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| Helping pharmacy & health communities improve access to Emergency Contraception (EC) |
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EC PHARMACY UPDATEIn October 2007, State Health Commissioner Richard Daines announced that the agency will add $2.2 million to this year's family planning agency grants to cover the cost of EC. He also said that the state will add a supplement to the Medicaid rate for Implanon and IUD’s — more costly methods of birth control. In December 2006, the state Health Department, under Republican former Governor Pataki, changed the Medicaid rules to allow Plan B to be fully covered by Medicaid. The new administration of Democratic Governor Spitzer is implementing the change, effective February 1, 2007. Consumers age 18 and older may use Medicaid to cover Plan B purchased OTC; Medicaid will still pay for Plan B with a prescription for women under 18 or those without proof of age. Information for pharmacists and pharmacy staff in New York is available here. In Spring of 2006, the New York City Department of Health and Mental Hygiene (NYC DOHMH) awarded four 3-year contracts to increase awareness of and access to emergency contraception, as part of the Mayor Bloomberg’s Healthy Mothers, Healthy Babies initiative. The winners of the competitive RFP include Planned Parenthood of New York City, Maternal Health and Research Association of NYC, New York Presbyterian Hospital, and the Harlem Health Promotion Project affiliated with the Mailman School of Public Health, Columbia University. Together, these organizations will be providing professional development and community-based outreach through their extensive service networks and in collaboration with community-based organizations. The initiative will cover the five boroughs of the city, with a particular concentration on communities and populations with high rates of unintended pregnancy. Read PPNYC’s Spring 2006 ChoiceVoice EC newsletter (PDF-1.1MB). The Academy for Educational Development (AED) conducted a training for pharmacists in the Bronx in March 2006 and in July, with the assistance of Family Planning Advocates of NYS, tabled pharmacists at the summer meeting of the Pharmacists Society of the State of New York. Also in July, AED, in coordination with the NYC DOHMH Healthy Mothers/Healthy Babies campaign, participated in the pharmacist detailing project in communities with high rates of unintended pregnancy. In February 2006, two companion bills SB 6686 and AB 9906 (Assemblywoman Amy Paulin (D)) were introduced again to enact the unintended pregnancy prevention act and provides for access to EC through a pharmacist or registered nurse for self-administration by the patient. In January 2005, the Unintended Pregnancy Prevention Act (A 116 / S 1576) was re-introduced. The bills allow trained pharmacists and registered nurses to dispense EC through a non-patient specific order written by a licensed physician, certified nurse practitioner or licensed midwife. Although A 116 passed the Assembly and the Senate, Governor George Patak vetoed the legislation due to concerns about minors' access. An additional bill A 8075 introduced in May 2005 included parental notification to minors. In April 2005, Mayor Michael Bloomberg announced a $3 Million Initiative to reduce unintended pregnancies and improve reproductive health. The proposal, named Healthy Women/Healthy Babies, includes EC education and outreach, public health detailing on family planning, pharmacist outreach and education, advance prescriptions of EC, and expansion of the Nurse Family Partnership. NARAL Pro-Choice New York visited pharmacies in New York City to see if they stocked EC and informed pharmacists about EC in March 2005. In the previous legislative session, on February 2, 2004, the Act (A 888) passed by a vote of 120 to 25 in the State Assembly. The Senate Republicans, the majority party in the New York State Senate, conferenced the bill in late August 2004 but declined to bring it to the floor for a vote. Advocates in New York urged passage of the bill before the close of the 2004 legislative session. In a press conference held in Albany on Tuesday, June 1, members of the Emergency Contraception Access Campaign joined Assemblymember Amy Paulin (sponsor of A.888), other members of the Assembly and Dr. Vivian Lewis, a member of the FDA Reproductive Health Drugs Advisory Committee, to urge the Senate to pass the Unintended Pregnancy Prevention Act (S.3339). On February 8, 2004 the New York City Council released findings of a follow-up investigation of its 2002 study to determine whether pharmacies stock EC. The new report indicates that 25% of pharmacies in NYC still do not stock EC and none of them had complied with Local Law 25 which requires that they post signs indicating that they do not carry EC products. However, the City Council’s report did find 20% more pharmacies citywide are carrying EC than its initial 2002 study. In November 2003, New York State Office of the State Comptroller