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Second Regular Session

Sixty-first General Assembly

LLS NO. 98­0253.01 JLB HOUSE BILL 98­1015

STATE OF COLORADO

BY REPRESENTATIVE Leyba;

also SENATOR Wham.

REREVISED

HEWI

A BILL FOR AN ACT

CONCERNING CONTINUATION OF THE AUTHORITY OF THE DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT TO REGULATE THE ADMINISTRATION AND MONITORING OF MEDICATIONS IN FACILITIES BY QUALIFIED UNLICENSED PERSONS.

Bill Summary

(Note: This summary applies to this bill as introduced and does not necessarily reflect any amendments that may be subsequently adopted.)

Sunset Process ­ House Health, Environment, Welfare and Institutions Committee. Continues until July 1, 2009, the department of public health and environment's regulation of facilities that use qualified unlicensed persons to monitor and administer medication. Clarifies the facilities in which the medication administration program may be utilized. Authorizes persons to fill and label medication reminder boxes after they have been properly trained in an approved program.

Requires the next sunset review to examine the regulatory process that governs the facilities using such training programs.


Be it enacted by the General Assembly of the State of Colorado:

SECTION 1.  12­22­304 (5) (e), Colorado Revised Statutes, is amended to read:

12­22­304.  License required ­ controlled substances ­ drug precursors ­ fund created ­ repeal. (5)  The following persons need not be licensed by the department or by the board to lawfully possess controlled substances under this part 3:

(e) (I)  Employees of facilities who are administering and monitoring medications to persons under the care or jurisdiction thereof pursuant to the provisions of section 25­1­107 (1) (ee), C.R.S.

(II)  This paragraph (e) is repealed, effective July 1, 1998. Prior to such repeal, the exception to the licensure requirement set forth in this paragraph (e) shall be subject to review pursuant to the provisions of section 2­3­1201, C.R.S., by the sunrise and sunset review committee.

SECTION 2.  12­36­106 (3) (o), Colorado Revised Statutes, is amended to read:

12­36­106.  Practice of medicine defined ­ exemptions from licensing requirements ­ repeal. (3)  Nothing in this section shall be construed to prohibit, or to require a license under this article with respect to, any of the following acts:

(o) (I)  The administration and monitoring of medications in facilities as provided in section 25­1­107 (1) (ee), C.R.S.

(II)  This paragraph (o) is repealed, effective July 1, 1998. Prior to such repeal, the exemption to licensure requirement set forth in this paragraph (o) shall be subject to review by a legislative committee of reference designated pursuant to section 2­3­1201, C.R.S., to conduct the review pursuant to section 24­34­104, C.R.S., and the provisions of section 24­34­104 (5) to (12), C.R.S., concerning a wind­up period, an analysis and evaluation, public hearings, and claims by or against an agency shall apply to the operation of the program specified in this paragraph (o).

SECTION 3.  12­38­125 (1) (h), Colorado Revised Statutes, is amended to read:

12­38­125.  Exclusions. (1)  No provision of this article shall be construed to prohibit:

(h) (I)  The administration and monitoring of medications in facilities pursuant to section 25­1­107 (1) (ee), C.R.S.

(II)  This paragraph (h) is repealed, effective July 1, 1998. Prior to such repeal, the exclusion set forth in this paragraph (h) shall be subject to review by a legislative committee of reference designated pursuant to section 2­3­1201, C.R.S., to conduct the review pursuant to section 24­34­104, C.R.S., and the provisions of section 24­34­104 (5) to (12), C.R.S., concerning a wind­up period, an analysis and evaluation, public hearings, and claims by or against an agency shall apply to the operation of the program specified in this paragraph (h).

SECTION 4.  25­1­107 (1) (ee) (I.5), (1) (ee) (II.5) (I), and (1) (ee) (VI), Colorado Revised Statutes, are amended to read:

25­1­107.  Powers and duties of the department ­ repeal. (1)  The department has, in addition to all other powers and duties imposed upon it by law, the following powers and duties:

