Hawaii-2016-HB2253-Amended

SECTION 1. The legislature finds that the department of health reports that accidental poisonings, commonly referred to as drug overdoses, are one of the leading causes of injury-related mortality in Hawaii. According to the department of health, opioid pain relievers, such as oxycodone or hydrocodone, contributed to thirty-five per cent or two hundred seventy of the seven hundred seventy-eight drug overdose deaths from 2010 through 2014. This may be an underestimate. Public health experts including the Centers for Disease Control and Prevention and the Substance Abuse Mental Health Services Administration recommend increasing access to opioid antagonists such as naloxone hydrochloride to prevent overdose-related mortalities.

The purpose of this Act is to expand access to opioid antagonists to prevent fatal overdoses of drugs.

SECTION 2. The Hawaii Revised Statutes is amended by adding a new chapter to be appropriately designated and to read as follows:

"CHAPTER

OVERDOSE PREVENTION AND EMERGENCY RESPONSE ACT

§ -1 Definitions. As used in this chapter:

"Harm reduction organization" means an organization that provides services, including medical care, counseling, homeless services, or addiction treatment, to individuals at risk of experiencing an opiate-related drug overdose event or to the friends and family members of an at-risk individual.

"Health care professional" includes a physician, physician assistant, or advanced practice registered nurse who is authorized to prescribe an opioid antagonist.

"Naloxone hydrochloride" means a pure opioid antagonist that has no agonist properties and is not a scheduled drug as provided in title 21 United States Code section 812.

"Opioid antagonist" means any drug that binds to opioid receptors and blocks or disinhibits the effects of opioids acting on those receptors.

"Opioid-related drug overdose" means a condition that includes extreme physical illness, decreased level of consciousness, respiratory depression, coma, or death resulting from the consumption or use of an opioid, or other substance with which an opioid is combined, or that a layperson would reasonably believe to be an opioid-related drug overdose that requires medical assistance.

"Protocol" means a specific written plan for a course of medical treatment containing a written set of specific directions created by a physician, group of physicians, hospital medical committee, or pharmacy and therapeutics committee.

"Standing order" means a prescription order by a health care professional who is otherwise authorized to prescribe an opioid antagonist that is not specific to and does not identify a particular patient.

§ -2 Immunity. (a) Notwithstanding any law to the contrary, a health care professional authorized to prescribe an opioid antagonist may, directly or by standing order, prescribe, dispense, and distribute an opioid antagonist to an individual at risk of experiencing an opioid-related overdose or to another person in a position to assist an individual at risk of experiencing an opioid-related overdose. Any such prescription shall be regarded as being issued for a legitimate medical purpose in the usual course of professional practice.

(b) A health care professional or pharmacist who, acting in good faith and with reasonable care, prescribes, dispenses, or distributes an opioid antagonist shall not be subject to any criminal or civil liability or any professional disciplinary action for:

(1) Prescribing, dispensing, or distributing the opioid antagonist; or

(2) Any outcomes resulting from the eventual administration of the opioid antagonist.

(d) A person who, acting in good faith and with reasonable care, administers an opioid antagonist to another person whom the person believes to be suffering an opioid-related drug overdose shall be immune from criminal prosecution, sanction under any professional licensing statute, and civil liability, for acts or omissions resulting from the act.

§ -3 Opioid antagonist administration; emergency personnel; first responders. Emergency medical services personnel, law enforcement officers, and fire fighters may administer an opioid antagonist in cases of opioid�related drug overdose.

§ -4 Medicaid coverage. The department of human services shall ensure that naloxone hydrochloride for outpatient use is covered by the medicaid prescription drug program on the same basis as other covered drugs.

§ -5 Opioid antagonist; storage and dispensing; pharmacy exemption. Notwithstanding any law to the contrary, a person or harm reduction organization acting under a standing order issued by a health care professional licensed under chapter 453 who is authorized to prescribe an opioid antagonist:

(1) May store an opioid antagonist without being subject to any part of chapter 328 except part VII;

(2) May dispense an opioid antagonist without charge or compensation; and

(3) Shall be exempt from the pharmacy license requirements and pharmacy permit requirements of chapter 461.

§ -6 Dispensing naloxone hydrochloride without prescription. (a) The board of pharmacy shall adopt standardized protocols for licensed pharmacists to dispense or otherwise furnish naloxone hydrochloride to patients who do not hold an individual prescription for naloxone hydrochloride.

(b) Notwithstanding any law to the contrary, a licensed pharmacist may dispense naloxone hydrochloride to any person as long as the pharmacist complies with the protocols adopted pursuant to subsection (a).

§ -7 Unintentional drug overdose; reporting. The department of health shall ascertain, document, and publish an annual report on the number of, trends in, patterns in, and risk factors related to unintentional opioid-related drug overdose fatalities occurring each year within the State. The report shall provide information on interventions that would be effective in reducing the rate of fatal or nonfatal drug overdose."

SECTION 3. This Act does not affect rights and duties that matured, penalties that were incurred, and proceedings that were begun before its effective date.

SECTION 4. This Act shall take effect on July 1, 2070.

HOUSE OF REPRESENTATIVES	H.B. NO.	2253
TWENTY-EIGHTH LEGISLATURE, 2016		H.D. 1
STATE OF HAWAII