Sponsored by:
Senator CHRISTOPHER "KIP" BATEMAN
District 16 (Hunterdon, Mercer, Middlesex and Somerset)
Co-Sponsored by:
Senator Diegnan
SYNOPSIS
Amends "Overdose Prevention Act" to clarify that pharmacists and health care practitioners may dispense opioid antidotes pursuant to standing order, and that prescribers may issue such standing order, with immunity from liability.
CURRENT VERSION OF TEXT
Introduced Pending Technical Review by Legislative Counsel.
An Act concerning overdose prevention, and amending P.L.2013, c.46.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. Section 3 of P.L.2013, c.46 (C.24:6J-3) is amended to read as follows:
3. As used in this act:
"Commissioner" means the Commissioner of Human Services.
"Dispense" means the act of handing out or otherwise distributing a drug to a recipient, except that, when the term is used in specific relation to a pharmacist, it shall mean the same as that term is defined by section 2 of P.L.2003, c.280 (C.45:14-41).
"Drug overdose" means an acute condition including, but not limited to, physical illness, coma, mania, hysteria, or death resulting from the consumption or use of a controlled dangerous substance or another substance with which a controlled dangerous substance was combined and that a layperson would reasonably believe to require medical assistance.
"Emergency medical response entity" means an organization, company, governmental entity, community-based program, or healthcare system that provides pre-hospital emergency medical services and assistance to opioid or heroin addicts or abusers in the event of an overdose.
"Emergency medical responder" means a person, other than a health care practitioner, who is employed on a paid or volunteer basis in the area of emergency response, including, but not limited to, an emergency medical technician acting in that person's professional capacity.
"Health care practitioner" means a prescriber, pharmacist, or other individual whose professional practice is regulated pursuant to Title 45 of the Revised Statutes, and who, in accordance with the practitioner's scope of professional practice, prescribes or dispenses an opioid antidote.
"Medical assistance" means professional medical services that are provided to a person experiencing a drug overdose by a health care practitioner, acting within the practitioner's scope of professional practice, including professional medical services that are mobilized through telephone contact with the 911 telephone emergency service.
"Opioid antidote" means naloxone hydrochloride, or any other similarly acting drug approved by the United States Food and Drug Administration for the treatment of an opioid overdose.
"Patient" means a person who is at risk of an opioid overdose or a person who is not at risk of an opioid overdose who, in the person's individual capacity, obtains an opioid antidote from a health care practitioner, professional, or professional entity for the purpose of administering that antidote to another person in an emergency, in accordance with subsection [c.] d. of section 4 of P.L.2013, c.46 (C.24:6J-4). "Patient" includes a professional who is acting in that professional's individual capacity, but does not include a professional who is acting in a professional capacity.
"Pharmacist" means an individual who is licensed and authorized by law, pursuant to P.L.2003, c.280 (C.45:14-40 et seq.), to engage in the practice of pharmacy, including the dispensing of drugs.
"Prescriber" means a health care practitioner authorized by law to prescribe medications who, acting within the practitioner's scope of professional practice, prescribes an opioid antidote. "Prescriber" includes, but is not limited to, a physician, physician assistant, or advanced practice nurse.
"Professional" means a person, other than a health care practitioner, who is employed on a paid basis or is engaged on a volunteer basis in the areas of substance abuse treatment or therapy, criminal justice, or a related area, and who, acting in that person's professional or volunteer capacity, obtains an opioid antidote from a health care practitioner for the purposes of dispensing or administering that antidote to other parties in the course of business or volunteer activities. "Professional" includes, but is not limited to, a sterile syringe access program employee, or a law enforcement official.
"Professional entity" means an organization, company, governmental entity, community-based program, sterile syringe access program, or any other organized group that employs two or more professionals who engage, during the regular course of business or volunteer activities, in direct interactions with opioid or heroin addicts or abusers or other persons susceptible to opioid overdose, or with other persons who are in a position to provide direct medical assistance to opioid or heroin addicts or abusers in the event of an overdose.
