROPRACTIC,  DENTISTRY,  NURSING,  PODIATRY,
PHARMACY,  MEDICINE,  PHYSICAL THERAPY, PHYSICIAN ASSISTANCE, PSYCHOLOGY
AND OCCUPATIONAL THERAPY.
  2. STATE CHRONIC PAIN MANAGEMENT EDUCATION AND TRAINING COUNCIL.   (A)
THE  STATE  CHRONIC  PAIN  MANAGEMENT  EDUCATION AND TRAINING COUNCIL IS
HEREBY ESTABLISHED IN THE DEPARTMENT TO BE AN EXPERT PANEL TO ADVISE THE
COMMISSIONER AND COMMISSIONER OF EDUCATION ON: (I) ADVANCES IN THE OPTI-
MUM TREATMENT, MANAGEMENT AND BEST PRACTICES RELATED  TO  MITIGATING  OR
ALLEVIATING  CHRONIC  PAIN, (II) TO PROMOTE BETTER INTERDISCIPLINARY AND
COORDINATED PROVISION OF CARE RELATED TO CHRONIC PAIN MANAGEMENT,  (III)
TO DEVELOP NEW PUBLIC POLICIES RELATED TO ADVANCING THE TEACHING OF SUCH
NEW  TREATMENTS,  MANAGEMENT REGIMENS, OR BEST PRACTICES ON CHRONIC PAIN
MANAGEMENT AND CARE IN CHRONIC PAIN CARE CERTIFIED MEDICAL  SCHOOLS  AND
CHRONIC  PAIN CARE CERTIFIED RESIDENCY PROGRAMS, AND (IV) DEVELOP GUIDE-
LINES TO ASSIST THE EDUCATION DEPARTMENT IN ESTABLISHING  MATERIALS  AND
CURRICULA  TO  BE  USED  IN  PROVIDING PROFESSIONAL CONTINUING EDUCATION
PROGRAMS FOR THOSE HEALTH CARE PROFESSIONALS REGULATED BY  SUCH  DEPART-
MENT.
  (B)  THE COUNCIL SHALL BE COMPOSED OF TWENTY-FIVE MEMBERS APPOINTED BY
THE  COMMISSIONER.  THE  COMMISSIONER  SHALL  SEEK  RECOMMENDATIONS  FOR
APPOINTMENTS  TO  SUCH  COUNCIL FROM HEALTH CARE PROFESSIONAL, CONSUMER,
MEDICAL INSTITUTIONAL, MEDICAL EDUCATIONAL  LEADERS  AND  OTHER  PROFES-
SIONAL  EDUCATIONAL LEADERS FROM THIS STATE. THE MEMBERSHIP OF THE COUN-
CIL SHALL INCLUDE: NINE REPRESENTATIVES OF MEDICAL SCHOOLS AND  HOSPITAL
ORGANIZATIONS;  TWO REPRESENTATIVES OF MEDICAL ACADEMIES; ONE ACUPUNCTU-
RIST LICENSED PURSUANT TO SECTION EIGHTY-TWO  HUNDRED  FOURTEEN  OF  THE
EDUCATION  LAW;  INDIVIDUAL  REPRESENTATIVES  OF  ORGANIZATIONS  BROADLY
REPRESENTATIVE OF PHYSICIANS, FAMILY  PHYSICIANS,  PRIMARY  CARE  PHYSI-
CIANS,  INTERNAL  MEDICINE, RHEUMATOLOGY, NURSING, GERONTOLOGY, HOSPICE,
NEUROLOGY, PSYCHIATRY, PEDIATRICS,  SURGERY,  ACUPUNCTURE,  CHIROPRACTIC
CARE,  PODIATRIC CARE, PHARMACISTS OR THOSE PROFESSIONALS RELATED TO THE
PRESCRIPTION OR MANUFACTURE OF PAIN MEDICATIONS, EMERGENCY  ROOM  HEALTH
CARE PROFESSIONALS, MASSAGE THERAPISTS, OCCUPATIONAL AND PHYSICAL THERA-
PY,  PATIENT  ADVOCATES AND THE HOSPITAL PHILANTHROPIC COMMUNITY; HEALTH
CARE PLAN PAYORS OR INSURERS; THE EXECUTIVE DIRECTOR OR A MEMBER OF  THE
NEW  YORK  STATE  COUNCIL ON GRADUATE MEDICAL EDUCATION; AND A MEMBER OF
THE NEW YORK STATE PALLIATIVE CARE EDUCATION AND TRAINING COUNCIL.
