Bill S2361A-2013

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

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

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  • Feb 6, 2014: PRINT NUMBER 2361A
  • Feb 6, 2014: AMEND AND RECOMMIT TO HEALTH
  • Jan 8, 2014: REFERRED TO HEALTH
  • Jan 16, 2013: REFERRED TO HEALTH

Memo

BILL NUMBER:S2361A

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

PURPOSE:

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

SUMMARY OF PROVISIONS:

Section 1: Legislative intent.

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

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

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

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

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

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

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

JUSTIFICATION:

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

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

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

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

LEGISLATIVE HISTORY:

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

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

2012 - S. 2723-C - Referred to Health

2014 - This bill was amended in 2014 to alter sponsors in the Assembly and Senate.

FISCAL IMPLICATIONS:

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

EFFECTIVE DATE:

Immediately.


Text

STATE OF NEW YORK ________________________________________________________________________ 2361--A 2013-2014 Regular Sessions IN SENATE January 16, 2013 ___________
Introduced by Sens. KLEIN, CARLUCCI, HANNON, MAZIARZ -- read twice and ordered printed, and when printed to be committed to the Committee on Health -- 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 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. (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; ONE ACUPUNCTU- RIST LICENSED PURSUANT TO SECTION EIGHTY-TWO HUNDRED FOURTEEN OF THE EDUCATION LAW; INDIVIDUAL REPRESENTATIVES OF ORGANIZATIONS BROADLY REPRESENTATIVE OF PHYSICIANS, FAMILY PHYSICIANS, PRIMARY CARE PHYSI- CIANS, INTERNAL MEDICINE, RHEUMATOLOGY, NURSING, GERONTOLOGY, HOSPICE, NEUROLOGY, PSYCHIATRY, PEDIATRICS, SURGERY, ACUPUNCTURE, CHIROPRACTIC CARE, PODIATRIC CARE, PHARMACISTS OR THOSE PROFESSIONALS RELATED TO THE PRESCRIPTION OR MANUFACTURE OF PAIN MEDICATIONS, EMERGENCY ROOM HEALTH CARE PROFESSIONALS, MASSAGE THERAPISTS, OCCUPATIONAL AND PHYSICAL THERA- PY, PATIENT ADVOCATES AND THE HOSPITAL PHILANTHROPIC COMMUNITY; HEALTH CARE PLAN PAYORS OR INSURERS; THE EXECUTIVE DIRECTOR OR A MEMBER OF THE NEW YORK STATE COUNCIL ON GRADUATE MEDICAL EDUCATION; AND A MEMBER OF THE NEW YORK STATE PALLIATIVE CARE EDUCATION AND TRAINING COUNCIL. (C) THE MEMBERS OF THE COUNCIL SHALL HAVE EXPERTISE IN THE TREATMENT AND MANAGEMENT