Health Care Availability and Access Committee
Filed: 2/16/2005
 
 

 




 

 		












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AMENDMENT TO HOUSE BILL 130




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    AMENDMENT NO. ______. Amend House Bill 130 by replacing 
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everything after the enacting clause with the following:

 
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    "Section 1. Short title. This Act may be cited as the Home 
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Health and Hospice Drug Dispensation and Administration Act.
 
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    Section 5. Legislative intent. The General Assembly 
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intends to protect the home health care and hospice services 
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patient by allowing authorized nursing employees in the home 
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health and hospice professions to have specified drugs readily 
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available when a patient may require their use.




 
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    Section 10. Definitions. In this Act: 
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    "Authorized nursing employee" means a registered nurse or  
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advanced practice nurse, as defined in the Nursing and Advanced 
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Practice Nursing Act, who is employed by a home health agency 
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or hospice licensed in this State.
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    "Home health agency" has the meaning ascribed to it in 
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Section 2.04 of the Home Health Agency Licensing Act.

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    "Hospice" means a full hospice, as defined in Section 3 of 
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the Hospice Program Licensing Act. 
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    "Physician" means a physician licensed under the Medical 
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Practice Act of 1987 to practice medicine in all its branches.
 
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    Section 15. Purchase of specified drugs. A home health 
 


 






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agency or hospice may purchase sealed portable containers of 
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drugs specified in Section 20 of this Act pursuant to a 
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prescription from its medical director who is a physician or 
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from a physician for the purpose of administration to the 
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agency's or hospice's patients under the patient's treating 
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physician's orders.
 
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    Section 20. Possession of specified drugs. 
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    (a)    A home health agency, hospice, or authorized  nursing 
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employee of an agency or hospice, in compliance with this 
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Section, may possess or transport the following specified drugs 
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in a sealed portable container for the purpose of 
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administration to the agency's or hospice's patients pursuant 
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to the patient's treating physician's orders:


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        (1)   Sterile saline in a sealed portable container of a 
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    size determined by the dispensing pharmacist.
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        (2) Sterile water.
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        (3)   Not more than 5 dosage units of any of the 
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    following items in an individually sealed, unused portable 
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    container:


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            (A)  Heparin sodium lock flush in a concentration of 
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        10 units per milliliter or 100 units per milliliter.
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            (B) Epinephrine HCI solution in a concentration of 
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        one to 1,000.


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        (4)   Not more than 2 dosage units of Diphenhydramine 
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    (Benadryl) 50 milligrams intravenously in an individually 
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    sealed, unused portable container, clearly labeled, and 
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    placed in a protective carrier.
 
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    Section 25. Proper procedures. 
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    (a)                            A home health agency, hospice, or authorized nursing 
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employee of an agency or hospice may purchase, possess, or 
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transport drugs listed in Section 20 of this Act in a sealed 
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portable container only if the agency or hospice has 
 


 






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established policies and procedures to ensure that:


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        (1)    the container is handled properly with respect to 
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    storage, transportation, and temperature stability;
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        (2)   a drug is removed from the container only on a 
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    physician's written or oral order;
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        (3)   the administration of any drug in the container is 
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    performed in accordance with a specific treatment 
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    protocol; and
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        (4)   the agency or hospice maintains a written signature 
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    record of the dates and times the container is in the 
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    possession of an authorized nursing employee.

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    (b)                            An authorized nursing employee of an agency or hospice 
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who administers a drug listed in Section 20 of this Act may 
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administer the drug only in the patient's residence under a 
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treating physician's orders in connection with the provision of 
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emergency treatment or the adjustment of parenteral drug 
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therapy.
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    (c)                            When an authorized nursing employee of an agency or 
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hospice administers a drug listed in Section 20 of this Act 
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pursuant to a treating physician's oral order, the authorized 
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nursing employee or the agency or hospice shall

reduce the 
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order to written form and send this written confirmation  to the 
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patient's treating physician by mail or facsimile 
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transmission, not later than 24 hours after receipt of the 
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order.
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    (d)                            A pharmacist who dispenses a sealed portable container 
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under Section 20 of this Act shall ensure that the container:


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        (1)   Is designed to allow access to the contents of the 
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    container only if a tamper-proof seal is broken.
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        (2)   Bears a label that lists the drugs in the container 
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    and provides notice of the container's expiration date, 
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    which is the earlier of:
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            (A) the date that is 6 months after the date on 
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        which the container is dispensed; or 
 


 






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            (B) the earliest expiration date of any drug in the 
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        container.
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    (e)                              A pharmacy that dispenses a sealed portable container 
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under this Act shall provide written instructions and counsel  
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the authorized nursing employee of a home health agency or 
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hospice on the safe storage, transportation, and temperature 
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stability of the contents of the sealed container.
 

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    Section 99. Effective date. This Act takes effect upon 
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becoming law.".