  (C) THE MEMBERS OF THE COUNCIL SHALL HAVE EXPERTISE IN  THE  TREATMENT
AND  MANAGEMENT  OF  CHRONIC  PAIN  AND  THE  CARE  OF PATIENTS THAT ARE
AFFLICTED WITH CHRONIC PAIN CONDITIONS. THE TERM OF SUCH  MEMBERS  SHALL
BE  FOUR  YEARS  AND SUCH TERMS MAY BE RENEWED. MEMBERS SHALL RECEIVE NO
COMPENSATION FOR THEIR SERVICES, BUT SHALL BE ALLOWED ACTUAL AND  NECES-
SARY EXPENSES IN THE PERFORMANCE OF THEIR DUTIES.
  (D) A CHAIR AND VICE-CHAIR OF THE COUNCIL SHALL BE ELECTED ANNUALLY BY
THE COUNCIL. THE COUNCIL SHALL MEET UPON THE CALL OF THE COMMISSIONER OR
THE  CHAIR.  THE  COUNCIL  MAY  ADOPT  REGULATIONS  CONSISTENT WITH THIS
SECTION.

S. 2361                             4

  (E) THE COMMISSIONER SHALL DESIGNATE SUCH EMPLOYEES  AND  PROVIDE  FOR
OTHER  RESOURCES  FROM  THE DEPARTMENT AS MAY BE REASONABLY NECESSARY TO
PROVIDE SUPPORT AND SERVICES FOR THE WORK OF THE  COUNCIL.  THE  COUNCIL
MAY  EMPLOY ADDITIONAL STAFF AND CONSULTANTS AND INCUR OTHER EXPENSES TO
CARRY  OUT  ITS  DUTIES,  TO  BE PAID FOR FROM AMOUNTS WHICH MAY BE MADE
AVAILABLE TO THE COUNCIL FOR THAT PURPOSE.
  (F) THE COUNCIL MAY PROVIDE  TECHNICAL  INFORMATION  AND  GUIDANCE  TO
HEALTH  CARE  PROFESSIONALS  ON  THE  LATEST BEST PRACTICES, STRATEGIES,
THERAPIES AND MEDICATIONS TO TREAT OR MANAGE CHRONIC PAIN.  FURTHER,  TO
PROVIDE  TECHNICAL INFORMATION AND GUIDANCE TO HEALTH CARE PROFESSIONALS
TO ENCOURAGE BETTER COORDINATED CARE  TO  TREAT  OR  MITIGATE  THE  PAIN
SUFFERED BY CHRONIC PAIN PATIENTS.
  3.    POLICIES TO BE CONSIDERED, EXAMINED AND POSSIBLY ADVANCED BY THE
COUNCIL. THE COUNCIL SHALL CONSIDER AND EXAMINE THE  FOLLOWING  POLICIES
AND GUIDELINES IN THE ADOPTION OF ANY RULES AND REGULATIONS:
  (A)  THE  TREATMENT  AND CARE PROVIDED TO PATIENTS THAT SUFFER CHRONIC
PAIN SHOULD BE CENTERED IN THE PRIMARY CARE ENVIRONMENT AND FOSTER COOR-
DINATED CARE BETWEEN THE VARIOUS HEALTH CARE PROFESSIONAL DISCIPLINES.
