NY State Senate Bill 2023-S3222

Current Bill Status - In Senate Committee Health Committee

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

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 03, 2024	referred to health
Jan 30, 2023	referred to health

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2023-S3222 (ACTIVE) - Details

See Assembly Version of this Bill:: A7853
Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Add Art 28-CC §2894, Pub Health L; add §95-l, St Fin L
Versions Introduced in Other Legislative Sessions:: 2019-2020: S7771, A10054
2021-2022: S4883, A194

2023-S3222 (ACTIVE) - Summary

Establishes an emergency insulin program and corresponding emergency insulin program trust fund to facilitate emergency access to analog insulins.

2023-S3222 (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S3222

SPONSOR: RIVERA
 
TITLE OF BILL:

An act to amend the public health law and the state finance law, in
relation to an emergency insulin program

 
PURPOSE:

The purpose of this bill is to establish an emergency insulin program

 
SUMMARY OF SPECIFIC PROVISIONS:

Section 1 amends the public law by adding a new article 28-CC as it
relates to establishing an emergency insulin program. This section
allows the commissioner to establish an emergency insulin program to
ensure that recipients of the program can access emergency supplies of
analog insulin and other related supplies. The commission shall estab-
lish standards of the program that include analog insulin prescribing,
dispensing, distribution, and possession. Analog insulins, health care
professionals, pharmacist, and recipient are all defined in this section

for the purposes of this article. The use or dispensing of analog insu-
lin, in accordance with this section, shall be considered first aid or
emergency treatment for the purpose of any statute relating to liabil-
ity.

Section 2 amends the finance law by adding a new section 95-1 as it
relates to the emergency insulin program trust fund. The emergency insu-
lin fund will be established in the joint custody of the state comp-
troller and the commissioner of taxation and finance to support the
emergency insulin program and fund emergency access to analog insulin.

Section 3 gives the effective date.

 
JUSTIFICATION:

In December 2022, Governor Kathy Hochul declared a diabetes health emer-
gency in New York State to tackle an epidemic that affects over 2
million state residents. When not managed properly, diabetes can have
serious and debilitating health effects, including heart disease, kidney
failure, blindness, and lower limb amputation. Severe complications of
diabetes include Diabetic Ketoacidosis, also referred to as DKA, and
even death. In recent years, New York has seen a significant increase in
leg and foot amputation and eye disease. In New York City alone, there
was a 356% increase in diabetes-related deaths during the early months
of the COVID-19 pandemic.

Diabetes management is important in preventing further complications.
Type 1 and some Type 2 diabetics depend upon insulin for their very
survival. The recent increase in the cost of insulin made it difficult
for some diabetics to obtain their necessary medication.  When patients
can't afford insulin, which can cost thousands of dollars even for those
who are insured, they have resorted to rationing the little medication
they can afford. In fact, one study found that one in four people with
type 1 diabetes admitted to not taking their insulin as prescribed, or
rationing, due to the cost.


This legislation creates an Emergency Insulin Program, modeled after New
York State's Opioid Overdose Prevention Program which has expanded
access to life-saving Naloxone to reverse an opioid overdose widely
available in our state. Under the Emergency Insulin Program, individuals
who are uninsured or underinsured would be able to get analog insulin
through a non-patient specific prescription at certain pharmacies,
including clinic and hospital pharmacies. The Department of Health would
be able to establish a sliding scale for certain cost sharing, which
would be capped at $100 per month for a thirty day supply of insulins
and supplies.

The bill directs the Department of Health to immediately engage analog
insulin manufacturers to support the state program and facilitate quick
access to affordable analog insulin in emergency situations through a
public private partnership to streamline existing patient support
programs such manufactures have. The three manufacturers of analog insu-
lin each have programs designed to help people access their products at
a reduced rate or for free, however each program is different and advo-
cates argue that they are difficult to access, especially in emergency
situations. Recognizing that manufacturers want to make sure everyone
can access the life-saving medications they offer to patents, this bill
establishes an Emergency Insulin Program Trust fund to accept funds for
the statewide program. Like New York's highly successful Opioid Overdose
Prevention Program, this program would allow for non-patient specific
prescriptions for analog insulins and utilize chain pharmacies and 340B
pharmacies, which are able to provide the lowest cost medications, to
distribute the insulins and supplies to recipients who qualify.

While it is true there are some types of human insulin that can be
accessed over the counter and for a relatively low fee, these are often
referred to as "dead in bed" insulin because they do not provide the
level of support many type 1 and some type 2 diabetics require. These
low cost human insulins are less commonly prescribed by doctors precise-
ly because of their unpredictable rate of absorption, which can result
in more frequent low and high blood sugars. They require more monitoring
and more supplies and, according to advocates, when people transition
from the newer and more costly analog insulins the risk of "dead in bed"
syndrome is greatly increased.