OF CHRONIC PAIN AND THE CARE OF PATIENTS THAT ARE AFFLICTED WITH CHRONIC PAIN CONDITIONS. THE TERM OF SUCH MEMBERS SHALL BE FOUR YEARS AND SUCH TERMS MAY BE RENEWED. MEMBERS SHALL RECEIVE NO COMPENSATION FOR THEIR SERVICES, BUT SHALL BE ALLOWED ACTUAL AND NECES- SARY EXPENSES IN THE PERFORMANCE OF THEIR DUTIES. (D) A CHAIR AND VICE-CHAIR OF THE COUNCIL SHALL BE ELECTED ANNUALLY BY THE COUNCIL. THE COUNCIL SHALL MEET UPON THE CALL OF THE COMMISSIONER OR THE CHAIR. THE COUNCIL MAY ADOPT REGULATIONS CONSISTENT WITH THIS SECTION.
(E) THE COMMISSIONER SHALL DESIGNATE SUCH EMPLOYEES AND PROVIDE FOR OTHER RESOURCES FROM THE DEPARTMENT AS MAY BE REASONABLY NECESSARY TO PROVIDE SUPPORT AND SERVICES FOR THE WORK OF THE COUNCIL. THE COUNCIL MAY EMPLOY ADDITIONAL STAFF AND CONSULTANTS AND INCUR OTHER EXPENSES TO CARRY OUT ITS DUTIES, TO BE PAID FOR FROM AMOUNTS WHICH MAY BE MADE AVAILABLE TO THE COUNCIL FOR THAT PURPOSE. (F) THE COUNCIL MAY PROVIDE TECHNICAL INFORMATION AND GUIDANCE TO HEALTH CARE PROFESSIONALS ON THE LATEST BEST PRACTICES, STRATEGIES, THERAPIES AND MEDICATIONS TO TREAT OR MANAGE CHRONIC PAIN. FURTHER, TO PROVIDE TECHNICAL INFORMATION AND GUIDANCE TO HEALTH CARE PROFESSIONALS TO ENCOURAGE BETTER COORDINATED CARE TO TREAT OR MITIGATE THE PAIN SUFFERED BY CHRONIC PAIN PATIENTS. 3. POLICIES TO BE CONSIDERED, EXAMINED AND POSSIBLY ADVANCED BY THE COUNCIL. THE COUNCIL SHALL CONSIDER AND EXAMINE THE FOLLOWING POLICIES AND GUIDELINES IN THE ADOPTION OF ANY RULES AND REGULATIONS: (A) THE TREATMENT AND CARE PROVIDED TO PATIENTS THAT SUFFER CHRONIC PAIN SHOULD BE CENTERED IN THE PRIMARY CARE ENVIRONMENT AND FOSTER COOR- DINATED CARE BETWEEN THE VARIOUS HEALTH CARE PROFESSIONAL DISCIPLINES. (B) CHRONIC PAIN MANAGEMENT AND CARE SHOULD BE COORDINATED TO HELP MINIMIZE THE DISPENSING OF PRESCRIPTION DRUGS, AVOID DUPLICATIVE AND COSTLY EVALUATIONS AND DIAGNOSTIC TESTS, AND TREATMENTS TO MINIMIZE CHRONIC PAIN. (C) DEVELOPMENT OF CHRONIC PAIN MANAGEMENT AND CARE TECHNIQUES THAT ADDRESSES DISCREPANCIES THAT MAY OCCUR IN THE TREATMENT OF PATIENTS BASED ON RACE, ETHNICITY, GENDER, INCOME LEVEL OR AGE. (D) DEVELOP AND PROMOTE THE USE OF BEST PRACTICES TO MITIGATE THE SUFFERING OF CHRONIC PAIN IN PATIENTS. THE UTILIZATION OF SUCH BEST PRACTICES CAN BE PROMOTED BY: (I) THE PROVISION OF PROFESSIONAL CONTINU- ING EDUCATION PROGRAMS TO ALL HEALTH CARE PROFESSIONALS ON ADVANCES IN BEST PRACTICES IN CHRONIC PAIN MANAGEMENT AND CARE, AND (II) THE DEVEL- OPMENT OF ADVANCES IN BEST PRACTICES BASED ON NEW RESEARCH, CLINICAL EXPERIENCE, AND THE PROMOTION OF INTER-DISCIPLINARY DIALOG AND COOPER- ATION BETWEEN THE VARIOUS HEALTH CARE PROFESSIONALS. (E) ENCOURAGE THE WIDER USE OF COORDINATED HEALTH INFORMATION TECHNOL- OGY SYSTEMS TO TRACK PAIN DISORDERS, TREATMENTS, AND OUTCOMES AS A MECH- ANISM TO IMPROVE CHRONIC PAIN CARE AND TO BETTER INTEGRATE COORDINATED CARE AMONG THE VARIOUS TREATING HEALTH CARE PROFESSIONALS. (F) CONSIDER