  (B) CHRONIC PAIN MANAGEMENT AND CARE SHOULD  BE  COORDINATED  TO  HELP
MINIMIZE  THE  DISPENSING  OF  PRESCRIPTION DRUGS, AVOID DUPLICATIVE AND
COSTLY EVALUATIONS AND DIAGNOSTIC  TESTS,  AND  TREATMENTS  TO  MINIMIZE
CHRONIC PAIN.
  (C)  DEVELOPMENT  OF  CHRONIC PAIN MANAGEMENT AND CARE TECHNIQUES THAT
ADDRESSES DISCREPANCIES THAT MAY OCCUR  IN  THE  TREATMENT  OF  PATIENTS
BASED ON RACE, ETHNICITY, GENDER, INCOME LEVEL OR AGE.
  (D)  DEVELOP  AND  PROMOTE  THE  USE OF BEST PRACTICES TO MITIGATE THE
SUFFERING OF CHRONIC PAIN IN PATIENTS.  THE  UTILIZATION  OF  SUCH  BEST
PRACTICES CAN BE PROMOTED BY: (I) THE PROVISION OF PROFESSIONAL CONTINU-
ING  EDUCATION  PROGRAMS TO ALL HEALTH CARE PROFESSIONALS ON ADVANCES IN
BEST PRACTICES IN CHRONIC PAIN MANAGEMENT AND CARE, AND (II) THE  DEVEL-
OPMENT  OF  ADVANCES  IN  BEST PRACTICES BASED ON NEW RESEARCH, CLINICAL
EXPERIENCE, AND THE PROMOTION OF INTER-DISCIPLINARY DIALOG  AND  COOPER-
ATION BETWEEN THE VARIOUS HEALTH CARE PROFESSIONALS.
  (E) ENCOURAGE THE WIDER USE OF COORDINATED HEALTH INFORMATION TECHNOL-
OGY SYSTEMS TO TRACK PAIN DISORDERS, TREATMENTS, AND OUTCOMES AS A MECH-
ANISM  TO  IMPROVE CHRONIC PAIN CARE AND TO BETTER INTEGRATE COORDINATED
CARE AMONG THE VARIOUS TREATING HEALTH CARE PROFESSIONALS.
  (F) CONSIDER ALTERATIONS IN MEDICAID AND PRIVATE  PAYOR  REIMBURSEMENT
RATES  AND  PRACTICES  TO  ENCOURAGE  MORE  OPTIMUM PROVISION OF QUALITY
CHRONIC PAIN MANAGEMENT AND CARE BY ALL HEALTH CARE PROFESSIONALS.
  (G) ENCOURAGE A BALANCED APPROACH TO REGULATE THE  DISTRIBUTION,  USE,
AND  PRESCRIPTION  OF  MEDICATIONS  THAT  ARE USED TO TREAT CHRONIC PAIN
CONDITIONS. SUCH BALANCED APPROACH NEEDS TO  ENSURE  THAT  PATIENTS  CAN
OBTAIN  THE MEDICATIONS THAT THEY NEED, BUT ARE NOT OVER PRESCRIBED SUCH
MEDICATIONS, WHICH CAN LEAD TO PATIENT ABUSE  OR  LONG  TERM  ADDICTION.
FURTHER,  THE  NEED  TO  MONITOR  MULTIPLE DAILY MEDICATION PRESCRIPTION
REGIMENS, COUPLED WITH  PSYCHOLOGICAL,  BEHAVIORAL,  AND  SOCIAL  INTER-
VENTION  ACTIVITIES  OF  SUCH PATIENTS. FURTHER, TO REDUCE THE THREAT OF
DRUG ABUSE, ADDICTION OR DIVERSION  OF  SUCH  MEDICATIONS  TO  USES  NOT
RELATED TO PROPER TREATMENT OF CHRONIC PAIN CONDITIONS.