In recent years, the Opioid Overdose Prevention Program has been
expanded to provide access to life-saving medication in pharmacies, not
just through community-based organizations. Like overdose, the risk of
death from a lack of insulin occurs far too often and quickly. New York
State must do all it can to make sure that diabetics who depend on insu-
lin for their survival can access emergency supplies of analog insulin,
just as we currently ensure that friends, families, and first responders
are equipped with life-saving naloxone in case of an overdose. There is
no question that a person who depends on daily insulin for their
survival is at grave risk without timely access to affordable insulin.
Nobody should die from rationing or running out of insulin, or from
being forced to switch to less reliable human insulin. The Emergency
Insulin Program can make sure New York, with the cooperation of manufac-
turers of analog insulins, is doing all it can to ensure those in need
can access this life-saving medication.

 
LEGISLATIVE HISTORY:

2019-2020: S7771/A10054 Gottfried
2021-2022: S4883/A194 Gottfried

 
FISCAL IMPLICATIONS:

To be determined, but potential savings as expensive hospitalizations as
a result of severe adverse reactions from patients rationing or running
out of insulin are avoided.

 
EFFECTIVE DATE:
This act shall take effect immediately

2023-S3222 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   3222
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             January 30, 2023
                                ___________
 
 Introduced by Sens. RIVERA, GOUNARDES, KRUEGER, MYRIE, PERSAUD, SEPULVE-
   DA -- 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 state finance law, in
   relation to an emergency insulin program

   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-CC to read as follows:
                               ARTICLE 28-CC
                         EMERGENCY INSULIN PROGRAM
 SECTION 2894. EMERGENCY INSULIN PROGRAM.
   § 2894. EMERGENCY INSULIN PROGRAM. 1. THE COMMISSIONER  IS  AUTHORIZED
 AND  DIRECTED  TO  ESTABLISH AN EMERGENCY INSULIN PROGRAM TO ENSURE THAT
 RECIPIENTS OF THE PROGRAM CAN ACCESS EMERGENCY SUPPLIES OF ANALOG  INSU-
 LINS  AND  RELATED SUPPLIES.   THE COMMISSIONER SHALL IMMEDIATELY ENGAGE
 ANALOG INSULIN MANUFACTURERS TO SUPPORT THE STATE PROGRAM AND FACILITATE
 QUICK ACCESS TO AFFORDABLE ANALOG INSULINS IN EMERGENCY SITUATIONS.  THE
 COMMISSIONER  SHALL  ESTABLISH  STANDARDS  FOR APPROVAL OF ANY EMERGENCY
 INSULIN PROGRAM, AND ANALOG INSULIN  PRESCRIBING,  DISPENSING,  DISTRIB-
 UTION,  AND  POSSESSION  PURSUANT TO THIS SECTION WHICH MAY INCLUDE, BUT
 NOT BE LIMITED TO, STANDARDS FOR PROGRAM DIRECTORS, APPROPRIATE CLINICAL
 OVERSIGHT, TRAINING, RECORD KEEPING AND REPORTING. THE EMERGENCY INSULIN
 PROGRAM SHALL, PURSUANT TO AN APPROPRIATION OR SUFFICIENT FUNDS  IN  THE
 EMERGENCY  INSULIN  PROGRAM  TRUST  FUND,  BE AVAILABLE TO RECIPIENTS NO
 LATER THAN APRIL FIRST, TWO THOUSAND TWENTY-FOUR.
   2. (A) AS USED IN THIS SECTION:
   (I) "ANALOG INSULINS" MEANS AT A MINIMUM  SHORT-ACTING,  RAPID-ACTING,
 INTERMEDIATE AND LONG ACTING INSULIN DRUGS APPROVED BY THE FOOD AND DRUG
 ADMINISTRATION  THAT, WHEN ADMINISTERED, TO CERTAIN RECIPIENTS ARE LIFE-
 SAVING, AND HELP AVOID SERIOUS ADVERSE EFFECTS ASSOCIATED WITH TYPE  ONE
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD05256-01-3