ALTERATIONS IN MEDICAID AND PRIVATE PAYOR REIMBURSEMENT RATES AND PRACTICES TO ENCOURAGE MORE OPTIMUM PROVISION OF QUALITY CHRONIC PAIN MANAGEMENT AND CARE BY ALL HEALTH CARE PROFESSIONALS. (G) ENCOURAGE A BALANCED APPROACH TO REGULATE THE DISTRIBUTION, USE, AND PRESCRIPTION OF MEDICATIONS THAT ARE USED TO TREAT CHRONIC PAIN CONDITIONS. SUCH BALANCED APPROACH NEEDS TO ENSURE THAT PATIENTS CAN OBTAIN THE MEDICATIONS THAT THEY NEED, BUT ARE NOT OVER PRESCRIBED SUCH MEDICATIONS, WHICH CAN LEAD TO PATIENT ABUSE OR LONG TERM ADDICTION. FURTHER, THE NEED TO MONITOR MULTIPLE DAILY MEDICATION PRESCRIPTION REGIMENS, COUPLED WITH PSYCHOLOGICAL, BEHAVIORAL, AND SOCIAL INTER- VENTION ACTIVITIES OF SUCH PATIENTS. FURTHER, TO REDUCE THE THREAT OF DRUG ABUSE, ADDICTION OR DIVERSION OF SUCH MEDICATIONS TO USES NOT RELATED TO PROPER TREATMENT OF CHRONIC PAIN CONDITIONS. 4. GRANTS FOR UNDERGRADUATE MEDICAL EDUCATION IN CHRONIC PAIN TREAT- MENT AND MANAGEMENT. (A) THE COMMISSIONER IS AUTHORIZED, WITHIN AMOUNTS FROM ANY SOURCE APPROPRIATED OR OTHERWISE PROVIDED FOR SUCH PURPOSE, TO MAKE GRANTS TO CHRONIC PAIN CARE CERTIFIED MEDICAL SCHOOLS AND SCHOOLS OF HEALTH CARE PROFESSIONALS TO ENHANCE THE STUDY AND RESEARCH OF CHRON- IC PAIN TREATMENT AND MANAGEMENT, INCREASE THE OPPORTUNITIES FOR UNDER-
GRADUATE MEDICAL EDUCATION IN CHRONIC PAIN CARE TREATMENT AND MANAGE- MENT, AND ENCOURAGE THE EDUCATION OF PHYSICIANS IN CHRONIC PAIN CARE MANAGEMENT AND TREATMENT. (B) GRANT PROCEEDS UNDER THIS SUBDIVISION MAY BE USED FOR FACULTY DEVELOPMENT IN CHRONIC PAIN CARE TREATMENT AND MANAGEMENT; RECRUITMENT OF FACULTY WITH AN EXPERTISE IN THE MANAGEMENT AND TREATMENT OF CHRONIC PAIN; COSTS INCURRED TEACHING MEDICAL STUDENTS AT HOSPITAL-BASED SITES, NON-HOSPITAL BASED AMBULATORY CARE SETTINGS, CERTIFIED HOME HEALTH AGEN- CIES, LICENSED LONG TERM HOME HEALTH CARE PROGRAMS, PRIVATE AND PUBLIC HEALTH CARE CLINICS, AND IN PRIVATE PHYSICIAN PRACTICES INCLUDING, BUT NOT LIMITED TO PERSONNEL, ADMINISTRATION AND STUDENT-RELATED EXPENSES; EXPANSION OR DEVELOPMENT OF PROGRAMS THAT TRAIN PHYSICIANS IN THE TREAT- MENT AND MANAGEMENT OF CHRONIC PAIN; AND OTHER INNOVATIVE PROGRAMS DESIGNED TO INCREASE THE COMPETENCY OF MEDICAL STUDENTS TO PROVIDE CHRONIC PAIN CARE TO PATIENTS. (C) GRANTS UNDER THIS SUBDIVISION SHALL BE AWARDED BY THE COMMISSIONER THROUGH A COMPETITIVE APPLICATION PROCESS TO THE COUNCIL. THE COUNCIL SHALL MAKE RECOMMENDATIONS FOR FUNDING TO THE COMMISSIONER. 5. GRANTS FOR GRADUATE HEALTH CARE PROFESSIONAL EDUCATION IN CHRONIC PAIN TREATMENT AND MANAGEMENT. (A) THE COMMISSIONER IS AUTHORIZED, WITH- IN AMOUNTS FROM ANY SOURCE APPROPRIATED OR OTHERWISE PROVIDED FOR SUCH PURPOSE, TO MAKE GRANTS TO CHRONIC PAIN CARE CERTIFIED RESIDENCY PROGRAMS TO ESTABLISH OR EXPAND EDUCATION IN CHRONIC PAIN TREATMENT AND MANAGEMENT FOR GRADUATE MEDICAL EDUCATION, AND TO INCREASE THE OPPORTU- NITIES FOR TRAINEE EDUCATION IN THE TREATMENT AND MANAGEMENT OF