Senate Bill S2723C

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

                                  2723

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                            January 31, 2011
                               ___________

Introduced  by  Sen.  KLEIN  -- 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 clinical education in pain management

  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
28-F to read as follows:
                              ARTICLE 28-F
                             PAIN MANAGEMENT
SECTION 2900.   CLINICAL EDUCATION IN PAIN MANAGEMENT.
        2900-A. ADVISORY COMMITTEE ON PAIN MANAGEMENT EDUCATION.
  S 2900. CLINICAL EDUCATION IN PAIN  MANAGEMENT.  1.  EVERY  PHYSICIAN,
PHYSICIAN  ASSISTANT  AND  SPECIALIST  ASSISTANT PRACTICING IN THE STATE
SHALL, EVERY FOUR YEARS COMPLETE COURSE WORK OR TRAINING REGARDING  PAIN
MANAGEMENT,  APPROPRIATE TO THE PROFESSIONAL'S PRACTICE, APPROVED BY THE
DEPARTMENT IN ACCORDANCE WITH STANDARDS PROMULGATED BY THE DEPARTMENT IN
CONSULTATION WITH THE EDUCATION DEPARTMENT; AND SO  DOCUMENT  COMPLETION
TO THE DEPARTMENT.
  2.  THE DEPARTMENT SHALL PROVIDE AN EXEMPTION FROM THIS REQUIREMENT TO
ANYONE 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 COURSE WORK
OR TRAINING BECAUSE OF THE NATURE OF HIS OR HER PRACTICE, OR
  (B)  HE  OR  SHE  HAS  COMPLETED COURSE WORK OR TRAINING DEEMED BY THE
DEPARTMENT TO BE EQUIVALENT TO THE STANDARDS FOR COURSE WORK OR TRAINING
APPROVED BY THE DEPARTMENT UNDER THIS SECTION.
  3. EXISTING CURRICULA, INCLUDING CURRICULA DEVELOPED BY A  NATIONALLY-
RECOGNIZED HEALTH CARE PROFESSIONAL, SPECIALTY, OR PROVIDER ASSOCIATION,
OR  NATIONALLY-RECOGNIZED PAIN MANAGEMENT ASSOCIATION, MAY BE CONSIDERED
IN IMPLEMENTING THIS SECTION. CURRICULA SHALL INCLUDE BUT NOT BE LIMITED