  4.  GRANTS  FOR UNDERGRADUATE MEDICAL EDUCATION IN CHRONIC PAIN TREAT-
MENT AND MANAGEMENT. (A) THE COMMISSIONER IS AUTHORIZED, WITHIN  AMOUNTS
FROM  ANY SOURCE APPROPRIATED OR OTHERWISE PROVIDED FOR SUCH PURPOSE, TO
MAKE GRANTS TO CHRONIC PAIN CARE CERTIFIED MEDICAL SCHOOLS  AND  SCHOOLS
OF HEALTH CARE PROFESSIONALS TO ENHANCE THE STUDY AND RESEARCH OF CHRON-
IC  PAIN TREATMENT AND MANAGEMENT, INCREASE THE OPPORTUNITIES FOR UNDER-

S. 2361                             5

GRADUATE MEDICAL EDUCATION IN CHRONIC PAIN CARE  TREATMENT  AND  MANAGE-
MENT,  AND  ENCOURAGE  THE  EDUCATION OF PHYSICIANS IN CHRONIC PAIN CARE
MANAGEMENT AND TREATMENT.
  (B)  GRANT  PROCEEDS  UNDER  THIS  SUBDIVISION MAY BE USED FOR FACULTY
DEVELOPMENT IN CHRONIC PAIN CARE TREATMENT AND  MANAGEMENT;  RECRUITMENT
OF  FACULTY WITH AN EXPERTISE IN THE MANAGEMENT AND TREATMENT OF CHRONIC
PAIN; COSTS INCURRED TEACHING MEDICAL STUDENTS AT HOSPITAL-BASED  SITES,
NON-HOSPITAL BASED AMBULATORY CARE SETTINGS, CERTIFIED HOME HEALTH AGEN-
CIES,  LICENSED  LONG TERM HOME HEALTH CARE PROGRAMS, PRIVATE AND PUBLIC
HEALTH CARE CLINICS, AND IN PRIVATE PHYSICIAN PRACTICES  INCLUDING,  BUT
NOT  LIMITED  TO PERSONNEL, ADMINISTRATION AND STUDENT-RELATED EXPENSES;
EXPANSION OR DEVELOPMENT OF PROGRAMS THAT TRAIN PHYSICIANS IN THE TREAT-
MENT AND MANAGEMENT OF  CHRONIC  PAIN;  AND  OTHER  INNOVATIVE  PROGRAMS
DESIGNED  TO  INCREASE  THE  COMPETENCY  OF  MEDICAL STUDENTS TO PROVIDE
CHRONIC PAIN CARE TO PATIENTS.
  (C) GRANTS UNDER THIS SUBDIVISION SHALL BE AWARDED BY THE COMMISSIONER
THROUGH A COMPETITIVE APPLICATION PROCESS TO THE  COUNCIL.  THE  COUNCIL
SHALL MAKE RECOMMENDATIONS FOR FUNDING TO THE COMMISSIONER.
  5.  GRANTS  FOR GRADUATE HEALTH CARE PROFESSIONAL EDUCATION IN CHRONIC
PAIN TREATMENT AND MANAGEMENT. (A) THE COMMISSIONER IS AUTHORIZED, WITH-
IN AMOUNTS FROM ANY SOURCE APPROPRIATED OR OTHERWISE PROVIDED  FOR  SUCH
PURPOSE,  TO  MAKE  GRANTS  TO  CHRONIC  PAIN  CARE  CERTIFIED RESIDENCY
PROGRAMS TO ESTABLISH OR EXPAND EDUCATION IN CHRONIC PAIN TREATMENT  AND
MANAGEMENT  FOR GRADUATE MEDICAL EDUCATION, AND TO INCREASE THE OPPORTU-
NITIES FOR TRAINEE EDUCATION IN THE TREATMENT AND MANAGEMENT OF  CHRONIC
PAIN IN THE HOSPITAL-BASED AND NON-HOSPITAL-BASED SETTINGS.
