75R10850 PEP-F
By Berlanga H.B. No. 3075
Substitute the following for H.B. No. 3075:
By Berlanga C.S.H.B. No. 3075
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the possession of dangerous drugs by a home and
1-3 community support services agency.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Subchapter A, Chapter 142, Health and Safety
1-6 Code, is amended by amending Section 142.0061 and adding Sections
1-7 142.0062 and 142.0063 to read as follows:
1-8 Sec. 142.0061. POSSESSION OF STERILE WATER OR SALINE
1-9 [DANGEROUS DRUGS]. A home and community support services agency or
1-10 its employees who are registered nurses or licensed vocational
1-11 nurses may purchase, store, or transport for the purpose of
1-12 administering to their home health or hospice patients under
1-13 physician's orders [the following dangerous drugs]:
1-14 (1) sterile water for injection and irrigation; and
1-15 (2) sterile saline for injection and irrigation.
1-16 Sec. 142.0062. POSSESSION OF CERTAIN VACCINES OR TUBERCULIN.
1-17 (a) A home and community support services agency or its employees
1-18 who are registered nurses or licensed vocational nurses may
1-19 purchase, store, or transport for the purpose of administering to
1-20 the agency's employees, home health or hospice patients, or patient
1-21 family members under physician's standing orders the following
1-22 dangerous drugs:
1-23 (1) hepatitis B vaccine;
1-24 (2) influenza vaccine; and
2-1 (3) tuberculin purified protein derivative for
2-2 tuberculosis testing.
2-3 (b) A home and community support services agency that
2-4 purchases, stores, or transports a vaccine or tuberculin under this
2-5 section shall ensure that any standing order for the vaccine or
2-6 tuberculin:
2-7 (1) is signed and dated by the physician;
2-8 (2) identifies the vaccine or tuberculin covered by
2-9 the order;
2-10 (3) indicates that the recipient of the vaccine or
2-11 tuberculin has been assessed as an appropriate candidate to receive
2-12 the vaccine or tuberculin and has been assessed for the absence of
2-13 any contraindication;
2-14 (4) indicates that appropriate procedures are
2-15 established for responding to any negative reaction to the vaccine
2-16 or tuberculin; and
2-17 (5) orders that a specific medication or category of
2-18 medication be administered if the recipient has a negative reaction
2-19 to the vaccine or tuberculin.
2-20 Sec. 142.0063. POSSESSION OF CERTAIN DANGEROUS DRUGS.
2-21 (a) A home and community support services agency in compliance
2-22 with this section or its employees who are registered nurses or
2-23 licensed vocational nurses may purchase, store, or transport for
2-24 the purpose of administering to their home health or hospice
2-25 patients in accordance with Subsection (c) the following dangerous
2-26 drugs:
2-27 (1) any of the following items in a sealed portable
3-1 container of a size determined by the dispensing pharmacist:
3-2 (A) 1,000 milliliters of 0.9 percent sodium
3-3 chloride intravenous infusion;
3-4 (B) 1,000 milliliters of five percent dextrose
3-5 in water injection; or
3-6 (C) sterile saline; or
3-7 (2) not more than five dosage units of any of the
3-8 following items in an individually sealed, unused portable
3-9 container:
3-10 (A) heparin sodium lock flush in a concentration
3-11 of 10 units per milliliter or 100 units per milliliter;
3-12 (B) epinephrine HCl solution in a concentration
3-13 of 1 to 1,000;
3-14 (C) diphenhydramine HCl solution in a
3-15 concentration of 50 milligrams per milliliter;
3-16 (D) methylprednisolone in a concentration of 125
3-17 milligrams per two milliliters;
3-18 (E) naloxone in a concentration of one milligram
3-19 per milliliter in a two-milliliter vial;
3-20 (F) promethazine in a concentration of 25
3-21 milligrams per milliliter;
3-22 (G) glucagon in a concentration of one milligram
3-23 per milliliter;
3-24 (H) furosemide in a concentration of 10
3-25 milligrams per milliliter;
3-26 (I) lidocaine 2.5 percent and prilocaine 2.5
3-27 percent cream in a five-gram tube; or
4-1 (J) lidocaine HCl solution in a concentration of
4-2 one percent in a two-milliliter vial.
4-3 (b) A home and community support services agency or the
4-4 agency's authorized employees may purchase, store, or transport
4-5 dangerous drugs in a sealed portable container under this section
4-6 only if the agency has established policies and procedures to
4-7 ensure that:
4-8 (1) the container is handled properly with respect to
4-9 storage, transportation, and temperature stability;
4-10 (2) a drug is removed from the container only on a
4-11 physician's written or oral order;
4-12 (3) the administration of any drug in the container is
4-13 performed in accordance with a specific treatment protocol; and
4-14 (4) the agency maintains a written record of the dates
4-15 and times the container is in the possession of a registered nurse
4-16 or licensed vocational nurse.
