Representative Carol Spackman Moss proposes the following substitute bill:


1     
OPIATE OVERDOSE RESPONSE ACT AMENDMENTS

2     
2017 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Carol Spackman Moss

5     
Senate Sponsor: Brian E. Shiozawa

6     

7     LONG TITLE
8     General Description:
9          This bill amends civil liability in the Opiate Overdose Response Act.
10     Highlighted Provisions:
11          This bill:
12          ▸     identifies the persons who are not civilly liable when administering an opiate
13     antagonist under certain circumstances;
14          ▸     permits an overdose outreach provider to furnish an opiate antagonist to another
15     overdose outreach provider; and
16          ▸     makes technical changes.
17     Money Appropriated in this Bill:
18          None
19     Other Special Clauses:
20          None
21     Utah Code Sections Affected:
22     AMENDS:
23          26-55-102, as last amended by Laws of Utah 2016, Chapters 127, 202, 207, and 208
24          26-55-104, as last amended by Laws of Utah 2016, Chapters 202, 207, 208 and last
25     amended by Coordination Clause, Laws of Utah 2016, Chapter 202

26          26-55-106, as enacted by Laws of Utah 2016, Chapter 207 and last amended by
27     Coordination Clause, Laws of Utah 2016, Chapter 202
28          58-17b-501, as last amended by Laws of Utah 2013, Chapter 262
29     

30     Be it enacted by the Legislature of the state of Utah:
31          Section 1. Section 26-55-102 is amended to read:
32          26-55-102. Definitions.
33          As used in this chapter:
34          (1) "Controlled substance" means the same as that term is defined in Title 58, Chapter
35     37, Utah Controlled Substances Act.
36          (2) "Dispense" means the same as that term is defined in Section 58-17b-102.
37          (3) "Health care facility" means a hospital, a hospice inpatient residence, a nursing
38     facility, a dialysis treatment facility, an assisted living residence, an entity that provides home-
39     and community-based services, a hospice or home health care agency, or another facility that
40     provides or contracts to provide health care services, which facility is licensed under Chapter
41     21, Health Care Facility Licensing and Inspection Act.
42          (4) "Health care provider" means:
43          (a) a physician, as defined in Section 58-67-102;
44          (b) an advanced practice registered nurse, as defined in Section 58-31b-102;
45          (c) a physician assistant, as defined in Section 58-70a-102; or
46          (d) an individual licensed to engage in the practice of dentistry, as defined in Section
47     58-69-102.
48          (5) "Increased risk" means risk exceeding the risk typically experienced by an
49     individual who is not using, and is not likely to use, an opiate.
50          (6) "Local health department" means:
51          (a) a local health department, as defined in Section 26A-1-102; or
52          (b) a multicounty local health department, as defined in Section 26A-1-102.
53          (7) "Opiate" means the same as that term is defined in Section 58-37-2.
54          (8) "Opiate antagonist" means naloxone hydrochloride or any similarly acting drug that
55     is not a controlled substance and that is approved by the federal Food and Drug Administration
56     for the diagnosis or treatment of an opiate-related drug overdose.

57          (9) "Opiate-related drug overdose event" means an acute condition, including a
58     decreased level of consciousness or respiratory depression resulting from the consumption or
59     use of a controlled substance, or another substance with which a controlled substance was
60     combined, and that a person would reasonably believe to require medical assistance.
61          (10) "Overdose outreach provider" means:
62          (a) a law enforcement agency;
63          (b) a fire department;
64          (c) an emergency medical service provider, as defined in Section 26-8a-102;
65          (d) emergency medical service personnel, as defined in Section 26-8a-102;
66          (e) an organization providing treatment or recovery services for drug or alcohol use;
67          (f) an organization providing support services for an individual, or a family of an
68     individual, with a substance use disorder;
69          (g) an organization providing substance use or mental health services under contract
70     with a local substance abuse authority, as defined in Section 62A-15-102, or a local mental
71     health authority, as defined in Section 62A-15-102;
72          (h) an organization providing services to the homeless;
73          (i) a local health department; [or]
74          (j) an individual licensed to practice pharmacy under Title 58, Chapter 17b, Pharmacy
75     Practice Act; or
76          [(j)] (k) an individual.
77          (11) "Patient counseling" means the same as that term is defined in Section
78     58-17b-102.
79          (12) "Pharmacist" means the same as that term is defined in Section 58-17b-102.
80          (13) "Pharmacy intern" means the same as that term is defined in Section 58-17b-102.
81          (14) "Prescribe" means the same as that term is defined in Section 58-17b-102.
82          Section 2. Section 26-55-104 is amended to read:
83          26-55-104. Prescribing, dispensing, and administering an opiate antagonist --
84     Immunity from liability.
85          (1) (a) (i) For purposes of Subsection (1)(a)(ii), "a person other than a health care
86     facility or health care provider" includes the following, regardless of whether the person has
87     received funds from the department through the Opiate Overdose Outreach Pilot Program

