NY State Senate Bill 2015-S7885

Archive: Last Bill Status - In Senate Committee Health Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
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Delivered to Governor
Signed By Governor

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Date of Action	Assembly Actions - Lowercase Senate Actions - UPPERCASE
May 20, 2016	referred to health

2015-S7885 (ACTIVE) - Details

Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Amd §§2135, 2781 & 2781-a, add §2781-b, Pub Health L; amd §§6527, 6909 & 6801, Ed L

2015-S7885 (ACTIVE) - Summary

Relates to HIV prevention, education and authorized prescriptions.

2015-S7885 (ACTIVE) - Sponsor Memo

                                 BILL NUMBER:  S7885

 TITLE OF BILL :

An act to amend the public health law and the education law, in
relation to HIV prevention and care

 SUMMARY OF PROVISIONS :

Section 1 of the bill would amend PHL § 2135 to expand
patient-specific data sharing to include information as to the degree
to which persons with HIV are in care or out of care. It would also
allow such information to be shared between local and state health
departments, health care providers, care coordinators, and other
health and health information entities.

Section 2 of the bill would add a new PHL § 2781-b to authorize health
care providers to test, diagnose, refer, treat, and prescribe for HIV
infection, HIV related illness, and AIDS, including preventive
treatment, to an individual under eighteen years of age who has
capacity to consent and who has been, may have been, or is at risk of
being exposed to HIV. Testing under this section may be provided
without the consent or knowledge of the minor's parent or guardian,
and any information shall not be disclosed except as allowed by law.

Section 3 of the bill would amend PHL § 2781 to remove provisions

related to informed consent of the subject of an HIV related test and
to require, at a minimum, that the protected individual be advised
that an HIV related test is being performed. It would also authorize a
health care practitioner to perform an HIV test after the subject of
the test is notified that HIV testing will be performed unless the
individual declines or a person authorized pursuant to consent to
health care for such individual declines.

Section 4 of the bill would amend PHL § 2781-a(1) to provide that any
individual over the age of thirteen shall be offered an HIV related
test. Current law limits the mandatory offering to individuals between
the ages of thirteen and sixty-four years.

Section 5 of the bill would add a new Educ. L. § 6527(g) to authorize
physicians to issue a non-specific order for registered nurses to
screen persons at increased risk for syphilis, gonorrhea and
Chlamydia.

Section 6 of the bill would add a new Educ. L. § 6909(4)(g) to
authorize registered nurses to screen persons at increased risk for
syphilis, gonorrhea and Chlamydia pursuant to a non-patient specific
order.

Section 7 of the bill would add a new Educ. L. § 6527(7-a) to
authorize physicians to prescribe and order a patient specific or
non-patient specific order to a pharmacist for dispensing medications
for the purpose of preventing HIV.

Section 8 of the bill would add a new Educ. L. § 6909(8) to authorize
a nurse practitioner to prescribe and order a patient specific or
non-patient specific order to a pharmacist for dispensing medications
for the purpose of preventing HIV.

Section 9 of the bill would add a new Educ. L. § 6801(5) to authorize
a licensed pharmacist to dispense medications for the purpose of
preventing HIV pursuant to a non-patient specific order.

Section 10 would set forth an immediate effective date, provided that
the amendments to Educ. L. § 6801(5) shall not affect the expiration
of such section.
 STATEMENT IN SUPPORT :

Expansion of eligibility for data sharing:

HIV related data is routinely collected across New York State and
reported through a variety of systems. New York State continues to use
data effectively to inform and build on our capacity to understand the
HIV epidemic in the state, improve patient outcomes, and prevent new
infections. In 2014, a change in State law allowed for the sharing of
surveillance data with medical providers to improve linkage and
retention of HIV-infected persons in care. This change was made
because there are thousands of HIV-infected New Yorkers who are not in
continuous care and who are not virally suppressed. Viral suppression
is the ultimate goal for persons with HIV, as it improves health and
virtually eliminates the possibility of further transmission of HIV.

This bill would extend existing law to those organizations charged
with identifying people who are out of care and linking them to care,
such as care management/care coordination providers, health homes, and
health information entities. Many individuals fall out of care due to
having complex needs in addition to social barriers related to
housing, employment, substance use and mental health issues. These
individuals are more likely to be identified by these community based
providers.