  (B)  GRANTS  UNDER  THIS  SUBDIVISION FOR GRADUATE HEALTH CARE PROFES-
SIONAL EDUCATION AND EDUCATION IN CHRONIC PAIN TREATMENT AND  MANAGEMENT
MAY  BE  USED  FOR  ADMINISTRATION, FACULTY RECRUITMENT AND DEVELOPMENT;
START-UP COSTS AND COSTS INCURRED TEACHING THE MOST ADVANCED STRATEGIES,
THERAPIES, MEDICATIONS OR BEST PRACTICES WITH  REGARD  TO  THE  CARE  OF
PATIENTS  WITH  CHRONIC  PAIN  IN  EITHER HOSPITAL-BASED OR NON-HOSPITAL
BASED SETTINGS INCLUDING, BUT NOT LIMITED TO  PERSONNEL,  ADMINISTRATION
AND  TRAINEE  RELATED EXPENSES; AND OTHER EXPENSES DEEMED REASONABLE AND
NECESSARY BY THE COMMISSIONER.
  (C) GRANTS UNDER THIS SUBDIVISION SHALL BE AWARDED BY THE COMMISSIONER
THROUGH A COMPETITIVE APPLICATION PROCESS TO THE  COUNCIL.  THE  COUNCIL
SHALL MAKE RECOMMENDATIONS FOR FUNDING TO THE COMMISSIONER.
  6.   CHRONIC  PAIN  HEALTH  CARE  PROFESSIONAL  PRACTITIONER  RESOURCE
CENTERS.  THE COMMISSIONER, IN CONSULTATION WITH THE COUNCIL, MAY DESIG-
NATE A CHRONIC  PAIN  TREATMENT  AND  MANAGEMENT  PRACTITIONER  RESOURCE
CENTER  OR  CENTERS.  SUCH RESOURCE CENTER MAY BE STATEWIDE OR REGIONAL,
AND SHALL ACT AS A SOURCE OF TECHNICAL SUPPORT, INFORMATION AND GUIDANCE
FOR PRACTITIONERS ON THE LATEST STRATEGIES,  THERAPIES,  MEDICATIONS  OR
BEST  PRACTICES  WITH  REGARD TO THE OPTIMUM TREATMENT AND MANAGEMENT OF
CHRONIC PAIN. THE DEPARTMENT, IN  CONSULTATION  WITH  THE  COUNCIL,  MAY
CONTRACT  WITH NOT-FOR-PROFIT ORGANIZATIONS OR ASSOCIATIONS TO ESTABLISH
AND MANAGE SUCH RESOURCE CENTERS. SUCH RESOURCE CENTER MAY CHARGE A  FEE
TO HELP OFFSET THE COST OF PROVIDING SUCH SERVICES.
  7.  CONTINUING  EDUCATION  REQUIREMENTS FOR HEALTH CARE PROFESSIONALS.
THE COUNCIL, IN CONSULTATION WITH THE DEPARTMENT, THE EDUCATION  DEPART-
MENT  AND HEALTH CARE PROFESSIONAL ORGANIZATIONS; SHALL DEVELOP, COMPILE
AND PUBLISH INFORMATION AND COURSE MATERIALS ON THE  ADVANCED  TREATMENT
AND  MITIGATION OF CHRONIC PAIN SUFFERED BY PATIENTS. IN ADDITION WITHIN
TWO YEARS OF THE EFFECTIVE DATE OF THIS ARTICLE, THE COUNCIL SHALL  MAKE
RECOMMENDATIONS  TO THE EDUCATION DEPARTMENT FOR THE COURSE WORK, TRAIN-

S. 2361                             6

ING AND CURRICULUM TO BE INCLUDED IN THE  CONTINUING  EDUCATION  ON  THE
BEST  PRACTICES, STRATEGIES, THERAPIES AND APPROACHES FOR THE MITIGATION
AND TREATMENT OF CHRONIC PAIN REQUIRED TO BE COMPLETED  BY  THE  VARIOUS
HEALTH  CARE PROFESSIONS PURSUANT TO PARAGRAPH D OF SUBDIVISION THREE OF
SECTION SIXTY-FIVE HUNDRED SEVEN OF THE EDUCATION LAW. SUCH  RECOMMENDA-
TIONS  SHALL  INCLUDE COMPONENTS WHICH ADDRESS THE INCREASING AND NECES-
SARY INTERDISCIPLINARY COOPERATION BETWEEN HEALTH CARE PROFESSIONALS FOR
THE COORDINATED REDUCTION OF CHRONIC PAIN IN PATIENTS AND THE  REDUCTION
OF HEALTH CARE COSTS.