88     created in Section 26-55-107:
89          (A) a person described in Subsections 26-55-107(1)(a)(i)(A) through (1)(a)(i)(F); or
90          (B) an organization, defined by department rule made under Subsection
91     26-55-107(7)(e), that is in a position to assist an individual who is at increased risk of
92     experiencing an opiate-related drug overdose event.
93          (ii) Except as provided in Subsection (1)(b), [a person, including an overdose outreach
94     provider, but not including a health care facility or health care provider, that] the following
95     individuals are not liable for any civil damages for acts or omissions made as a result of
96     administering an opiate antagonist when the individual acts in good faith to administer [an] the
97     opiate antagonist to an individual whom the person believes to be experiencing an
98     opiate-related drug overdose event [is not liable for any civil damages for acts or omissions
99     made as a result of administering the opiate antagonist.]:
100          (A) an overdose outreach provider; or
101          (B) a person other than a health care facility or health care provider.
102          (b) A health care provider:
103          (i) [does] is not [have immunity] immune from liability under Subsection (1)(a) when
104     the health care provider is acting within the scope of the health care provider's responsibilities
105     or duty of care; and
106          (ii) [does have immunity] is immune from liability under Subsection (1)(a) if the health
107     care provider is under no legal duty to respond and otherwise complies with Subsection (1)(a).
108          (2) Notwithstanding Sections 58-1-501, 58-17b-501, and 58-17b-502, a health care
109     provider who is licensed to prescribe an opiate antagonist may prescribe, including by a
110     standing prescription drug order issued in accordance with Subsection 26-55-105(2), or
111     dispense an opiate antagonist:
112          (a) (i) to an individual who is at increased risk of experiencing an opiate-related drug
113     overdose event;
114          (ii) for an individual described in Subsection (2)(a)(i), to a family member [of], friend
115     [of], or other person, including a person described in Subsections 26-55-107(1)(a)(i)(A)
116     through (1)(a)(i)(F), that is in a position to assist [an] the individual [who is at increased risk of
117     experiencing an opiate-related drug overdose event]; or
118          (iii) to an overdose outreach provider for:

119          (A) furnishing the opiate antagonist to an individual [who is at increased risk of
120     experiencing an opiate-related drug overdose event, or to a family member of, friend of, or
121     other individual who is in a position to assist an individual who is at increased risk of
122     experiencing an opiate-related drug overdose event] described in Subsection (2)(a)(i) or (ii), as
123     provided in Section 26-55-106; or
124          (B) administering to an individual experiencing an opiate-related drug overdose event;
125          (b) without a prescriber-patient relationship; and
126          (c) without liability for any civil damages for acts or omissions made as a result of
127     prescribing or dispensing the opiate antagonist in good faith.
128          (3) A health care provider who dispenses an opiate antagonist to an individual or an
129     overdose outreach provider under Subsection (2)(a) shall provide education to the individual or
130     overdose provider that includes written instruction on how to:
131          (a) recognize an opiate-related drug overdose event; and
132          (b) respond appropriately to an opiate-related drug overdose event, including how to:
133          (i) administer an opiate antagonist; and
134          (ii) ensure that an individual to whom an opiate antagonist has been administered
135     receives, as soon as possible, additional medical care and a medical evaluation.
136          Section 3. Section 26-55-106 is amended to read:
137          26-55-106. Overdose outreach providers.
138          Notwithstanding Sections 58-1-501, 58-17b-501, and 58-17b-502:
139          (1) an overdose outreach provider may:
140          (a) obtain an opiate antagonist dispensed on prescription by:
141          (i) a health care provider, in accordance with Subsections 26-55-104(2) and (3); or
142          (ii) a pharmacist or pharmacy intern, as otherwise authorized by Title 58, Chapter 17b,
143     Pharmacy Practice Act;
144          (b) store the opiate antagonist; and
145          (c) furnish the opiate antagonist:
146          (i) (A) to an individual who is at increased risk of experiencing an opiate-related drug
147     overdose event; or
148          (B) to a family member [of], friend [of], overdose outreach provider, or other
149     individual who is in a position to assist an individual who is at increased risk of experiencing