released “Emergency Contraception in New York State” (PDF-124K) / Methodology (PDF-32K) outlining the fiscal benefit of improved access to EC in NY state. Giving women in New York State increased access to emergency contraceptive pills would result in 122,000 fewer unintended pregnancies and 82,000 fewer abortions and as a result cut health care spending in New York State by $452 million annually, concludes Comptroller Alan Hevesi. In 2002, Assembly Member Amy Paulin, with the support of NARAL Pro-Choice New York, initiated EC pharmacy legislation. The legislation failed to make it to the Assembly floor for a vote. In 2003, Assembly Member Paulin re-introduced, and Senator Nancy Larraine introduced, EC pharmacy legislation (A 888 / SB 3339), with the support of the Pharmacy Society of the State of New York (PSSNY), and the Emergency Contraception Access Campaign, a coalition of organizations led by NARAL Pro-Choice New York and ACOG District II/New York. The Campaign has 60 organizational members including physicians, nurses, midwives, pharmacy groups, women’s organizations, community-based organizations, and Planned Parenthood affiliates. The legislation passed the Assembly but died in committee in the Senate. PSSNY’s has had a strong interest in EC since first learning of Washington’s Pharmacy Access initiative. In 1998, the PSSNY House of Delegates considered, but did not pass, a resolution to support legislation permitting pharmacists to offer EC through collaborative practice agreements with prescribers. In 1999, the resolution was reintroduced and passed. A member of the PSSNY Board, who is on faculty at the Albany College of Pharmacy, testified before the New York State Assembly Health Committee in support of A 888 on behalf of PSSNY. The NY Chapter of PSSNY also supported an ACPE-approved training for pharmacists. As part of its work on the Emergency Contraception Access Campaign, ACOG developed a brochure for physicians and pharmacists. The Campaign and Family Planning Advocates of NYS also conducted two regional meetings on pharmacy access to EC, one in Buffalo and the other in the Rochester/Syracuse region, as part of its educational efforts. On May 15, 2003 the Campaign convened a roundtable that was attended by key stakeholder groups in favor of pharmacy access. Papers will be compiled and disseminated in Fall 2003. EC access issues have been extremely visible in the State and New York City. In 2003, as a result of a partnership between Family Planning Advocates of New York State and the New York State Coalition Against Sexual Assault, the state legislature passed a bill that mandates hospital emergency departments to inform survivors of sexual assault about EC and provide it on site, to those who want it. The New York City Council also enacted three EC access bills in 2003.
A follow-up investigation from the City Council found that almost 25% of NYC hospitals do not comply with Local Law 26, although critics disagreed with the way the study was conducted. An investigation on Local Law 19 found that 10 of the 36 district health centers carried EC and that the cost of it was up to $90 at one health center. In summer of 2002, the New York City Council conducted a survey (PDF-1.5MB) of 170 pharmacies (half chain and half independent) in the 5 boroughs of NYC. Findings revealed that overall, 55% of pharmacies stocked on of the dedicated EC products — Plan B or Preven — with wide variation by borough. The New York City Department of Health and Mental Hygiene (NYCDOHMH) started in 2003 offering EC in all of its STD clinics, following the success of an EC pilot using its Jamaica STD clinic. For press coverage in this state, click here. For outreach materials in this state, click here.
CONTACTSCraig Burridge, M.S., C.A.E. Macary Weck Christina Tenuta Linda Simkin Marjorie McMeniman, PhD, MS Christa R. Nyman, MPP Jessica Fisher Steve Rubin Nyanda Labor, MPH
USEFUL LINKSNY Office of the Professions Pharmacist Society of the State of New York New York State Assembly Family Planning Advocates of New York State Upper Hudson Planned Parenthood Planned Parenthood of Buffalo and Erie County Planned Parenthood of Nassau County Planned Parenthood of the Southern Tier Planned Parenthood of New York City Planned Parenthood of Niagara County Planned Parenthood of South Central New York Northern Adirondack Planned Parenthood Planned Parenthood of the Mid-Hudson Valley Planned Parenthood of the Rochester/Syracuse Region Planned Parenthood Mohawk Hudson, Inc. Planned Parenthood of Northern New York Planned Parenthood Hudson Peconic Planned Parenthood of Tompkins County Medical and Health Research Association of New York City, Inc NARAL Pro-Choice New York State
PROTOCOL ENVIRONMENTUnfriendly Environment: New Authority Required In this state, no authority exists for collaborative practice agreements. Any initiative to provide direct pharmacy access to EC would require significant advocacy activity to secure statutory and/or regulatory authority.
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