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AB-714 Opioid prescription drugs: prescribers.(2019-2020)

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Date Published: 04/04/2019 09:00 PM
AB714:v97#DOCUMENT

Amended  IN  Assembly  April 04, 2019
Amended  IN  Assembly  March 19, 2019

CALIFORNIA LEGISLATURE— 2019–2020 REGULAR SESSION

Assembly Bill No. 714


Introduced by Assembly Member Wood

February 19, 2019


An act to amend Sections 740 and 741 of the Business and Professions Code, relating to healing arts, and declaring the urgency thereof, to take effect immediately.


LEGISLATIVE COUNSEL'S DIGEST


AB 714, as amended, Wood. Opioid prescription drugs: prescribers.
Existing law requires a prescriber, as defined, to offer to a patient a prescription for naloxone hydrochloride or another drug approved by the United States Food and Drug Administration for the complete or partial reversal of opioid depression when certain conditions are present, including if the patient presents with an increased risk for overdose or a history of substance use disorder, and to provide education on overdose prevention to patients receiving a prescription and specified other persons.
This bill would make those provisions applicable only to a patient receiving a prescription for an opioid or benzodiazepine medication, and would make the provisions specific to opioid-induced respiratory depression, opioid overdose, opioid use disorder, and opioid overdose prevention, as specified. The bill bill, among other exclusions, would exclude from the above-specified provisions requiring prescribers to offer a prescription and provide education prescribers when prescribing, ordering, or administering ordering medications to be administered to a patient in an inpatient health facility and prescribers prescribing to a patient in outpatient-based hospice care. or outpatient setting. The bill would define terms for purposes of those provisions.
This bill would declare that it is to take effect immediately as an urgency statute.
Vote: 2/3   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

The people of the State of California do enact as follows:


SECTION 1.

 Section 740 of the Business and Professions Code is amended to read:

740.
 For purposes of this article, the following definitions apply:
(a) “Administer” means the direct application of a drug or device to the body of a patient by injection, inhalation, ingestion, or other means.

(b)“Hospice care” means a specialized form of multidisciplinary health care that is designed to provide palliative care, alleviate the physical, emotional, social, and spiritual discomforts of an individual who is experiencing the last phases of life due to the existence of a terminal disease, and to provide supportive care for the primary caregiver and the family of the hospice patient and shall include both inpatient and outpatient care.

(c)

(b) “Order” means an order entered on the chart or medical record of a patient registered in an inpatient health facility by or on the order of a prescriber.

(d)

(c) “Prescriber” means a person licensed, certified, registered, or otherwise subject to regulation pursuant to this division, or an initiative act referred to in this division, who is authorized to prescribe prescription drugs.

SEC. 2.

 Section 741 of the Business and Professions Code is amended to read:

741.
 (a) Notwithstanding any other law, when prescribing an opioid or benzodiazepine medication to a patient, a prescriber shall do the following:
(1) Offer the patient a prescription for naloxone hydrochloride or another drug approved by the United States Food and Drug Administration for the complete or partial reversal of opioid-induced respiratory depression when one or more of the following conditions are present:
(A) The prescription dosage for the patient is 90 or more morphine milligram equivalents of an opioid medication per day.
(B) An opioid medication is prescribed concurrently with within a year from the date a prescription for benzodiazepine. benzodiazepine has been dispensed to the patient.
(C) The patient presents with an increased risk for opioid overdose, including a patient with a history of opioid overdose, a patient with a history of opioid use disorder, or a patient at risk for returning to a high dose of opioid medication to which the patient is no longer tolerant.
(2) Consistent with the existing standard of care, provide education to the patient on opioid overdose prevention and the use of naloxone hydrochloride or another drug approved by the United States Food and Drug Administration for the complete or partial reversal of opioid-induced respiratory depression.
(3) Consistent with the existing standard of care, provide education on opioid overdose prevention and the use of naloxone hydrochloride or another drug approved by the United States Food and Drug Administration for the complete or partial reversal of opioid-induced respiratory depression to one or more persons designated by the patient, or, for a patient who is a minor, to the minor’s parent or guardian.
(b) A prescriber is not required to provide the education specified in paragraphs (2) or (3) of subdivision (a) if the patient receiving the prescription declines the education or has received the education within the past 24 months.

(b)

(c) This section does not apply to a prescriber when under any of the following circumstances:
(1) When prescribing to an inmate or a youth under the jurisdiction of the Department of Corrections and Rehabilitation or the Division of Juvenile Justice within the Department of Corrections and Rehabilitation.

(c)This section does not apply to a prescriber when prescribing, ordering, or administering medications to a patient in an inpatient health facility, as defined in Section 1250 of the Health and Safety Code.

(d)This section does not apply to a prescriber when prescribing medications to a patient in outpatient-based hospice care.

(2) When ordering medications to be administered to a patient while the patient is in either an inpatient or outpatient setting.
(3) When prescribing medications to a patient who is terminally ill, as defined in subdivision (c) of Section 11159.2 of the Health and Safety Code.

SEC. 3.

 This act is an urgency statute necessary for the immediate preservation of the public peace, health, or safety within the meaning of Article IV of the California Constitution and shall go into immediate effect. The facts constituting the necessity are:
In order to properly address the health crisis caused by opioid addiction and the loss of life caused by opioid-induced respiratory failure in this state as soon as possible, it is necessary that this bill take effect immediately.