Access to HIV testing, prevention and treatment for minors:

Under current State law, minors can consent to testing for STDs and
HIV and to treatment for STDs without parental or guardian consent.
However, treatment for HIV is not included, a gap in care that would
be addressed by this bill. Young people at highest risk often have
other complications that can delay access to care, such as sexual
orientation or gender identity issues, homelessness, substance abuse,
or a lack of support systems. Delaying treatment for HIV leads to
disease progression as well as increased transmission of the virus to
others. In addition, young people at high risk who are negative should
be able to consent to pre-exposure prophylaxis (PrEP) so they can stay
negative.

Streamlined/routine testing of HIV/AIDS:

Almost half of all new infections may be from persons who are unaware
of their HIV status. Testing must be increased in health care venues
in order to identify persons with HIV and treat them early in their
infection. To further bring HIV testing guidelines in line with
federal guidelines, streamlining HIV testing, making it a routine part
of health care, unless a patient explicitly refuses the HIV test is
necessary. This bill would eliminate remaining barriers to routine
testing, and thousands of New Yorkers living with HIV who are not
aware of their HIV status will be identified.

Expanding the age beyond 64

HIV testing must be made available to more New Yorkers. This bill
would extend the upper age for the offer of an HIV test beyond the age
of 64, mandating the offer to all adults regardless of age. Older
adults beyond the age of 64 are at risk of HIV and other STD
infection, and half of all people living with diagnosed HIV infection
in this State are age 50 and older. Additionally, approximately 200
cases of HIV are diagnosed each year in persons age 60 and older in
New York State. With the advent of new medications, persons diagnosed
with HIV are able to live average life spans. However, early diagnosis
and access to treatment are essential.

Authorize registered nurses to screen for certain STDs pursuant to
non-patient specific order:
Each year there are more than 100,000 diagnosed cases of syphilis,
gonorrhea, and Chlamydia in New York State. STD screening and sexual
health care must become more routine in order to address increasing
STD infections and protect the health of New Yorkers. In order to
expand STD screening and the identification and treatment of infected
persons, and in order to reduce the burden on strained STD clinics and
other health care settings, this bill would allow registered nurses to
screen persons at increased risk for syphilis, gonorrhea and chlamydia
pursuant to a non-patient specific order. This is consistent with the
Ending the Epidemic Blueprint recommendations recognizing that STDs
put people at greater risk of HIV infection, and with U.S. Preventive
Services (USPS) recommendations.

Pharmacy access to medications for HIV infection prevention:

PEP (Post-Exposure Prophylaxis) is an HIV prevention method that only
works if used within a short period of time after possible exposure to
the virus (72 hours after exposure but treatment is recommended within
36 hours). Most New Yorkers currently need to go to an emergency room
to access PEP. This bill would now allow pharmacists to dispense PEP
without a patient specific order. This is a cost effective method that
can have a significant impact on HIV prevention and improve referral
and or coordination with doctors and other health professionals for
follow-up to PEP.

 BUDGET IMPLICATIONS :

None.

 EFFECTIVE DATE :
Immediate.

2015-S7885 (ACTIVE) - Bill Text download pdf

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

                                  7885

                            I N  S E N A T E

                              May 20, 2016
                               ___________

Introduced  by Sen. HANNON -- (at request of the Governor) -- 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 HIV prevention and care

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

  Section  1.  Section  2135  of  the  public  health law, as amended by
section 3 of part A of chapter 60 of the laws of  2014,  is  amended  to
read as follows:
  S  2135.  Confidentiality.  All  reports or information secured by the
department, municipal health commissioner  or  district  health  officer
under  the provisions of this title shall be confidential except: (a) in
so far as is necessary to carry out the provisions of  this  title;  (b)
when  used in the aggregate, without patient specific identifying infor-
mation, in programs approved by the commissioner for the improvement  of
the  quality of medical care provided to persons with HIV/AIDS; (c) when
used within the state  or  local  health  department  by  public  health
disease programs to assess co-morbidity or completeness of reporting and
to  direct  program  needs,  in  which case patient specific identifying
information shall not be disclosed outside the  state  or  local  health
department;  or  (d)  when  used  for  purposes  of  patient linkage and
retention in care, patient specific  identified  information,  INCLUDING
INFORMATION  AS  TO  THE DEGREE TO WHICH PERSONS WITH HIV ARE IN CARE OR
OUT OF CARE, may be shared between local and  state  health  departments
[and],  health  care  providers  [currently  treating the patient], CARE
COORDINATORS AND OTHER HEALTH AND HEALTH INFORMATION ENTITIES as DEFINED
AND approved by the commissioner.
  S 2. The public health law is amended by adding a new  section  2781-b
to read as follows:
  S  2781-B.  ACCESS  TO  HIV/AIDS TESTING, PREVENTION AND TREATMENT FOR
MINORS. A HEALTH CARE PROVIDER LICENSED, CERTIFIED OR OTHERWISE  AUTHOR-
IZED  TO  PRACTICE UNDER TITLE EIGHT OF THE EDUCATION LAW, ACTING WITHIN
HIS OR HER LAWFUL SCOPE OF PRACTICE, MAY, CONSISTENT WITH THIS  ARTICLE,