 S. 3222                             2
 
 DIABETES  AND IN SOME LIMITED CASES TYPE TWO DIABETES, AND OTHER MEDICA-
 TIONS AND SUPPLIES APPROVED BY THE DEPARTMENT FOR SUCH PURPOSE.
   (II) "HEALTH CARE PROFESSIONAL" MEANS A PERSON LICENSED, REGISTERED OR
 AUTHORIZED  PURSUANT  TO  TITLE  EIGHT OF THE EDUCATION LAW TO PRESCRIBE
 PRESCRIPTION DRUGS.
   (III) "PHARMACIST" MEANS A PERSON LICENSED OR AUTHORIZED  TO  PRACTICE
 PHARMACY  PURSUANT  TO ARTICLE ONE HUNDRED THIRTY-SEVEN OF THE EDUCATION
 LAW.
   (IV) "RECIPIENT" MEANS A PERSON: (1) DIAGNOSED WITH TYPE ONE DIABETES,
 OR TYPE TWO INSULIN DEPENDENT DIABETES; AND (2) WHO IS AT RISK OF  EXPE-
 RIENCING  SERIOUS  ADVERSE  HEALTH EFFECTS DUE TO A LACK OF ANALOG INSU-
 LINS; AND (3) WHO IS UNINSURED OR UNDERINSURED; OR (4)  AN  ORGANIZATION
 REGISTERED AS AN EMERGENCY INSULIN PROGRAM PURSUANT TO THIS SECTION.
   (B)(I)  A HEALTH CARE PROFESSIONAL MAY PRESCRIBE BY A PATIENT-SPECIFIC
 OR NON-PATIENT-SPECIFIC PRESCRIPTION, DISPENSE OR  DISTRIBUTE,  DIRECTLY
 OR INDIRECTLY, ANALOG INSULINS TO A RECIPIENT.
   (II) A PHARMACIST MAY DISPENSE ANALOG INSULINS, THROUGH A PATIENT-SPE-
 CIFIC  OR  NON-PATIENT-SPECIFIC PRESCRIPTION PURSUANT TO THIS PARAGRAPH,
 TO A RECIPIENT.
   (III) THE PROVISIONS OF THIS PARAGRAPH SHALL NOT BE DEEMED TO  REQUIRE
 A  PRESCRIPTION  FOR ANY ANALOG INSULINS THAT DO NOT OTHERWISE REQUIRE A
 PRESCRIPTION; NOR SHALL IT BE DEEMED TO LIMIT THE AUTHORITY OF A  HEALTH
 CARE  PROFESSIONAL TO PRESCRIBE, DISPENSE OR DISTRIBUTE, OR OF A PHARMA-
 CIST TO DISPENSE, ANALOG INSULINS UNDER ANY OTHER PROVISION OF LAW.
   (IV) ANY PHARMACY WITH TWENTY OR MORE LOCATIONS IN THE STATE, AND  ANY
 FACILITY  ESTABLISHED  PURSUANT  TO ARTICLE TWENTY-EIGHT OF THIS CHAPTER
 WHICH HAS A DRUG DISCOUNT PROGRAM AUTHORIZED  BY  SECTION  340B  OF  THE
 FEDERAL  PUBLIC HEALTH SERVICE ACT 42 U.S.C § 256B SHALL PURSUE OR MAIN-
 TAIN A NON-PATIENT-SPECIFIC PRESCRIPTION WITH AN AUTHORIZED HEALTH  CARE
 PROFESSIONAL TO DISPENSE ANALOG INSULINS TO A RECIPIENT UPON REQUEST, AS
 AUTHORIZED BY THIS SECTION; AND REGISTER WITH THE DEPARTMENT AS AN EMER-
 GENCY  INSULIN PROGRAM NO LATER THAN JANUARY FIRST, TWO THOUSAND TWENTY-
 FOUR.
   3. USE OR DISPENSING OF ANALOG INSULINS PURSUANT TO THIS SECTION SHALL
 BE CONSIDERED FIRST AID OR EMERGENCY TREATMENT FOR THE  PURPOSE  OF  ANY
 STATUTE RELATING TO LIABILITY.
   4.  THE COMMISSIONER SHALL IMMEDIATELY BEGIN TO WORK WITH ANALOG INSU-
 LIN MANUFACTURERS IN CREATING SUCH PROGRAM TO ENSURE  THEY  ARE  WORKING
 WITH  THE  STATE  IN A PUBLIC-PRIVATE PARTNERSHIP TO SUPPORT THE STATE'S
 STREAMLINED EMERGENCY INSULIN PROGRAM THAT MAY REPLICATE PATIENT SUPPORT
 PROGRAMS SUCH MANUFACTURERS HAVE.  A MANUFACTURER MAY CONTRIBUTE TO  THE
 PROGRAM  THROUGH  THE  EMERGENCY  INSULIN PROGRAM TRUST FUND ESTABLISHED
 PURSUANT TO SECTION NINETY-FIVE-1 OF THE STATE FINANCE LAW.
   5. THE COMMISSIONER MAY ESTABLISH A SLIDING SCALE FOR COST SHARING FOR
 CERTAIN RECIPIENTS WHICH SHALL NOT EXCEED  ONE  HUNDRED  DOLLARS  FOR  A
 THIRTY-DAY SUPPLY OF ANALOG INSULINS AND RELATED SUPPLIES.
   6.  THE  COMMISSIONER  SHALL PUBLISH FINDINGS ON THE EMERGENCY INSULIN
 PROGRAM INCLUDING BUT NOT LIMITED TO THE NUMBER OF PROGRAMS ESTABLISHED,
 THE NUMBER OF RECIPIENTS SERVED, THE TYPES AND AMOUNTS OF  ANALOG  INSU-
 LINS  PROVIDED,  THE  COSTS AND SAVINGS ASSOCIATED WITH THE PROGRAM, AND
 WHAT PUBLIC-PRIVATE PARTNERSHIPS THE STATE HAS  FACILITATED  TO  SUPPORT
 THIS  PROGRAM  TO THE GOVERNOR AND THE CHAIRS OF THE SENATE AND ASSEMBLY
 HEALTH COMMITTEES WITHIN ONE YEAR OF THE EFFECTIVE DATE OF THIS  ARTICLE
 AND EVERY TWO YEARS THEREAFTER.
   §  2. The state finance law is amended by adding a new section 95-1 to
 read as follows:
 S. 3222                             3
 