  8.  REPORT.    ON OR BEFORE MARCH FIRST OF EACH ODD NUMBERED YEAR, THE
COUNCIL SHALL SUBMIT TO THE GOVERNOR, THE COMMISSIONER, THE COMMISSIONER
OF EDUCATION, THE TEMPORARY PRESIDENT OF THE SENATE, THE SPEAKER OF  THE
ASSEMBLY, AND THE CHAIRS OF THE SENATE AND ASSEMBLY COMMITTEES ON HEALTH
A REPORT ON ITS ACTIVITIES AND ACCOMPLISHMENTS RELATING TO THE TREATMENT
AND MITIGATION OF CHRONIC PAIN. SUCH REPORT MAY ALSO INCLUDE SUCH LEGIS-
LATIVE PROPOSALS AS IT DEEMS NECESSARY TO MORE EFFECTIVELY IMPLEMENT THE
PROVISIONS OF THIS ARTICLE.
  S 3. Paragraphs b and c of subdivision 3 of section 6507 of the educa-
tion law, as added by chapter 987 of the laws of 1971, are amended and a
new paragraph d is added to read as follows:
  b.  Review  qualifications  in connection with licensing requirements;
[and]
  c. Provide for licensing examinations and reexaminations[.]; AND
  D. (I) ESTABLISH STANDARDS FOR PREPROFESSIONAL AND PROFESSIONAL EDUCA-
TION FOR HEALTH CARE PROFESSIONALS,  AS  DEFINED  IN  PARAGRAPH  (E)  OF
SUBDIVISION  ONE  OF  SECTION  TWENTY-EIGHT HUNDRED NINETY-NINE-K OF THE
PUBLIC HEALTH LAW, RELATING TO THE MITIGATION AND TREATMENT  OF  CHRONIC
PAIN.  IN  THE  PROMULGATION  OF  SUCH STANDARDS, THE DEPARTMENT AND THE
APPROPRIATE BOARD OF EACH SUCH PROFESSION SHALL  CONSIDER  AND,  TO  THE
EXTENT  PRACTICABLE,  IMPLEMENT THE RECOMMENDATIONS OF THE STATE CHRONIC
PAIN MANAGEMENT EDUCATION AND TRAINING COUNCIL. FURTHERMORE, SUCH STAND-
ARDS SHALL PROVIDE FOR SUCH TRAINING  AND  COURSEWORK  ON  THE  ADVANCED
TREATMENT AND MITIGATION OF CHRONIC PAIN AS SHALL BE APPROPRIATE FOR THE
HEALTH  CARE  PROFESSION, AND SHALL ADDRESS THE INCREASING AND NECESSARY
INTERDISCIPLINARY COOPERATION BETWEEN HEALTH CARE PROFESSIONALS FOR  THE
COORDINATED  REDUCTION  OF CHRONIC PAIN IN PATIENTS AND THE REDUCTION OF
HEALTH CARE COSTS.