(ee) (I.5)  Medication reminder boxes or systems may be used if such containers have been filled and properly labeled by a pharmacist licensed pursuant to article 22 of title 12, C.R.S., a nurse licensed pursuant to article 38 of title 12, C.R.S., AN UNLICENSED PERSON TRAINED PURSUANT TO THIS SUBPARAGRAPH (I.5), or filled and properly labeled through the gratuitous care by members of one's family or friends. NOTHING IN THIS SUBPARAGRAPH (I.5) AUTHORIZES OR SHALL BE CONSTRUED TO AUTHORIZE THE PRACTICE OF PHARMACY, AS DEFINED IN SECTION 12-22-102 (26). Unlicensed persons may physically assist a person who is physically impaired if such impairment affects the ability of the person to use the medication reminder, if such unlicensed person is trained pursuant to the provisions of this paragraph (ee). NO UNLICENSED PERSON SHALL FILL AND LABEL MEDICATION REMINDER BOXES PURSUANT TO THIS SUBPARAGRAPH (I.5) UNTIL SUCH PERSON HAS COMPLETED APPROPRIATE TRAINING APPROVED BY THE DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT, AND NO FACILITY SHALL USE AN UNLICENSED PERSON TO PERFORM SUCH SERVICES UNLESS SUCH FACILITY HAS A QUALIFIED MANAGER TO OVERSEE THE WORK OF SUCH UNLICENSED PERSON OR PERSONS. NOTWITHSTANDING ANY PROVISION OF THIS SUBPARAGRAPH (I.5) TO THE CONTRARY, EVERY UNLICENSED PERSON SHALL BE RE-EVALUATED FOR COMPETENCY AS DESCRIBED IN SUB-SUBPARAGRAPH (B) OF SUBPARAGRAPH (I) OF THIS PARAGRAPH (ee) EVERY FOUR YEARS. THE DEPARTMENT SHALL NOT APPROVE SUCH RE-EVALUATION FOR ANY PERSON ABOUT WHOM THE DEPARTMENT HAS RECEIVED A COMPLAINT UNTIL SUCH COMPLAINT IS RESOLVED TO THE SATISFACTION OF THE DEPARTMENT. EVERY UNLICENSED PERSON AND QUALIFIED MANAGER DESCRIBED IN THIS SUBPARAGRAPH (I.5) SHALL SIGN A DISCLOSURE STATEMENT UNDER PENALTY OF PERJURY STATING THAT HE OR SHE NEVER HAD A PROFESSIONAL LICENSE TO PRACTICE NURSING, MEDICINE, OR PHARMACY REVOKED IN THIS OR ANY OTHER STATE FOR REASONS DIRECTLY RELATED TO THE ADMINISTRATION OF MEDICATIONS. FOR PURPOSES OF THIS SUBPARAGRAPH (I.5), A "QUALIFIED MANAGER" MEANS A PERSON WHO:

(A)  IS THE OWNER OR OPERATOR OF THE FACILITY OR A SUPERVISOR DESIGNATED BY THE OWNER OR OPERATOR OF THE FACILITY FOR THE PURPOSE OF IMPLEMENTING THIS SUBPARAGRAPH (I.5); AND

(B)  HAS COMPLETED TRAINING IN THE ADMINISTRATION OF MEDICATIONS PURSUANT TO THIS SUBPARAGRAPH (I.5) OR IS A LICENSED NURSE PURSUANT TO ARTICLE 38 OF TITLE 12, C.R.S., A LICENSED PHYSICIAN PURSUANT TO ARTICLE 36 OF TITLE 12, C.R.S., OR A LICENSED PHARMACIST PURSUANT TO ARTICLE 22 OF TITLE 12, C.R.S. EVERY UNLICENSED PERSON WHO IS A "QUALIFIED MANAGER" WITHIN THE MEANING OF THIS SUBPARAGRAPH (I.5) SHALL, EVERY FIVE YEARS, SUCCESSFULLY COMPLETE A TEST APPROVED BY THE DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT PERTAINING TO THE ADMINISTRATION OF MEDICATIONS.

(I.6)  TO DEVELOP AND IMPLEMENT POLICIES AND PROCEDURES WITH RESPECT TO THE PROVISIONS IN SUBPARAGRAPH (I.5) OF THIS PARAGRAPH (ee) CONCERNING THE ADMINISTRATION OF MEDICATION REMINDER BOXES.

(II.5)  For purposes of this paragraph (ee), "facility" means:

(I)  Residential and day care programs providing services ALL SERVICES FUNDED THROUGH AND REGULATED BY THE DEPARTMENT OF HUMAN SERVICES PURSUANT TO ARTICLE 10.5 OF TITLE 27, C.R.S., in support of persons with developmental disabilities; pursuant to article 10.5 of title 27, C.R.S.; and

(VI) (A)  This paragraph (ee) is repealed, effective July 1, 1998.

