Authorizes pharmacists to perform collaborative drug therapy management

Summary of provisions

The bill would extend and expand the Collaborative Drug Therapy Demonstration Project and expand the scope of the authorization for collaborative drug therapy management (CDTM) as follows:

Section 1. Amends section 6801-a of the education law as follows:

* defines clinical services

* expands CDTM to general hospitals and nursing homes with an on-site pharmacy staffed by a licensed pharmacist; and

Section 2. Directs the State Education Department to prepare a report on the expanded CDTM program within four months of the program's expiration

Section 3. Extends the program for an additional three years.

Section 4. Sets forth the effective date of the act.

Justification

Collaborative Drug Therapy Management (CDTM) will further enhance the quality of healthcare for individuals with chronic medical conditions in three measurable areas: (1) improve clinical outcomes; (2) greater patient satisfaction; and (3) more efficient delivery of care. Assumed in this definition and reinforced in the attached reports are examples of positive financial impacts to the health care system which is a critical element in this whole transformation of care.

This bill creates a new certification that will qualify licensed pharmacists to enter into written voluntary CDTM agreements with physicians. These CDTM protocols will specify the actions that the New York State Education Department (SED) credentialed CDTM pharmacists are to follow when managing patients who are assigned to their care, by the authorizing practitioner, maintaining the established lines of responsibility for patient care. Diagnosis and oversight remain the purview of physicians, while managing the drug therapy would be the responsibility of the CDTM certified collaborating pharmacist. Given the requirements outlined in the bill for pharmacists to achieve the CDTM certification, it is clear that patient safety and high standards

of healthcare are preserved. In fact, most states allow qualified pharmacists to collaborate with primary care providers to provide comprehensive drug therapy management and since passage of the demonstration legislation, pharmacists have been successfully collaborating with physicians across New York State in managing drug therapies for patients with a broad range of disease states.

Introduction of this legislation follows the May 2014 release of a comprehensive report to the legislature that presents detailed, positive results of the CDTM demonstration programs that were initiated in several of the State's teaching hospitals as authorized by the 2011 law. The state-based, site-specific and disease-specific results in the Report to the Legislature corroborate findings in a substantial volume of peer-reviewed studies measuring evidence-based outcomes, performance-based criteria and the economic benefits of pharmacist-provided CDTM. Against every measurement, results were consistently better when pharmacists managed patients' drug therapies in collaboration with the treating practitioner. The report highlights results from patients being treated by pharmacists in anti-coagulation clinics as well as patients with diabetes, asthma, heart failure, cancer and HIV. The exhaustive report prepared by the New York State Board of Pharmacy is consistent with recommendations made in the 2011 Report to the U.S. Surgeon General that pharmacists should be recognized as health care providers. Consistent with the triple aim of improving healthcare quality and patient satisfaction while controlling overall healthcare costs, the evidence is clear and compelling that CDTM practiced by qualified pharmacists represents sound value and solid public policy.

The legislation reduces site-specific restrictions for the practice of CDTM in the current state law that authorized its demonstration. Under this proposal, once a pharmacist becomes CDTM-certified, the pharmacist can collaborate with physicians in a nursing home with an onsite pharmacy and licensed pharmacist and any general hospital. A pharmacist would only be permitted to undertake collaborative drug therapy management practice if SED has determined that the pharmacist has had the requisite clinical experience requirement and completed the proscribed clinical education component that entitles the pharmacist to engage in CDTM. SED and the New York State Board of Pharmacy (NYS BOP) would be responsible for evaluating pharmacist candidates for CDTM and to accept nationally accredited clinical residencies as well as certification programs in various settings. Examples of such settings include ambulatory care, cardiology, nutrition support, oncology, pharmacotherapy, geriatrics, asthma, diabetes, toxicology pediatric, critical care and others that may emerge in this growing area of healthcare.

As the health care system continues to evolve, programs such as the Delivery System Reform Incentive Program (DSRIP) and Value Based Care call out for members cf the pharmacy profession to be more engaged with medical providers. CDTM is a path not for all pharmacists but for a subset of the population who meet the standards established by this legislation and overseen by the NYS BOP can lead to achieve better patient care and outcomes.

Legislative history

New bill.

Fiscal implications

None

Effective date

Immediately