Revision: Jan. 13, 2016, midnight
\t \t\tSB 447-FN - AS INTRODUCED
2016 SESSION
\t16-2955
\t01/10
SENATE BILL\t447-FN
AN ACT\trelative to the controlled drug prescription health and safety program and establishing a commission to study Narcan.
SPONSORS:\tSen. Sanborn, Dist 9; Sen. Avard, Dist 12; Sen. Birdsell, Dist 19; Sen. Boutin, Dist 16; Sen. Carson, Dist 14; Sen. Cataldo, Dist 6
COMMITTEE:\tJudiciary
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ANALYSIS
\tThis bill makes various changes to the controlled drug prescription health and safety program, including:
\tI. Requiring prescribers to submit prescription requests to the program prior to prescribing controlled drugs.
\tII. Requiring opioid agreements between prescribers and patients if the patient is using opioids for more than 90 days within any 6-month period.
\tIII. Authorizing the program to allow access to information by the office of the chief medical examiner.
\tIV. Requiring all controlled drugs sold in New Hampshire to be tamper proof.
\tV. Establishing a commission to study Narcan.
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Explanation:\tMatter added to current law appears in bold italics.
\t\tMatter removed from current law appears [in brackets and struckthrough.]
\t\tMatter which is either (a) all new or (b) repealed and reenacted appears in regular type.
\t16-2955
\t01/10
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Sixteen
AN ACT\trelative to the controlled drug prescription health and safety program and establishing a commission to study Narcan.
Be it Enacted by the Senate and House of Representatives in General Court convened:
\t1 Controlled Drug Prescription Health and Safety Program; Definitions. Amend RSA 318-B:31, VI to read as follows:
\t\tVI. "Practitioner'' means a physician, dentist, podiatrist, veterinarian, pharmacist, APRN, physician assistant, naturopath, or other person licensed or otherwise permitted to prescribe, dispense, or administer a controlled substance in the course of licensed professional practice. "Practitioner" shall also include practitioners with a federal license to prescribe or administer a controlled substance.
\t2 Controlled Drug Prescription Health and Safety Program; Access to Program. Amend RSA 318-B:33, II-a to read as follows:
\t\tII-a. Only registered prescribers [and], dispensers, and the office of the chief medical examiner shall be eligible to access the program.
\t3 New Paragraph; Controlled Drug Prescription Health and Safety Program Operation; Reports Required. Amend RSA 318-B:33 by inserting after paragraph VIII the following new paragraph:
\t\tIX. The board shall submit a monthly report to the commissioner of the department of health and human services relative to prescriptions written as compared to prescriptions delivered.
\t4 New Paragraphs; Program Information. Amend RSA 318-B:35 by inserting after paragraph III the following new paragraphs:
\t\tIV. The program information shall be updated daily.
\t\tV. The program may access information of any other national data service.
\t5 New Sections; Registrants Required to Submit Requests to the Program Prior to Prescribing Controlled Substances; Opioid Agreements. Amend RSA 318-B by inserting after section 38 the following new sections:
\t318-B:39 Practitioners Required to Submit Requests to the? Program Prior to Prescribing Controlled Substances.
\t\tI. Practitioners required to register with the program under this subdivision shall submit prescription requests, including renewals, for controlled substances to the program. Prescription requests shall be in electronic form only.
\t\tII. Notwithstanding paragraph I, a practitioner may issue an emergency prescription for no longer than 5 days; provided, that the practitioner submits the request as soon as practicable to the program.
\t318-B:40 Opioid Agreements Required. A practitioner and his or her patient shall enter into an opioid treatment agreement if the patient is using opioids for more than 90 days within any 6-month period. The agreement shall include, but not be limited to:
\t\tI. The medical basis for the use of opioids.
\t\tII. A statement of the risks and potential side effects of long-term use of opioids.
\t\tIII. The patient's agreement to seek opioids only from the practitioner with whom the agreement is made and to not share the medication with others.
\t\tIV. The name of the single pharmacy at which the prescription will be filled.
\t\tV. The patient's agreement to forego controlled substances not included in the pain management agreement.
\t\tVI. Permission for the practitioner to conduct random drug tests to verify the proper use of the prescription.
\t\tVII. A statement of the consequences of violating the agreement, including that if the patient breaches the agreement, the practitioner may stop prescribing the pain-control medicines or terminate the practitioner–patient relationship.