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

                                                           LBD12044-01-6

S. 7885                             2

TEST,  DIAGNOSE,  REFER,  TREAT  AND  PRESCRIBE  FOR  HIV INFECTION, HIV
RELATED ILLNESS, AND AIDS, INCLUDING PREVENTIVE TREATMENT, TO  AN  INDI-
VIDUAL  UNDER  EIGHTEEN YEARS OF AGE WHO HAS CAPACITY TO CONSENT AND WHO
HAS  BEEN,  MAY HAVE BEEN, OR IS AT RISK OF BEING EXPOSED TO HIV.  TEST-
ING, DIAGNOSIS, REFERRAL, TREATMENT AND PRESCRIBING UNDER  THIS  SECTION
MAY BE PROVIDED WITHOUT THE CONSENT OR KNOWLEDGE OF THE PARENT OR GUARD-
IAN  OF  THE INDIVIDUAL. HEALTH RECORDS AND OTHER INFORMATION CONCERNING
SUCH TESTING, DIAGNOSIS, REFERRAL, TREATMENT  OR  PRESCRIBING  SHALL  BE
CONFIDENTIAL  HIV  RELATED INFORMATION AND SHALL NOT BE DISCLOSED EXCEPT
AS PROVIDED IN THIS ARTICLE. A PERSON UNDER THE AGE  OF  EIGHTEEN  YEARS
MAY  ALSO  CONSENT TO BE ENROLLED IN A HEALTH HOME OR OTHER FORM OF CARE
COORDINATION.
  S 3. Subdivisions 1 and 2 of section 2781 of the public health law, as
amended by section 2 of part A of chapter 60 of the laws  of  2014,  are
amended to read as follows:
  1. Except as provided in section three thousand one hundred twenty-one
of  the  civil  practice law and rules, or unless otherwise specifically
authorized or required by a state or federal law, no person shall  order
the  performance  of  an HIV related test without [first having received
informed consent of the subject of the test who has capacity to  consent
or,  when  the subject lacks capacity to consent, of a person authorized
pursuant to law to consent to health care for such individual. In  order
for  there  to  be informed consent, the person ordering the test shall,
prior to obtaining informed consent], at a  minimum  [advise],  ADVISING
the protected individual that an HIV-related test is being performed.
  2.  [Informed consent for HIV related testing pursuant to this section
shall be valid for such testing until such consent is revoked. Each time
that an HIV related test is ordered  pursuant  to  informed  consent  in
accordance  with  this section, the physician or other person authorized
pursuant to law to order the performance of the  HIV  related  test,  or
such  person's  representative,  shall  orally notify the subject of the
test or, when the subject lacks capacity to consent, a person authorized
pursuant to law to consent to health care for such individual,  that  an
HIV  related  test  will  be  conducted at such time, and shall note the
notification in the patient's record.] A PERSON AUTHORIZED  PURSUANT  TO
LAW  TO  PERFORM HIV TESTING MAY PERFORM A TEST AFTER THE SUBJECT OF THE
TEST IS NOTIFIED THAT HIV TESTING WILL BE PERFORMED UNLESS THE  INDIVID-
UAL  DECLINES  OR A PERSON AUTHORIZED TO CONSENT TO HEALTH CARE FOR SUCH
INDIVIDUAL DECLINES.
  S 4. Subdivision 1 of section 2781-a of  the  public  health  law,  as
added by chapter 308 of the laws of 2010, is amended to read as follows:
  1. Every individual [between the ages of] AGE thirteen [and sixty-four
years]  AND  OLDER  (or  younger  [or  older]  THAN THIRTEEN if there is
evidence or indication of risk activity) who receives health services as
an inpatient or in  the  emergency  department  of  a  general  hospital
defined  in  subdivision ten of section twenty-eight hundred one of this
chapter or who receives primary care services in an  outpatient  depart-
ment  of  such hospital or in a diagnostic and treatment center licensed
under article twenty-eight of this chapter or from a  physician,  physi-
cian  assistant,  nurse  practitioner, or midwife providing primary care
shall be offered an HIV related test unless the health care practitioner
providing such services reasonably believes that (a) the  individual  is
being  treated  for  a life threatening emergency; or (b) the individual
has previously been offered or has been the subject of  an  HIV  related
test  (except  that  a test shall be offered if otherwise indicated); or
(c) the individual lacks capacity to consent to an HIV related test.