150     an opiate-related drug overdose event; and
151          (ii) without liability for any civil damages for acts or omissions made as a result of
152     furnishing the opiate antagonist in good faith; and
153          (2) when furnishing an opiate antagonist under Subsection (1), an overdose outreach
154     provider:
155          (a) shall also furnish to the recipient of the opiate antagonist:
156          (i) the written instruction under Subsection 26-55-104(3) received by the overdose
157     outreach provider from the health care provider at the time the opiate antagonist was dispensed
158     to the overdose outreach provider; or
159          (ii) if the opiate antagonist was dispensed to the overdose outreach provider by a
160     pharmacist or pharmacy intern, any written patient counseling under Section 58-17b-613
161     received by the overdose outreach provider at the time of dispensing; and
162          (b) may provide additional instruction on how to recognize and respond appropriately
163     to an opiate-related drug overdose event.
164          Section 4. Section 58-17b-501 is amended to read:
165          58-17b-501. Unlawful conduct.
166          "Unlawful conduct" includes:
167          (1) knowingly preventing or refusing to permit an authorized agent of the division to
168     conduct an inspection pursuant to Section 58-17b-103;
169          (2) failing to deliver the license, permit, or certificate to the division upon demand, if it
170     has been revoked, suspended, or refused;
171          (3) (a) using the title "pharmacist," "druggist," "pharmacy intern," "pharmacy
172     technician," or a term having similar meaning, except by a person licensed as a pharmacist,
173     pharmacy intern, or pharmacy technician; or
174          (b) conducting or transacting business under a name that contains, as part of that name,
175     the words "drugstore," "pharmacy," "drugs," "medicine store," "medicines," "drug shop,"
176     "apothecary," "prescriptions," or a term having a similar meaning, or in any manner
177     advertising, otherwise describing, or referring to the place of the conducted business or
178     profession, unless the place is a pharmacy issued a license by the division, except an
179     establishment selling nonprescription drugs and supplies may display signs bearing the words
180     "packaged drugs," "drug sundries," or "nonprescription drugs," and is not considered to be a

181     pharmacy or drugstore by reason of the display;
182          (4) buying, selling, causing to be sold, or offering for sale, a drug or device that bears,
183     or the package bears or originally did bear, the inscription "sample," "not for resale," "for
184     investigational or experimental use only," or other similar words, except when a cost is
185     incurred in the bona fide acquisition of an investigational or experimental drug;
186          (5) using to a person's own advantages or revealing to anyone other than the division,
187     board, and its authorized representatives, or to the courts, when relevant to a judicial or
188     administrative proceeding under this chapter, information acquired under authority of this
189     chapter or concerning a method of process that is a trade secret;
190          (6) procuring or attempting to procure a drug or to have someone else procure or
191     attempt to procure a drug:
192          (a) by fraud, deceit, misrepresentation, or subterfuge;
193          (b) by forgery or alteration of a prescription or a written order;
194          (c) by concealment of a material fact;
195          (d) by use of a false statement in a prescription, chart, order, or report; or
196          (e) by theft;
197          (7) filling, refilling, or advertising the filling or refilling of prescriptions for a
198     consumer or patient residing in this state if the person is not licensed:
199          (a) under this chapter; or
200          (b) in the state from which he is dispensing;
201          (8) requiring an employed pharmacist, pharmacy intern, pharmacy technician, or
202     authorized supportive personnel to engage in conduct in violation of this chapter;
203          (9) being in possession of a prescription drug for an unlawful purpose;
204          (10) dispensing a prescription drug to a person who does not have a prescription from a
205     practitioner, except as permitted under Title 26, Chapter 55, Opiate Overdose Response Act, or
206     to a person who the person dispensing the drug knows or should know is attempting to obtain
207     drugs by fraud or misrepresentation;
208          (11) selling, dispensing, distributing, or otherwise trafficking in prescription drugs
209     when not licensed to do so or when not exempted from licensure; and
210          (12) a person using a prescription drug or controlled substance that was not lawfully
211     prescribed for the person by a practitioner.