\t\tVIII. Any other provisions to which the patient and the practitioner agree.
\t6 New Section; Controlled Drugs; Tamper Proof. Amend RSA 318-B by inserting after section 1-c the following new section:
\t318-B:1-d Controlled Drugs Required to be Tamper Proof. Controlled drugs and controlled drug analogs subject to regulation under this chapter shall be sold only in a tamper-proof form.
\t7 New Subdivision; Commission to Study Narcan. Amend RSA 126-A by inserting after section 68 the following new subdivision:
Commission to Study Narcan
\t126-A:69 Commission Established; Membership; Duties.
\t\tI. There is established a commission to study Narcan.
\t\t\t(a) The members of the commission shall be as follows:
\t\t\t\t(1) One member of the senate, appointed by the president of the senate.
\t\t\t\t(2) Two members of the house of representatives, appointed by the speaker of the house of representatives.
\t\t\t\t(3) The commissioner of the department of health and human services, or designee.
\t\t\t\t(4) A pharmacist, appointed by the board.
\t\t\t\t(5) A licensed alcohol and drug counselor, appointed by the chairperson of the board of licensing for alcohol and other drug use professionals.
\t\t\t\t(6) A licensed physician, appointed by the board of medicine.
\t\t\t\t(7) An emergency medical technician, appointed by the director of the division of fire standards and training and emergency medical services, department of safety.
\t\t\t\t(8) A public member, appointed by the governor.
\t\t\t\t(9) A public member, appointed by the senate president.
\t\t\t\t(10) A public member, appointed by the speaker of the house of representatives.
\t\t\t(b) Legislative members of the commission shall receive mileage at the legislative rate when attending to the duties of the commission.
\t\tII.(a) The commission shall study all aspects of Narcan, including, but not limited to:
\t\t\t\t(1) Whether there should be a registry established for those in possession of Narcan.
\t\t\t\t(2) The training required regarding dosage, conditions for administering Narcan, and other appropriate training.
\t\t\t\t(3) Whether there should be mandatory reporting of use of Narcan.
\t\t\t\t(4) Whether those persons who are administered Narcan should be required to go to outpatient treatment for a certain period of time.
\t\t\t(b) The commission shall solicit information from any person or entity the commission deems relevant to its study.
\t\tIII. The members of the commission shall elect a chairperson from among the members. The first meeting of the commission shall be called by the senate member. The first meeting of the commission shall be held within 45 days of the effective date of this section. Six members of the commission shall constitute a quorum.
\t\tIV. The commission shall report its findings and any recommendations for proposed legislation to the president of the senate, the speaker of the house of representatives, the senate clerk, the house clerk, the governor, and the state library on or before November 1, 2016.
\t8 Repeal. RSA 126-A:69, relative to a commission to study Narcan, is repealed.
\t\tI. Section 7 of this act shall take effect upon its passage.
\t\tII. Section 8 of this act shall take effect November 1, 2016.
\t\tIII. The remainder of this act shall take effect January 1, 2017.
\t\t\t\t\t\t\t\t\t\t\t16-2955
\t\t\t\t\t\t\t\t\t\t\t12/29/15
SB 447-FN- FISCAL NOTE
AN ACT\trelative to the controlled drug prescription health and safety program and establishing a commission to study Narcan.
FISCAL IMPACT:
The Office of Professional Licensure and Certification states this bill, as introduced, will increase state general fund expenditures in FY 2017, and may increase state general fund expenditures in FY 2018 and each year thereafter. There will be no impact on county or local expenditures, or on state, county, or local revenue.
The Office of Legislative Budget Assistant is awaiting information from the Department of Health and Human Services relative to the potential fiscal impact of this bill. The Department was last contacted on 12/29/15 to provide the information.
METHODOLOGY:
The Office of Professional Licensure and Certification states this bill requires prescribers to submit requests to the Prescription Health and Safety Program (Program) prior to prescribing controlled drugs. The Office states that the existing Program software is inadequate to support the mandatory use and enhanced reporting requirements contained in the bill, and will require an upgrade. The Office notes that the bill provides no appropriation for the Program to upgrade its software. The vendor that supplies the software indicates the cost will be at least $100,000 to $150,000, but the exact cost is indeterminable as of this writing. The Office is unable to determine whether the upgrade will result in ongoing cost increases beyond FY 2017. The Office further notes that at the present time, the Program funds it operations exclusively through the acceptance of grants, gifts, and user contributions.