S. 7885                             3

  S 5. Subdivision 6 of section 6527 of the education law is amended  by
adding a new paragraph (g) to read as follows:
  (G)  SCREENING OF PERSONS AT INCREASED RISK OF SYPHILIS, GONORRHEA AND
CHLAMYDIA.
  S 6. Subdivision 4 of section 6909 of the education law is amended  by
adding a new paragraph (g) to read as follows:
  (G) SCREENING OF PERSONS AT INCREASED RISK FOR SYPHILIS, GONORRHEA AND
CHLAMYDIA.
  S  7.  Section  6527  of  the education law is amended by adding a new
subdivision 7-a to read as follows:
  7-A. A LICENSED PHYSICIAN MAY PRESCRIBE AND ORDER A  PATIENT  SPECIFIC
ORDER  OR  NON-PATIENT SPECIFIC ORDER TO A LICENSED PHARMACIST, PURSUANT
TO REGULATIONS PROMULGATED BY THE COMMISSIONER IN CONSULTATION WITH  THE
COMMISSIONER  OF  HEALTH, AND CONSISTENT WITH THE PUBLIC HEALTH LAW, FOR
DISPENSING MEDICATIONS FOR THE PURPOSE OF PREVENTING HUMAN IMMUNODEFICI-
ENCY VIRUS INFECTION.
  S 8. Section 6909 of the education law is  amended  by  adding  a  new
subdivision 8 to read as follows:
  8.  A  CERTIFIED  NURSE PRACTITIONER MAY PRESCRIBE AND ORDER A PATIENT
SPECIFIC ORDER OR NON-PATIENT SPECIFIC ORDER TO A  LICENSED  PHARMACIST,
PURSUANT  TO REGULATIONS PROMULGATED BY THE COMMISSIONER IN CONSULTATION
WITH THE COMMISSIONER OF HEALTH, AND CONSISTENT WITH THE  PUBLIC  HEALTH
LAW,  FOR  DISPENSING  MEDICATIONS  FOR  THE PURPOSE OF PREVENTING HUMAN
IMMUNODEFICIENCY VIRUS INFECTION.
  S 9. Section 6801 of the education law is  amended  by  adding  a  new
subdivision 5 to read as follows:
  5. A LICENSED PHARMACIST MAY EXECUTE A NON-PATIENT SPECIFIC ORDER, FOR
DISPENSING MEDICATIONS FOR THE PURPOSE OF PREVENTING HUMAN IMMUNODEFICI-
ENCY  VIRUS  INFECTION,  BY  A PHYSICIAN LICENSED IN THIS STATE OR NURSE
PRACTITIONER CERTIFIED IN THIS STATE, PURSUANT TO RULES AND  REGULATIONS
PROMULGATED BY THE COMMISSIONER IN CONSULTATION WITH THE COMMISSIONER OF
HEALTH.
  S  10. This act shall take effect immediately; provided, however, that
the amendments to section 6801 of the education law made by section nine
of this act shall not affect the expiration of such section and shall be
deemed to expire therewith.

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Senate Bill S7885

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Archive: Last Bill Status - In Senate Committee Health Committee

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2015-S7885 (ACTIVE) - Details

2015-S7885 (ACTIVE) - Summary

2015-S7885 (ACTIVE) - Sponsor Memo

2015-S7885 (ACTIVE) - Bill Text download pdf

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Sponsored By

Kemp Hannon

Archive: Last Bill Status - In Senate Committee Health Committee

Actions

2015-S7885 (ACTIVE) - Details

2015-S7885 (ACTIVE) - Summary

2015-S7885 (ACTIVE) - Sponsor Memo

2015-S7885 (ACTIVE) - Bill Text download pdf

Comments