"Recipient" means a patient, pharmacist, health care practitioner, professional, professional entity, emergency medical responder, or emergency medical response entity who is prescribed or dispensed an opioid antidote in accordance with section 4 of P.L.2013, c.46 (C.24:6J-4).
(cf: P.L.2015, c.10, s.1)
2. Section 4 of P.L.2013, c.46 (C.24:6J-4) is amended to read as follows:
4. a. (1) A prescriber may prescribe an opioid antidote, through a standing order, to any pharmacist or health care practitioner in the State, as may be necessary to enable the pharmacist or health care practitioner to dispense the opioid antidote to third parties, in accordance with paragraph (2) of this subsection.
(2) A prescriber may prescribe, and a pharmacist or other health care practitioner [, as appropriate,] may [prescribe or] dispense , an opioid antidote:
(a) directly or through a standing order, to any recipient who is deemed by the health care practitioner to be capable of administering the opioid antidote to an overdose victim in an emergency;
(b) through a standing order, to any professional or emergency medical responder who is not acting in a professional or volunteer capacity for a professional entity, or for an emergency medical response entity, but who is deemed by the health care practitioner to be capable of administering opioid antidotes to overdose victims, as part of the professional's regular course of business or volunteer activities;
(c) through a standing order, to any professional who is not acting in a professional or volunteer capacity for a professional entity, but who is deemed by the health care practitioner to be capable of dispensing opioid antidotes to recipients, for administration thereby, as part of the professional's regular course of business or volunteer activities;
(d) through a standing order, to any professional entity or any emergency medical response entity, which is deemed by the health care practitioner to employ professionals or emergency medical responders, as appropriate, who are capable of administering opioid antidotes to overdose victims as part of the entity's regular course of business or volunteer activities;
(e) through a standing order, to any professional entity which is deemed by the health care practitioner to employ professionals who are capable of dispensing opioid antidotes to recipients, for administration thereby, as part of the entity's regular course of business or volunteer activities.
[(2)] (3) (a) For the purposes of this subsection, whenever the law expressly authorizes or requires a certain type of professional or professional entity to obtain a standing order for opioid antidotes pursuant to this section, such professional, or the professionals employed or engaged by such professional entity, as the case may be, shall be presumed by the prescribing or dispensing health care practitioner to be capable of administering or dispensing the opioid antidote, consistent with the express statutory requirement.
(b) For the purposes of this subsection, whenever the law expressly requires a certain type of emergency medical responder or emergency medical response entity to obtain a standing order for opioid antidotes pursuant to this section, such emergency medical responder, or the emergency medical responders employed or engaged by such emergency medical response entity, as the case may be, shall be presumed by the prescribing or dispensing health care practitioner to be capable of administering the opioid antidote, consistent with the express statutory requirement.
[(3)] (4) (a) Whenever a prescriber [or other health care practitioner prescribes or dispenses an opioid antidote to a professional or professional entity] issues a standing order pursuant to [a standing order issued under paragraph (1) of] this subsection, the standing order shall specify whether the [professional or professional entity] recipient is authorized thereby to directly administer the opioid antidote to overdose victims; to dispense the opioid antidote to other recipients, for their administration to third parties; or to both administer and dispense the opioid antidote. If a standing order does not include a specification in this regard, it shall be deemed to authorize the [professional or professional entity] recipient only to administer the opioid antidote with immunity, as provided by subsection c. or d. of this section, as appropriate, and it shall not be deemed to authorize the [professional or professional entity] recipient to engage in the further dispensing of the antidote [to recipients], unless such authority has been granted by law, as provided by subparagraph (b) of this paragraph.
(b) Notwithstanding the provisions of this paragraph to the contrary, if the law expressly authorizes or requires a certain type of [professional, professional entity, emergency medical responder, or emergency medical response entity] recipient to administer or dispense opioid antidotes pursuant to a standing order issued hereunder, the standing order issued pursuant to this section shall be deemed to grant the authority specified by the law, even if such authority is not expressly indicated on the face of the standing order.