  (II) THE COMMISSIONER SHALL ESTABLISH  STANDARDS  REQUIRING  THAT  ALL
HEALTH CARE PROFESSIONALS APPLYING, ON OR AFTER JANUARY FIRST, TWO THOU-
SAND  SIXTEEN,  INITIALLY OR FOR A RENEWAL OF A LICENSE, REGISTRATION OR
CERTIFICATE PURSUANT TO THIS TITLE, SHALL,  IN  ADDITION  TO  ALL  OTHER
LICENSURE,  REGISTRATION  OR  CERTIFICATION REQUIREMENTS, HAVE COMPLETED
SUCH COURSEWORK AND TRAINING IN THE TREATMENT AND MITIGATION OF  CHRONIC
PAIN  AS  SHALL  BE  REQUIRED PURSUANT TO SUBPARAGRAPH (I) OF THIS PARA-
GRAPH. THE COURSEWORK AND TRAINING SHALL BE OBTAINED FROM AN INSTITUTION
OR PROVIDER THAT HAS BEEN APPROVED BY THE  DEPARTMENT  TO  PROVIDE  SUCH
COURSEWORK  AND  TRAINING.  EACH  APPLICANT SHALL PROVIDE THE DEPARTMENT
WITH DOCUMENTATION SHOWING HE OR SHE HAS COMPLETED THE  REQUIRED  TRAIN-
ING.
  (III)  THE DEPARTMENT SHALL PROVIDE AN EXEMPTION FROM THE REQUIREMENTS
OF SUBPARAGRAPHS (I) AND (II) OF  THIS  PARAGRAPH  TO  ANY  HEALTH  CARE
PROFESSIONAL  WHO REQUESTS SUCH AN EXEMPTION AND WHO DEMONSTRATES TO THE
DEPARTMENT'S SATISFACTION THAT:
  (A) THERE WOULD BE NO NEED FOR HIM OR HER TO COMPLETE SUCH  COURSEWORK
AND TRAINING BECAUSE OF THE NATURE OF HIS OR HER PRACTICE; OR

S. 2361                             7

  (B)  HE  OR  SHE  HAS  COMPLETED COURSEWORK AND TRAINING DEEMED BY THE
DEPARTMENT TO BE EQUIVALENT TO THE STANDARDS FOR COURSEWORK AND TRAINING
APPROVED BY THE DEPARTMENT UNDER THIS PARAGRAPH.
  S  4.  Subdivision  7  of  section  2807-s of the public health law is
amended by adding a new paragraph (d) to read as follows:
  (D) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF THIS SECTION,  PRIOR
TO  THE  ALLOCATION OF FUNDS FOR DISTRIBUTION IN ACCORDANCE WITH SECTION
TWENTY-EIGHT HUNDRED SEVEN-J OF THIS ARTICLE PURSUANT TO PARAGRAPHS  (B)
AND  (C) OF THIS SUBDIVISION, THE COMMISSIONER ON AN ANNUALIZED BASIS UP
TO TWO MILLION FIVE HUNDRED THOUSAND DOLLARS FOR GRANTS FOR  UNDERGRADU-
ATE  HEALTH  CARE  PROFESSIONAL  EDUCATION IN CHRONIC PAIN TREATMENT AND
MANAGEMENT PURSUANT TO SUBDIVISION FOUR OF SECTION TWENTY-EIGHT  HUNDRED
NINETY-NINE-K  OF THIS CHAPTER; AND UP TO TWO MILLION FIVE HUNDRED THOU-
SAND DOLLARS FOR GRANTS FOR GRADUATE HEALTH CARE PROFESSIONAL  EDUCATION
IN CHRONIC PAIN TREATMENT AND MANAGEMENT PURSUANT TO SUBDIVISION FIVE OF
SECTION TWENTY-EIGHT HUNDRED NINETY-NINE-K OF THIS CHAPTER.
  S  5.  This act shall take effect immediately provided that the amend-
ments to subdivision 7 of section 2807-s of the public health  law  made
by  section  four  of  this  act shall not affect the expiration of such
section and shall expire therewith.

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