CHRONIC PAIN IN THE HOSPITAL-BASED AND NON-HOSPITAL-BASED SETTINGS. (B) GRANTS UNDER THIS SUBDIVISION FOR GRADUATE HEALTH CARE PROFES- SIONAL EDUCATION AND EDUCATION IN CHRONIC PAIN TREATMENT AND MANAGEMENT MAY BE USED FOR ADMINISTRATION, FACULTY RECRUITMENT AND DEVELOPMENT; START-UP COSTS AND COSTS INCURRED TEACHING THE MOST ADVANCED STRATEGIES, THERAPIES, MEDICATIONS OR BEST PRACTICES WITH REGARD TO THE CARE OF PATIENTS WITH CHRONIC PAIN IN EITHER HOSPITAL-BASED OR NON-HOSPITAL BASED SETTINGS INCLUDING, BUT NOT LIMITED TO PERSONNEL, ADMINISTRATION AND TRAINEE RELATED EXPENSES; AND OTHER EXPENSES DEEMED REASONABLE AND NECESSARY BY THE COMMISSIONER. (C) GRANTS UNDER THIS SUBDIVISION SHALL BE AWARDED BY THE COMMISSIONER THROUGH A COMPETITIVE APPLICATION PROCESS TO THE COUNCIL. THE COUNCIL SHALL MAKE RECOMMENDATIONS FOR FUNDING TO THE COMMISSIONER. 6. CHRONIC PAIN HEALTH CARE PROFESSIONAL PRACTITIONER RESOURCE CENTERS. THE COMMISSIONER, IN CONSULTATION WITH THE COUNCIL, MAY DESIG- NATE A CHRONIC PAIN TREATMENT AND MANAGEMENT PRACTITIONER RESOURCE CENTER OR CENTERS. SUCH RESOURCE CENTER MAY BE STATEWIDE OR REGIONAL, AND SHALL ACT AS A SOURCE OF TECHNICAL SUPPORT, INFORMATION AND GUIDANCE FOR PRACTITIONERS ON THE LATEST STRATEGIES, THERAPIES, MEDICATIONS OR BEST PRACTICES WITH REGARD TO THE OPTIMUM TREATMENT AND MANAGEMENT OF CHRONIC PAIN. THE DEPARTMENT, IN CONSULTATION WITH THE COUNCIL, MAY CONTRACT WITH NOT-FOR-PROFIT ORGANIZATIONS OR ASSOCIATIONS TO ESTABLISH AND MANAGE SUCH RESOURCE CENTERS. SUCH RESOURCE CENTER MAY CHARGE A FEE TO HELP OFFSET THE COST OF PROVIDING SUCH SERVICES. 7. CONTINUING EDUCATION REQUIREMENTS FOR HEALTH CARE PROFESSIONALS. THE COUNCIL, IN CONSULTATION WITH THE DEPARTMENT, THE EDUCATION DEPART- MENT AND HEALTH CARE PROFESSIONAL ORGANIZATIONS; SHALL DEVELOP, COMPILE AND PUBLISH INFORMATION AND COURSE MATERIALS ON THE ADVANCED TREATMENT AND MITIGATION OF CHRONIC PAIN SUFFERED BY PATIENTS. IN ADDITION WITHIN TWO YEARS OF THE EFFECTIVE DATE OF THIS ARTICLE, THE COUNCIL SHALL MAKE RECOMMENDATIONS TO THE EDUCATION DEPARTMENT FOR THE COURSE WORK, TRAIN-
ING AND CURRICULUM TO BE INCLUDED IN THE CONTINUING EDUCATION ON THE BEST PRACTICES, STRATEGIES, THERAPIES AND APPROACHES FOR THE MITIGATION AND TREATMENT OF CHRONIC PAIN REQUIRED TO BE COMPLETED BY THE VARIOUS HEALTH CARE PROFESSIONS PURSUANT TO PARAGRAPH D OF SUBDIVISION THREE OF SECTION SIXTY-FIVE HUNDRED SEVEN OF THE EDUCATION LAW. SUCH RECOMMENDA- TIONS SHALL INCLUDE COMPONENTS WHICH ADDRESS THE INCREASING AND NECES- SARY INTERDISCIPLINARY COOPERATION BETWEEN HEALTH CARE PROFESSIONALS FOR THE COORDINATED REDUCTION OF CHRONIC PAIN IN PATIENTS AND THE REDUCTION OF HEALTH CARE COSTS. 