4-17 (c) A home and community support services agency or the
4-18 agency's authorized employee who administers a drug listed in
4-19 Subsection (a) may administer the drug only in the patient's
4-20 residence under physician's orders in connection with the provision
4-21 of emergency treatment or the adjustment of:
4-22 (1) parenteral drug therapy; or
4-23 (2) vaccine or tuberculin administration.
4-24 (d) If a home and community support services agency or the
4-25 agency's authorized employee administers a drug listed in
4-26 Subsection (a) pursuant to a physician's oral order, the physician
4-27 shall promptly send a signed copy of the order to the agency, and
5-1 the agency shall:
5-2 (1) not later than 24 hours after receipt of the
5-3 order, reduce the order to written form and send a copy of the form
5-4 to the dispensing pharmacy by mail or facsimile transmission; and
5-5 (2) not later than 20 days after receipt of the order,
5-6 send a copy of the order as signed by and received from the
5-7 physician to the dispensing pharmacy.
5-8 (e) A pharmacist that dispenses a sealed portable container
5-9 under this section shall ensure that the container:
5-10 (1) is designed to allow access to the contents of the
5-11 container only if a tamper-proof seal is broken;
5-12 (2) bears a label that lists the drugs in the
5-13 container and provides notice of the container's expiration date,
5-14 which is the earlier of:
5-15 (A) the date that is six months after the date
5-16 on which the container is dispensed; or
5-17 (B) the earliest expiration date of any drug in
5-18 the container; and
5-19 (3) remains in the pharmacy or under the control of a
5-20 pharmacist, registered nurse, or licensed vocational nurse.
5-21 (f) If a home and community support services agency or the
5-22 agency's authorized employee purchases, stores, or transports a
5-23 sealed portable container under this section, the agency shall
5-24 deliver the container to the dispensing pharmacy for verification
5-25 of drug quality, quantity, integrity, and expiration dates not
5-26 later than the earlier of:
5-27 (1) the seventh day after the date on which the seal
6-1 on the container is broken; or
6-2 (2) the date for which notice is provided on the
6-3 container label.
6-4 (g) A pharmacy that dispenses a sealed portable container
6-5 under this section shall take reasonable precautionary measures to
6-6 ensure that the home and community support services agency
6-7 receiving the container complies with Subsection (f). On receipt
6-8 of a container under Subsection (f), the pharmacy shall perform an
6-9 inventory of the drugs used from the container and shall restock
6-10 and reseal the container before delivering the container to the
6-11 agency for reuse.
6-12 SECTION 2. Section 483.041(c), Health and Safety Code, is
6-13 amended to read as follows:
6-14 (c) Subsection (a) does not apply to the possession of a
6-15 dangerous drug in the usual course of business or practice or in
6-16 the performance of official duties by the following persons or an
6-17 agent or employee of the person:
6-18 (1) a pharmacy licensed by the board;
6-19 (2) a practitioner;
6-20 (3) a person who obtains a dangerous drug for lawful
6-21 research, teaching, or testing, but not for resale;
6-22 (4) a hospital that obtains a dangerous drug for
6-23 lawful administration by a practitioner;
6-24 (5) an officer or employee of the federal, state, or
6-25 local government;
6-26 (6) a manufacturer or wholesaler licensed by the
6-27 commissioner of health under Chapter 431 (Texas Food, Drug, and
7-1 Cosmetic Act);
7-2 (7) a carrier or warehouseman; or
7-3 (8) a home and community support services agency
7-4 licensed under and acting in accordance with Chapter 142[, which
7-5 may possess sterile water for injection and irrigation and sterile
7-6 saline for injection and irrigation as authorized by Section
7-7 142.0061].
7-8 SECTION 3. Section 19(f), Texas Pharmacy Act (Article
7-9 4542a-1, Vernon's Texas Civil Statutes), is amended to read as
7-10 follows:
7-11 (f) This Act does not apply to:
7-12 (1) a member of the faculty of a college of pharmacy
7-13 that is recognized by the board if the faculty member is a licensed
7-14 pharmacist and performs his services for the benefit of the college
7-15 only;
7-16 (2) a pharmacist-intern;
7-17 (3) a person who procures prescription drugs for
7-18 lawful research, teaching, or testing and not for resale; or
7-19 (4) a home and community support services agency that
7-20 possesses a dangerous drug as authorized by Section 142.0061,
7-21 142.0062, or 142.0063, Health and Safety Code.
7-22 SECTION 4. This Act takes effect September 1, 1997. The
7-23 change in law made by Section 2 of this Act applies only to an
7-24 offense committed on or after the effective date of this Act. An
7-25 offense committed before the effective date of this Act is covered
7-26 by the law in effect when the offense was committed, and the former
7-27 law is continued in effect for that purpose. For purposes of this
8-1 section, an offense was committed before the effective date of this
8-2 Act if any element of the offense occurred before that date.
8-3 SECTION 5. The importance of this legislation and the
8-4 crowded condition of the calendars in both houses create an
8-5 emergency and an imperative public necessity that the
8-6 constitutional rule requiring bills to be read on three several
8-7 days in each house be suspended, and this rule is hereby suspended.