State Seal2 copy††††††††††† Bill Number: H.B. 2493

††††††††††† Brophy Mcgee Floor Amendment

††††††††††† Reference to: House engrossed bill

††††††††††† Amendment drafted by: Leg Council

 

 

FLOOR AMENDMENT EXPLANATION

 

1.    Allows a pharmacist to dispense naloxone or any other FDA-approved opioid antagonist for emergency purposes on receipt of a standing order, instead of allowing the pharmacist to dispense the opioid antagonist without a prescription.

 

2.    Removes the provision that allows a health professional to require the person receiving the prescription to provide in writing a factual basis for a reasonable conclusion that the person or entity is a person who is at risk of experiencing an opioid-related overdose or that personís family member or an entity that is in a position to assist a person who is at risk of experiencing an opioid-related overdose.


 

Fifty-third Legislature††††††††††††††††††††††††††††††††††††††††††††† Brophy Mcgee

First Regular Session†††††††††††††††††††††††††††††††††††††††††††††††††† H.B. 2493

 

BROPHY MCGEE FLOOR AMENDMENT

SENATE AMENDMENTS TO H.B. 2493

(Reference to House engrossed bill)

 


Page 1, between lines 1 and 2, insert:

"Section 1.  Section 32-1968, Arizona Revised Statutes, is amended to read:

START_STATUTE32-1968.  Dispensing prescription‑only drug; prescription orders; refills; labels; misbranding; dispensing soft contact lenses; opioid antagonists

A.  A prescription‑only drug shall be dispensed only under one of the following conditions:

1.  By a medical practitioner in conformance with section 32‑1921.

2.  On a written prescription order bearing the prescribing medical practitioner's manual signature.

3.  On an electronically transmitted prescription order containing the prescribing medical practitioner's electronic or digital signature that is reduced promptly to writing and filed by the pharmacist.†

4.  On a written prescription order generated from electronic media containing the prescribing medical practitioner's electronic or manual signature.† A prescription order that contains only an electronic signature must be applied to paper that uses security features that will ensure the prescription order is not subject to any form of copying or alteration.

5.  On an oral prescription order that is reduced promptly to writing and filed by the pharmacist.

6.  By refilling any written, electronically transmitted or oral prescription order if a refill is authorized by the prescriber either in the original prescription order, by an electronically transmitted refill order that is documented promptly and filed by the pharmacist or by an oral refill order that is documented promptly and filed by the pharmacist.

7.  On a prescription order that the prescribing medical practitioner or the prescribing medical practitioner's agent transmits by fax or electronic mail e‑mail.

8.  On a prescription order that the patient transmits by fax or by e‑mail if the patient presents a written prescription order bearing the prescribing medical practitioner's manual signature when the prescription‑only drug is picked up at the pharmacy.

B.  A prescription order shall not be refilled if it is either:

1.  Ordered by the prescriber not to be refilled.

2.  More than one year since it was originally ordered.

C.  A prescription order shall contain the date it was issued, the name and address of the person for whom or owner of the animal for which the drug is ordered, refills authorized, if any, the legibly printed name, address and telephone number of the prescribing medical practitioner, the name, strength, dosage form and quantity of the drug ordered and directions for its use.†

D.  Any drug dispensed in accordance with subsection A of this section is exempt from the requirements of section 32‑1967, except section 32‑1967, subsection A, paragraphs 1, 10 and 11 and the packaging requirements of section 32‑1967, subsection A, paragraphs 7 and 8, if the drug container bears a label containing the name and address of the dispenser, the serial number, the date of dispensing, the name of the prescriber, the name of the patient, or, if an animal, the name of the owner of the animal and the species of the animal, directions for use and cautionary statements, if any, contained in the order.† This exemption does not apply to any drug dispensed in the course of the conduct of a business of dispensing drugs pursuant to diagnosis by mail or the internet or to a drug dispensed in violation of subsection A of this section.

E.  The board by rule also may require additional information on the label of prescription medication that the board believes to be necessary for the best interest of the public's health and welfare.

F.  A prescription‑only drug or a controlled substance that requires a prescription order is deemed to be misbranded if, at any time before dispensing, its label fails to bear the statement "Rx only".† A drug to which subsection A of this section does not apply is deemed to be misbranded if, at any time before dispensing, its label bears the caution statement quoted in this subsection.