   § 95-1. EMERGENCY INSULIN PROGRAM  TRUST  FUND.  1.  THERE  IS  HEREBY
 ESTABLISHED  IN  THE  JOINT  CUSTODY  OF  THE  STATE COMPTROLLER AND THE
 COMMISSIONER OF TAXATION AND FINANCE A SPECIAL FUND TO BE KNOWN  AS  THE
 "EMERGENCY INSULIN PROGRAM TRUST FUND".
   2.  SUCH FUND SHALL CONSIST OF ALL MONIES APPROPRIATED FOR ITS PURPOSE
 AND ALL MONIES RECEIVED, OR TO BE PAID INTO OR CREDITED TO SUCH FUND  BY
 ANALOG  INSULIN  MANUFACTURERS  PURSUANT  TO SUBDIVISION FOUR OF SECTION
 TWENTY-EIGHT HUNDRED NINETY-FOUR OF THE  PUBLIC  HEALTH  LAW.    NOTHING
 CONTAINED  HEREIN  SHALL  PREVENT  THE STATE FROM RECEIVING ASSESSMENTS,
 GRANTS, GIFTS OR BEQUESTS FOR THE PURPOSES OF THE  FUND  AS  DEFINED  IN
 THIS SECTION AND DEPOSITING THEM INTO THE FUND ACCORDING TO LAW.
   3.  MONIES OF THE FUND SHALL BE EXPENDED ONLY TO SUPPORT THE EMERGENCY
 INSULIN PROGRAM ESTABLISHED PURSUANT TO ARTICLE TWENTY-EIGHT-CC  OF  THE
 PUBLIC  HEALTH  LAW  ADMINISTERED  BY THE COMMISSIONER OF HEALTH AND FOR
 FUNDING EMERGENCY ACCESS TO ANALOG INSULINS.
   4. MONIES SHALL BE PAYABLE FROM THE FUND ON THE AUDIT AND  WARRANT  OF
 THE  COMPTROLLER  ON VOUCHERS APPROVED AND CERTIFIED BY THE COMMISSIONER
 OF HEALTH.
   § 3. This act shall take effect immediately.

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Senate Bill S3222

Sponsored By

Current Bill Status - In Senate Committee Health Committee

co-Sponsors

2023-S3222 (ACTIVE) - Details

2023-S3222 (ACTIVE) - Summary

2023-S3222 (ACTIVE) - Sponsor Memo

2023-S3222 (ACTIVE) - Bill Text download pdf

Comments

Senate Bill S3222

Share this bill

Sponsored By

Gustavo Rivera

Current Bill Status - In Senate Committee Health Committee

co-Sponsors

Andrew Gounardes

Liz Krueger

Zellnor Myrie

Roxanne J. Persaud

2023-S3222 (ACTIVE) - Details

2023-S3222 (ACTIVE) - Summary

2023-S3222 (ACTIVE) - Sponsor Memo

2023-S3222 (ACTIVE) - Bill Text download pdf

Comments