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD05533-01-1
              

S. 2723                             2

TO: PALLIATIVE MEDICINE;  PAIN;  NEUROPSYCHOLOGIC  AND  OTHER  SYMPTOMS;
ETHICS AND THE LAW; PATIENT AND FAMILY PERSPECTIVES ON END-OF-LIFE CARE;
ACUPUNCTURE TREATMENT; AND CLINICAL COMMUNICATION SKILLS. THE DEPARTMENT
SHALL  CONSULT  WITH ORGANIZATIONS REPRESENTATIVE OF HEALTH CARE PRACTI-
TIONERS, INSTITUTIONS AND  THOSE  WITH  EXPERTISE  IN  PAIN  MANAGEMENT,
INCLUDING EXPERTISE IN THE ACUPUNCTURE FIELD, WITH RESPECT TO THE STAND-
ARDS PROMULGATED UNDER THIS SECTION.
  S 2900-A. ADVISORY COMMITTEE ON PAIN MANAGEMENT EDUCATION. THE COMMIS-
SIONER, IN DEVELOPING, REVIEWING AND IMPLEMENTING THE EDUCATIONAL STAND-
ARDS  UNDER SECTION TWENTY-NINE HUNDRED OF THIS ARTICLE, AND THE COMMIS-
SIONER  OF  EDUCATION,  IN  DEVELOPING,   REVIEWING   AND   IMPLEMENTING
EDUCATIONAL  STANDARDS  UNDER  SECTION  SIXTY-FIVE HUNDRED FIVE-D OF THE
EDUCATION LAW, SHALL CONSULT THE ADVISORY COMMITTEE ON  PAIN  MANAGEMENT
EDUCATION  CREATED  BY  THIS  SECTION.    THE ADVISORY COMMITTEE ON PAIN
MANAGEMENT EDUCATION SHALL BE COMPRISED OF TWELVE MEMBERS  APPOINTED  AS
FOLLOWS:  SIX BY THE COMMISSIONER; AND SIX BY THE COMMISSIONER OF EDUCA-
TION. THE COMMITTEE SHALL BE REPRESENTATIVE OF HEALTH CARE PRACTITIONERS
AND  THEIR  PROFESSIONAL  ORGANIZATIONS,  PAIN  MANAGEMENT  SPECIALISTS,
INCLUDING  THOSE  IN THE ACUPUNCTURE FIELD, AND HEALTH CARE PRACTITIONER
EDUCATION EXPERTS.
  S 2. The education law is amended by adding a new  section  6505-d  to
read as follows:
  S  6505-D. CLINICAL EDUCATION IN PAIN MANAGEMENT. 1. EVERY HEALTH CARE
PRACTITIONER LICENSED OR  CERTIFIED  PURSUANT  TO  THIS  TITLE,  WHO  IS
AUTHORIZED  TO  ORDER,  PRESCRIBE, ADMINISTER OR DISPENSE PAIN-RELIEVING
MEDICATIONS OR OTHER TREATMENT FOR THE RELIEF  OF  PAIN  IN  THIS  STATE
(OTHER  THAN  A PHYSICIAN, PHYSICIAN ASSISTANT AND SPECIALIST ASSISTANT)
SHALL, EVERY FOUR YEARS COMPLETE COURSE WORK OR TRAINING REGARDING  PAIN
MANAGEMENT,  APPROPRIATE TO THE PROFESSIONAL'S PRACTICE, APPROVED BY THE
DEPARTMENT IN ACCORDANCE WITH STANDARDS PROMULGATED BY THE DEPARTMENT IN
CONSULTATION WITH THE DEPARTMENT OF  HEALTH;  AND  SO  DOCUMENT  TO  THE
DEPARTMENT.
  2.  THE DEPARTMENT SHALL PROVIDE AN EXEMPTION FROM THE REQUIREMENTS OF
SUBDIVISION ONE OF THIS SECTION TO ANYONE 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 COURSE WORK
OR TRAINING BECAUSE OF THE NATURE OF HIS OR HER PRACTICE, OR
  (B) THAT HE OR SHE HAS COMPLETED COURSE WORK OR TRAINING DEEMED BY THE
DEPARTMENT TO BE EQUIVALENT TO THE STANDARDS FOR COURSE WORK OR TRAINING
APPROVED BY THE DEPARTMENT UNDER THIS SECTION.
  3. EXISTING CURRICULA, INCLUDING CURRICULA DEVELOPED BY A  NATIONALLY-
RECOGNIZED HEALTH CARE PROFESSIONAL, SPECIALTY, OR PROVIDER ASSOCIATION,
OR  NATIONALLY-RECOGNIZED PAIN MANAGEMENT ASSOCIATION, MAY BE CONSIDERED
IN IMPLEMENTING THIS SECTION. CURRICULA SHALL INCLUDE BUT NOT BE LIMITED
TO: ACUPUNCTURE; PALLIATIVE MEDICINE; PAIN; NEUROPSYCHOLOGIC  AND  OTHER
SYMPTOMS;  ETHICS  AND  THE  LAW;  PATIENT  AND  FAMILY  PERSPECTIVES ON
END-OF-LIFE CARE; AND CLINICAL COMMUNICATION SKILLS. THE  DEPARTMENT  OF
HEALTH  SHALL  CONSULT  WITH ORGANIZATIONS REPRESENTATIVE OF HEALTH CARE
PRACTITIONERS; INSTITUTIONS AND THOSE WITH EXPERTISE IN PAIN  MANAGEMENT
WITH RESPECT TO THE STANDARDS PROMULGATED UNDER THIS SECTION.
  S 3. This act shall take effect immediately.

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

                                 2723--A

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                            January 31, 2011
                               ___________

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

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD05533-02-1
              

S. 2723--A                          2

With the continuing aging of New York's general population,  this  trend
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. 2723--A                          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; INDIVIDUAL
REPRESENTATIVES OF ORGANIZATIONS BROADLY REPRESENTATIVE  OF  PHYSICIANS,
FAMILY  PHYSICIANS,  PRIMARY CARE PHYSICIANS, INTERNAL MEDICINE, RHEUMA-
TOLOGY, NURSING, GERONTOLOGY,  HOSPICE,  NEUROLOGY,  PSYCHIATRY,  PEDIA-
TRICS,  SURGERY, CHIROPRACTIC CARE, PODIATRIC CARE, PHARMACISTS OR THOSE
PROFESSIONALS RELATED TO THE PRESCRIPTION OR MANUFACTURE OF PAIN MEDICA-
TIONS, EMERGENCY ROOM HEALTH  CARE  PROFESSIONALS,  MASSAGE  THERAPISTS,
OCCUPATIONAL  AND  PHYSICAL  THERAPY, PATIENT ADVOCATES AND THE HOSPITAL
PHILANTHROPIC COMMUNITY; HEALTH CARE PLAN PAYORS OR INSURERS; THE EXECU-
TIVE 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.
  (E) THE COMMISSIONER SHALL DESIGNATE SUCH EMPLOYEES  AND  PROVIDE  FOR
OTHER  RESOURCES  FROM  THE DEPARTMENT AS MAY BE REASONABLY NECESSARY TO

S. 2723--A                          4

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 TO ENHANCE
THE STUDY  AND  RESEARCH  OF  CHRONIC  PAIN  TREATMENT  AND  MANAGEMENT,
INCREASE THE OPPORTUNITIES FOR UNDERGRADUATE MEDICAL EDUCATION IN CHRON-
IC  PAIN  CARE  TREATMENT AND MANAGEMENT, AND ENCOURAGE THE EDUCATION OF
PHYSICIANS IN CHRONIC PAIN CARE MANAGEMENT AND TREATMENT.

