SENATE BILL NO. 1157
A bill to amend 1978 PA 368, entitled
"Public health code,"
by amending sections 9204 and 17744e (MCL 333.9204 and 333.17744e), section 9204 as amended by 2023 PA 97 and section 17744e as amended by 2022 PA 176.
the people of the state of michigan enact:
Sec. 9204. (1) Except as otherwise provided in subsection (2), a health professional other than a physician may administer an immunizing agent as long as if the immunizing agent is being administered under the direction of a physician and a health professional other than a physician or any other individual may administer an immunizing agent if it is being administered pursuant to a standing order issued under section 17744e.
(2) In addition to administering an immunizing agent under the direction of a physician under subsection (1), a pharmacist may order and administer a qualified immunizing agent in accordance with section 17724.
Sec. 17744e. (1) Notwithstanding any provision of this act to the contrary, the chief medical executive in the office of chief medical executive created within the department of health and human services qualified public health physician may issue a standing order that does not identify a particular patients patient at the time it is issued for a qualified drug or device if, in the judgment of the qualified public health physician, any of the following purposes:are met:
(a) A pharmacist dispensing opioid antagonists to individuals under this section.
(b) A community-based organization or a staff member of the community-based organization distributing opioid antagonists to individuals under this section.
(a) Both of the following are met:
(i) Issuing the standing order will significantly contribute to protecting or preserving public health such that the requirement that an individual obtain a prescription issued in the individual's name from a prescriber for the qualified drug or device is contrary to the interests of public health.
(ii) The risks of issuing the standing order are insubstantial.
(b) Both of the following are met:
(i) The standing order is necessary to protect or preserve public health from an emergent disease, event, or condition.
(ii) The emergent disease, event, or condition requires distributing the qualified drug or device in a manner that makes the requirement that an individual obtain a prescription issued in the individual's name from a prescriber for the qualified drug or device contrary to the interests of public health.
(2) A standing order must include all of the following information:
(a) The purpose of the standing order.
(b) The qualified drug or the device that is the subject of the standing order.
(c) The individuals who are eligible to receive the qualified drug or the device under the standing order.
(d) Whether the standing order is issued under subsection (1)(a) or (b).
(e) The justification supporting the qualified public health physician's decision to issue the standing order under subsections (1)(a)(i) to (ii) or (1)(b)(i) to (ii), as applicable.
(3) A standing order expires as follows:
(a) Except as otherwise provided in this subdivision, if a standing order is issued under subsection (1)(a), the standing order expires on the date the standing order is rescinded by the qualified public health physician or 1 year after the date the standing order is issued, whichever is earlier. The qualified public health physician may extend the standing order beyond 1 year after the date the standing order is issued if, not later than 7 days before the date the standing order is set to expire, the qualified public health physician posts on the publicly accessible website for the department of health and human services an explanation of why the standing order is effective and why it is necessary to maintain the standing order.
(b) Except as otherwise provided in this subdivision, if the standing order is issued under subsection (1)(b), the standing order expires on the date the qualified public health physician rescinds the standing order or 6 months after the date the standing order is issued, whichever is earlier. The qualified public health physician shall rescind a standing order issued under subsection (1)(b) if, in the professional judgment of the qualified public health physician, the emergent disease, event, or condition no longer meets the requirements described in subsection (1)(b)(ii). The qualified public health physician may extend the standing order beyond 6 months after the date the standing order is issued if, not later than 7 days before the date the standing order is set to expire, the qualified public health physician posts on the publicly accessible website for the department of health and human services an explanation of why the standing order is effective and why it is necessary to maintain the standing order.
(4) (2) Notwithstanding any provision of this act to the contrary, a pharmacist may dispense, or a community-based distribute, or administer a qualified drug or device pursuant to a standing order and a community-based organization or a staff member of the community-based organization an employee of the department of health and human services or a local health department may distribute an opioid antagonist to any individual or administer a qualified drug or device pursuant to a standing order. issued by the chief medical executive under subsection (1) and the rules promulgated under this section.
(5) (3) The Except as otherwise provided in subsection (6), the following are not liable in a civil action for damages resulting from the dispensing of an opioid antagonist or the administration of or failure to administer the opioid antagonist:issuance of a standing order or from the dispensing, distribution, or administration of a qualified drug or device pursuant to a standing order, as follows:
(a) The chief medical executive qualified public health physician who issues a the standing order for the opioid antagonist under this section.the qualified drug or device.
(b) A pharmacist who dispenses, the opioid antagonist distributes, or administers the qualified drug or device as authorized under this section.the standing order.
(c) A community-based organization that , or a staff member of the community-based organization who, distributes the opioid antagonist or administers the qualified drug or device as authorized under this section.the standing order.
(d) An employee of the department of health and human services or a local health department who distributes or administers the qualified drug or device as authorized under the standing order.
(4) The department, in consultation with the department of health and human services and local health departments, may promulgate rules regarding dispensing, training, distribution, and referral to implement this section.
(6) The immunity granted under subsection (5) does not apply in the event of an act or omission that that is willful and wanton misconduct or gross negligence.
(7) (5) As used in this section: , "community-based
(a) "Chief medical executive" means the chief medical executive in the office of chief medical executive created within the department of health and human services.
(b) "Community-based organization" means a public or private organization that provides health or human services to meet the needs of a community, including, but not limited to, a nonprofit organization, a social service provider, or an organization providing substance use disorder prevention, treatment, recovery, or harm reduction services. A community-based organization does not include an agency as that term is defined in section 101 of the administration of opioid antagonists act, 2019 PA 39, MCL 15.671. Community-based organization includes an employee or a volunteer of the community-based organization.
(c) "Qualified drug" means a drug other than a controlled substance.
(i) The individual is in the classified state civil service.
(ii) The individual is a physician licensed to practice medicine or osteopathic medicine and surgery under part 170 or 175.
(iii) The individual is designated by the department of health and human services to provide medical and public health consultation and support to the chief medical executive and the deputy director for public health in the department of health and human services.
(e) "Standing order" means an order that is issued under subsection (1).