G.  A pharmacist may fill a prescription order for soft contact lenses only as provided in this chapter.

H.  A pharmacist may dispense naloxone hydrochloride or any other opioid antagonist that is approved by the United States food and drug administration on the receipt of a standing order and according to protocols adopted by the board pursuant to section 32‑1979.  For the purposes of this subsection, "standing order" means a signed prescription order that authorizes the pharmacist to dispense naloxone hydrochloride or any other opioid antagonist for emergency purposes and that is issued by a medical practitioner licensed in this state or a state or county health officer who is a medical practitioner licensed in this state. END_STATUTE

Sec. 2.  Section 32-1979, Arizona Revised Statutes, is amended to read:

START_STATUTE32-1979.  Pharmacists; dispensing opioid antagonists; board protocols; immunity

A.  A pharmacist may dispense without a prescription, pursuant to a standing order issued pursuant to section 36‑2266 and according to protocols adopted by the board, naloxone hydrochloride or any other opioid antagonist that is approved by the United States food and drug administration for use according to the protocols specified by board rule to a person who is at risk of experiencing an opioid‑related overdose or to a family member or community member who is in a position to assist that person.

B.  A pharmacist who dispenses naloxone hydrochloride or any other opioid antagonist pursuant to subsection A of this section shall:

1.  Document the dispensing consistent with board rules.

2.  Instruct the individual to whom the opioid antagonist is dispensed to summon emergency services as soon as practicable either before or after administering the opioid antagonist.

C.  This section does not affect the authority of a pharmacist to fill or refill a prescription for naloxone hydrochloride or any other opioid antagonist that is approved by the United States food and drug administration.

D.  A pharmacist who dispenses an opioid antagonist pursuant to this section is immune from professional liability and criminal prosecution for any decision made, act or omission or injury that results from that act if the pharmacist acts with reasonable care and in good faith, except in cases of wanton or wilful neglect.END_STATUTE"

Renumber to conform

Page 3, after line 21, insert:

"Sec. 4.  Section 36-2266, Arizona Revised Statutes, is amended to read:

START_STATUTE36-2266.  Prescribing and dispensing; immunity; definition

A.  A physician who is licensed pursuant to title 32, chapter 13 or 17, a nurse practitioner licensed pursuant to title 32, chapter 15 and authorized by law to prescribe drugs or any other health professional who has prescribing authority and who is acting within the health professional's scope of practice may prescribe or dispense, directly or by a standing order, naloxone hydrochloride or any other opioid antagonist that is approved by the United States food and drug administration for use according to the protocol specified by the physician, nurse practitioner or other health professional to a person who is at risk of experiencing an opioid-related overdose, to a family member of that person, to a community organization that provides services to persons who are at risk of an opioid-related overdose or to any other person who is in a position to assist a person who is at risk of experiencing an opioid‑related overdose.

B.  A physician, nurse practitioner or other health professional who prescribes or dispenses naloxone hydrochloride or any other opioid antagonist pursuant to subsection A of this section shall instruct the individual to whom the opioid antagonist is dispensed to summon emergency services as soon as practicable, either before or after administering the opioid antagonist.

C.  Except in cases of gross negligence, wilful misconduct or intentional wrongdoing, a physician, nurse practitioner or other health professional who in good faith prescribes or dispenses an opioid antagonist pursuant to subsection A of this section is immune from professional liability and criminal prosecution for any decision made, act or omission or injury that results from that act if the physician, nurse practitioner or other health professional acts with reasonable care and in good faith.

D.  Before prescribing an opioid antagonist pursuant to subsection A of this section, a physician, nurse practitioner or other health professional may require the person receiving the prescription, as an indicator of good faith, to provide in writing a factual basis for a reasonable conclusion that the person or entity meets the description in subsection A of this section of a person or entity who is able to receive an opioid antagonist under this section.

E.  D.  For the purposes of this section, "person" includes an employee of a school district or charter school who is acting in the person's official capacity.END_STATUTE"

Amend title to conform


 

KATE BROPHY MCGEE

 

2493FloorBROPHY MCGEE

03/29/2017

5:52 PM

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