S. 2723--A                          5

  (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 MEDICAL EDUCATION IN CHRONIC PAIN TREATMENT 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 RESIDENCY PROGRAMS TO ESTABLISH OR
EXPAND  EDUCATION  IN CHRONIC PAIN TREATMENT AND MANAGEMENT FOR GRADUATE
MEDICAL EDUCATION, AND TO INCREASE THE OPPORTUNITIES FOR TRAINEE  EDUCA-
TION   IN   THE   TREATMENT  AND  MANAGEMENT  OF  CHRONIC  PAIN  IN  THE
HOSPITAL-BASED AND NON-HOSPITAL-BASED SETTINGS.
  (B) GRANTS UNDER THIS SUBDIVISION FOR GRADUATE MEDICAL  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, MEDICA-
TIONS 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-
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

S. 2723--A                          6

HEALTH  CARE  PROFESSIONS  PURSUANT TO PARAGRAPH D OF SUBDIVISION TWO 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 (F) 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 FOURTEEN, 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
  (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. 2723--A                          7

  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 MEDICAL 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  THOUSAND  DOLLARS  FOR
GRANTS  FOR  GRADUATE  MEDICAL  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.

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

                                 2723--B

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                            January 31, 2011
                               ___________

Introduced  by  Sens. KLEIN, CARLUCCI, HANNON, VALESKY -- read twice and
  ordered printed, and when printed to be committed to the Committee  on
  Health  --  committee  discharged,  bill amended, ordered reprinted as
  amended and recommitted  to  said  committee  --  recommitted  to  the
  Committee  on  Health  in  accordance  with  Senate  Rule 6, sec. 8 --
  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 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

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD05533-05-2
              

S. 2723--B                          2

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
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.

S. 2723--B                          3

  (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-
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;  INDIVIDUAL
REPRESENTATIVES  OF  ORGANIZATIONS BROADLY REPRESENTATIVE OF PHYSICIANS,
FAMILY PHYSICIANS, PRIMARY CARE PHYSICIANS, INTERNAL  MEDICINE,  RHEUMA-
TOLOGY,  NURSING,  GERONTOLOGY,  HOSPICE,  NEUROLOGY, PSYCHIATRY, PEDIA-
TRICS, SURGERY, CHIROPRACTIC CARE, PODIATRIC CARE, PHARMACISTS OR  THOSE
PROFESSIONALS RELATED TO THE PRESCRIPTION OR MANUFACTURE OF PAIN MEDICA-
TIONS,  EMERGENCY  ROOM  HEALTH  CARE PROFESSIONALS, MASSAGE THERAPISTS,
OCCUPATIONAL AND PHYSICAL THERAPY, PATIENT ADVOCATES  AND  THE  HOSPITAL
PHILANTHROPIC COMMUNITY; HEALTH CARE PLAN PAYORS OR INSURERS; THE EXECU-
TIVE  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

S. 2723--B                          4

THE CHAIR. THE  COUNCIL  MAY  ADOPT  REGULATIONS  CONSISTENT  WITH  THIS
SECTION.
  (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  TO  ENHANCE

S. 2723--B                          5

THE  STUDY  AND  RESEARCH  OF  CHRONIC  PAIN  TREATMENT  AND MANAGEMENT,
INCREASE THE OPPORTUNITIES FOR UNDERGRADUATE MEDICAL EDUCATION IN CHRON-
IC PAIN CARE TREATMENT AND MANAGEMENT, 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 MEDICAL EDUCATION IN CHRONIC PAIN TREATMENT 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 RESIDENCY PROGRAMS TO ESTABLISH OR
EXPAND  EDUCATION  IN CHRONIC PAIN TREATMENT AND MANAGEMENT FOR GRADUATE
MEDICAL EDUCATION, AND TO INCREASE THE OPPORTUNITIES FOR TRAINEE  EDUCA-
TION   IN   THE   TREATMENT  AND  MANAGEMENT  OF  CHRONIC  PAIN  IN  THE
HOSPITAL-BASED AND NON-HOSPITAL-BASED SETTINGS.
  (B) GRANTS UNDER THIS SUBDIVISION FOR GRADUATE MEDICAL  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, MEDICA-
TIONS 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

S. 2723--B                          6

RECOMMENDATIONS  TO THE EDUCATION DEPARTMENT FOR THE COURSE WORK, TRAIN-
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  TWO  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 (F) 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 FIFTEEN, 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. 2723--B                          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  MEDICAL 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 THOUSAND DOLLARS FOR
GRANTS FOR GRADUATE MEDICAL 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.