[(4)] (5) Any prescriber , pharmacist, or other health care practitioner who prescribes or dispenses an opioid antidote in good faith, and in accordance with the provisions of this subsection, shall not, as a result of the practitioner's acts or omissions, be subject to any criminal or civil liability, or any professional disciplinary action under Title 45 of the Revised Statutes for prescribing or dispensing an opioid antidote in accordance with P.L.2013, c.46 (C.24:6J-1 et [seq.] al.).
b. (1) Any professional or professional entity that has obtained a standing order, pursuant to subsection a. of this section, for the dispensing of opioid antidotes, may dispense an opioid antidote to any recipient who is deemed by the professional or professional entity to be capable of administering the opioid antidote to an overdose victim in an emergency.
(2) Any professional or professional entity that dispenses an opioid antidote in accordance with paragraph (1) of this subsection, in good faith, and pursuant to a standing order issued under subsection a. of this section, shall not, as a result of any acts or omissions, be subject to any criminal or civil liability or any professional disciplinary action for dispensing an opioid antidote in accordance with P.L.2013, c.46 (C.24:6J-1 et [seq.] al.).
c. (1) Any emergency medical responder or emergency medical response entity that has obtained a standing order, pursuant to subsection a. of this section, for the administration of opioid antidotes, may administer an opioid antidote to overdose victims.
(2) Any emergency medical responder or emergency medical response entity that administers an opioid antidote, in good faith, in accordance with paragraph (1) of this subsection, and pursuant to a standing order issued under subsection a. of this section, shall not, as a result of any acts or omissions, be subject to any criminal or civil liability, or any disciplinary action, for administering the opioid antidote in accordance with P.L.2013, c.46 (C.24:6J-1 et [seq.] al.)
d. (1) Any person who is the recipient of an opioid antidote [, which has been] prescribed or dispensed for administration purposes pursuant to subsection a. or b. of this section, who is not subject to the provisions of subsection c. of this section, and who has received overdose prevention information pursuant to section 5 of P.L.2013, c.46 (C.24:6J-5), may administer the opioid antidote to another person in an emergency, without fee, if the antidote recipient believes, in good faith, that the other person is experiencing an opioid overdose.
(2) Any person who administers an opioid antidote pursuant to paragraph (1) of this subsection shall not, as a result of the person's acts or omissions, be subject to any criminal or civil liability for administering the opioid antidote in accordance with P.L.2013, c.46 (C.24:6J-1 et [seq.] al.).
e. In addition to the immunity that is provided by this section for authorized persons who are engaged in the prescribing, dispensing, or administering of an opioid antidote, the immunity provided by section 7 or section 8 of P.L.2013, c.46 (C.2C:35-30 or C.2C:35-31) shall apply to a person who acts in accordance with this section, provided that the requirements of those sections, as applicable, have been met.
(cf: P.L.2015, c.10, s.2)
3. This act shall take effect immediately.
STATEMENT
This bill would amend the "Overdose Prevention Act" (OPA), P.L.2013, c.46 (C.24:6J-1 et al.) to clarify that pharmacists and health care practitioners may dispense naloxone/Narcan and other opioid antidotes pursuant to a standing order, and that a prescriber may issue such a standing order, with immunity from civil, criminal, and professional liability.
The OPA currently authorizes all "health care practitioners," including pharmacists, prescribers, and other practitioners, to dispense opioid antidotes, with immunity, "through a standing order." However, it does not expressly authorize a prescriber to issue a standing order to pharmacists and health care practitioners for dispensation purposes. The bill would correct this oversight.
In so doing, the bill would redefine the term opioid antidote "recipient" to include pharmacists and health care practitioners, and it would amend the text of the OPA to include reference to all opioid antidote recipients, where appropriate.
The bill would also make some other minor technical changes to the OPA, in order to: (1) correct erroneous citations appearing in the law; and (2) clarify that the immunity provisions of subsection d. of section 4 of the OPA (C.24:6J-4) are applicable only to those opioid recipients who are not already immunized under another provision of that section.