(B)  Prior to such repeal, the program established by this paragraph (ee) shall be subject to review by a legislative committee of reference designated pursuant to section 2­3­1201, C.R.S., to conduct the review pursuant to section 24­34­104, C.R.S., and the provisions of section 24­34­104 (5) to (12), C.R.S., concerning a wind­up period, an analysis and evaluation, public hearings, and claims by or against an agency shall apply to the operation of the program specified in this paragraph (ee).

SECTION 5.  Repeal. 24­34­104 (27.5) (a), (27.5) (b), (27.5) (c), and (27.5) (d), Colorado Revised Statutes, are repealed as follows:

24­34­104.  General assembly review of regulatory agencies and functions for termination, continuation, or reestablishment. (27.5) (a)  The program for the administration and monitoring of medications in facilities authorized pursuant to section 25­1­107 (1) (ee), C.R.S., shall terminate on July 1, 1998.

(b)  The exemption from licensure under the "Uniform Controlled Substances Act of 1992", article 18 of title 18, C.R.S., pursuant to section 12­22­304 (5) (e) (I), C.R.S., for persons who administer or monitor medications in facilities in compliance with the program authorized in section 25­1­107 (1) (ee), C.R.S., shall terminate on July 1, 1998.

(c)  The exemption from licensure under the "Colorado Medical Practice Act" pursuant to section 12­36­106 (3) (o) (I), C.R.S., for persons who administer and monitor medications in facilities in compliance with the program authorized in section 25­1­107 (1) (ee), C.R.S., shall terminate on July 1, 1998.

(d)  The exemption from licensure under the "Nurse Practice Act" pursuant to section 12­38­125 (1) (h) (I), C.R.S., for persons who administer and monitor medications in facilities in compliance with the program authorized in section 25­1­107 (1) (ee), C.R.S., shall terminate on July 1, 1998.

SECTION 6.  24­34­104, Colorado Revised Statutes, is amended BY THE ADDITION OF A NEW SUBSECTION to read:

24­34­104.  General assembly review of regulatory agencies and functions for termination, continuation, or reestablishment. (40)  THE FOLLOWING AGENCIES, FUNCTIONS, OR BOTH, SHALL TERMINATE ON JULY 1, 2009:

(a)  THE PROGRAM FOR THE ADMINISTRATION AND MONITORING OF MEDICATIONS IN FACILITIES AUTHORIZED PURSUANT TO SECTION 25­1­107 (1) (ee), C.R.S.

(b)  THE EXEMPTION FROM LICENSURE UNDER THE "UNIFORM CONTROLLED SUBSTANCES ACT OF 1992", ARTICLE 18 OF TITLE 18, C.R.S., PURSUANT TO SECTION 12­22­304 (5) (e) (I), C.R.S., FOR PERSONS WHO ADMINISTER OR MONITOR MEDICATIONS IN FACILITIES IN COMPLIANCE WITH THE PROGRAM AUTHORIZED IN SECTION 25­1­107 (1) (ee), C.R.S.

(c)  THE EXEMPTION FROM LICENSURE UNDER THE "COLORADO MEDICAL PRACTICE ACT" PURSUANT TO SECTION 12­36­106 (3) (o) (I), C.R.S., FOR PERSONS WHO ADMINISTER AND MONITOR MEDICATIONS IN FACILITIES IN COMPLIANCE WITH THE PROGRAM AUTHORIZED IN SECTION 25­1­107 (1) (ee), C.R.S.

(d)  THE EXEMPTION FROM LICENSURE UNDER THE "NURSE PRACTICE ACT" PURSUANT TO SECTION 12­38­125 (1) (h) (I), C.R.S., FOR PERSONS WHO ADMINISTER AND MONITOR MEDICATIONS IN FACILITIES IN COMPLIANCE WITH THE PROGRAM AUTHORIZED IN SECTION 25­1­107 (1) (ee), C.R.S.

SECTION 7.  Effective date ­ applicability. This act shall take effect July 1, 1998, and shall apply to services provided on or after said date.

SECTION 8.  Safety clause. The general assembly hereby finds, determines, and declares that this act is necessary for the immediate preservation of the public peace, health, and safety.