8. REPORT. ON OR BEFORE MARCH FIRST OF EACH ODD NUMBERED YEAR, THE COUNCIL SHALL SUBMIT TO THE GOVERNOR, THE COMMISSIONER, THE COMMISSIONER OF EDUCATION, THE TEMPORARY PRESIDENT OF THE SENATE, THE SPEAKER OF THE ASSEMBLY, AND THE CHAIRS OF THE SENATE AND ASSEMBLY COMMITTEES ON HEALTH A REPORT ON ITS ACTIVITIES AND ACCOMPLISHMENTS RELATING TO THE TREATMENT AND MITIGATION OF CHRONIC PAIN. SUCH REPORT MAY ALSO INCLUDE SUCH LEGIS- LATIVE PROPOSALS AS IT DEEMS NECESSARY TO MORE EFFECTIVELY IMPLEMENT THE PROVISIONS OF THIS ARTICLE. S 3. Paragraphs b and c of subdivision 3 of section 6507 of the educa- tion law, as added by chapter 987 of the laws of 1971, are amended and a new paragraph d is added to read as follows: b. Review qualifications in connection with licensing requirements; [and] c. Provide for licensing examinations and reexaminations[.]; AND D. (I) ESTABLISH STANDARDS FOR PREPROFESSIONAL AND PROFESSIONAL EDUCA- TION FOR HEALTH CARE PROFESSIONALS, AS DEFINED IN PARAGRAPH (E) OF SUBDIVISION ONE OF SECTION TWENTY-EIGHT HUNDRED NINETY-NINE-K OF THE PUBLIC HEALTH LAW, RELATING TO THE MITIGATION AND TREATMENT OF CHRONIC PAIN. IN THE PROMULGATION OF SUCH STANDARDS, THE DEPARTMENT AND THE APPROPRIATE BOARD OF EACH SUCH PROFESSION SHALL CONSIDER AND, TO THE EXTENT PRACTICABLE, IMPLEMENT THE RECOMMENDATIONS OF THE STATE CHRONIC PAIN MANAGEMENT EDUCATION AND TRAINING COUNCIL. FURTHERMORE, SUCH STAND- ARDS SHALL PROVIDE FOR SUCH TRAINING AND COURSEWORK ON THE ADVANCED TREATMENT AND MITIGATION OF CHRONIC PAIN AS SHALL BE APPROPRIATE FOR THE HEALTH CARE PROFESSION, AND SHALL ADDRESS THE INCREASING AND NECESSARY INTERDISCIPLINARY COOPERATION BETWEEN HEALTH CARE PROFESSIONALS FOR THE COORDINATED REDUCTION OF CHRONIC PAIN IN PATIENTS AND THE REDUCTION OF HEALTH CARE COSTS. (II) THE COMMISSIONER SHALL ESTABLISH STANDARDS REQUIRING THAT ALL HEALTH CARE PROFESSIONALS APPLYING, ON OR AFTER JANUARY FIRST, TWO THOU- SAND SEVENTEEN, 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 4. Subdivision 7 of section 2807-s of the public health law is amended by adding a new paragraph (d) to read as follows: (D) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF THIS SECTION, PRIOR TO THE ALLOCATION OF FUNDS FOR DISTRIBUTION IN ACCORDANCE WITH SECTION TWENTY-EIGHT HUNDRED SEVEN-J OF THIS ARTICLE PURSUANT TO PARAGRAPHS (B) AND (C) OF THIS SUBDIVISION, THE COMMISSIONER ON AN ANNUALIZED BASIS UP TO TWO MILLION FIVE HUNDRED THOUSAND DOLLARS FOR GRANTS FOR UNDERGRADU- ATE HEALTH CARE PROFESSIONAL EDUCATION IN CHRONIC PAIN TREATMENT AND MANAGEMENT PURSUANT TO SUBDIVISION FOUR OF SECTION TWENTY-EIGHT HUNDRED NINETY-NINE-K OF THIS CHAPTER; AND UP TO TWO MILLION FIVE HUNDRED THOU- SAND DOLLARS FOR GRANTS FOR GRADUATE HEALTH CARE PROFESSIONAL EDUCATION IN CHRONIC PAIN TREATMENT AND MANAGEMENT PURSUANT TO SUBDIVISION FIVE OF SECTION TWENTY-EIGHT HUNDRED NINETY-NINE-K OF THIS CHAPTER. S 5. This act shall take effect immediately provided that the amend- ments to subdivision 7 of section 2807-s of the public health law made by section four of this act shall not affect the expiration of such section and shall expire therewith.

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