Medication dispensing

AN ACT Relating to expanding the situations in which medications 1
can be dispensed or delivered from hospitals and health care 2
entities; and amending RCW 70.41.480 and 18.64.450.3
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:4
Sec. 1. RCW 70.41.480 and 2024 c 251 s 2 are each amended to 5
read as follows: 6
(1) The legislature finds that high quality, safe, and 7
compassionate health care services for patients of Washington state 8
must be available at all times. The legislature further finds that 9
there is a need for patients being released from hospital emergency 10
departments to maintain access to emergency medications when 11
community or hospital pharmacy services are not available, including 12
medication for opioid overdose reversal and for the treatment for 13
opioid use disorder as appropriate , human immunodeficiency virus 14
postexposure prophylaxis drugs, anti-infectives, and drugs that come 15
prepackaged by the manufacturer . It is the intent of the legislature 16
to accomplish this objective by allowing practitioners with 17
prescriptive authority to prescribe limited amounts of prepackaged 18
emergency medications to patients being discharged from hospital 19
emergency departments when access to community or outpatient hospital 20
pharmacy services is not otherwise available. 21
H-0169.2
HOUSE BILL 1186
State of Washington 69th Legislature 2025 Regular Session
By Representatives Parshley, Rule, Low, Reed, Ramel, Macri, Obras,
Farivar, Doglio, Fosse, Ormsby, Salahuddin, Bernbaum, and Hill
Prefiled 01/07/25. Read first time 01/13/25. Referred to Committee
on Health Care & Wellness.
p. 1 HB 1186
(2) A hospital may allow a practitioner to prescribe prepackaged 1
emergency medications and allow a practitioner or a registered nurse 2
licensed under chapter 18.79 RCW to distribute prepackaged emergency 3
medications to patients being discharged from a hospital emergency 4
department in the following circumstances: 5
(a) During times when community or outpatient hospital pharmacy 6
services are not available within 15 miles within Washington by road;7
(b) When, in the judgment of the practitioner and consistent with 8
hospital policies and procedures, a patient has no reasonable ability 9
to reach the local community or outpatient pharmacy; or10
(c) When a patient is identified as needing human 11
immunodeficiency virus postexposure prophylaxis drugs or therapies.12
(3) A hospital may only allow this practice if ((: The )) the 13
director of the hospital pharmacy, in collaboration with appropriate 14
hospital medical staff, develops policies and procedures regarding 15
the following: 16
(a) Development of a list, preapproved by the pharmacy director, 17
of the types of emergency medications to be prepackaged and 18
distributed; 19
(b) Assurances that emergency medications to be prepackaged 20
pursuant to this section are prepared by a pharmacist or under the 21
supervision of a pharmacist licensed under chapter 18.64 RCW;22
(c) Development of specific criteria under which emergency 23
prepackaged medications may be prescribed and distributed consistent 24
with the limitations of this section; 25
(d) Assurances that any practitioner authorized to prescribe 26
prepackaged emergency medication or any nurse authorized to 27
distribute prepackaged emergency medication is trained on the types 28
of medications available and the circumstances under which they may 29
be distributed; 30
(e) Procedures to require practitioners intending to prescribe 31
prepackaged emergency medications pursuant to this section to 32
maintain a valid prescription either in writing or electronically in 33
the patient's records prior to a medication being distributed to a 34
patient; 35
(f) Establishment of a limit of no more than a 48 hour supply of 36
emergency medication as the maximum to be dispensed to a patient, 37
except when ((community)):38
(i) Community or hospital outpatient pharmacy services will not 39
be available within 48 hours((, or when antibiotics));40
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(ii) Anti-infectives or human immunodeficiency virus postexposure 1
prophylaxis drugs or therapies are required; or2
(iii) Drugs or therapies are packaged directly by the 3
manufacturer in quantities larger than a 48-hour supply;4
(g) Assurances that prepackaged emergency medications will be 5
kept in a secure location in or near the emergency department in such 6
a manner as to preclude the necessity for entry into the pharmacy; 7
and 8
(h) Assurances that nurses or practitioners will distribute 9
prepackaged emergency medications to patients only after a 10
practitioner has counseled the patient on the medication.11
(4) The delivery of a single dose of medication for immediate 12
administration to the patient is not subject to the requirements of 13
this section. 14
(5) Nothing in this section restricts the authority of a 15
practitioner in a hospital emergency department to distribute opioid 16
overdose reversal medication under RCW 69.41.095. 17
(6) A practitioner or a nurse in a hospital emergency department 18
must dispense or distribute opioid overdose reversal medication in 19
compliance with RCW 70.41.485. 20
(7) For purposes of this section: 21
(a) "Emergency medication" means any medication commonly 22
prescribed to emergency department patients, including those drugs, 23
substances or immediate precursors listed in schedules II through V 24
of the uniform controlled substances act, chapter 69.50 RCW, as now 25
or hereafter amended((.)) ;26
(b) "Distribute" means the delivery of a drug or device other 27
than by administering or dispensing((.)) ;28
(c) "Manufacturer" has the same meaning as provided in RCW 29
18.64.011;30
(d) "Opioid overdose reversal medication" has the same meaning as 31
provided in RCW 69.41.095((.32
(d)));33
(e) "Practitioner" means any person duly authorized by law or 34
rule in the state of Washington to prescribe drugs as defined in RCW 35
18.64.011(((29).36
(e))); and37
(f) "Nurse" means a registered nurse or licensed practical nurse 38
as defined in chapter 18.79 RCW. 39
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Sec. 2. RCW 18.64.450 and 2013 c 19 s 26 are each amended to 1
read as follows: 2
(1) In order for a health care entity to purchase, administer, 3
dispense, and deliver legend drugs, the health care entity must be 4
licensed by the department. 5
(2) In order for a health care entity to purchase, administer, 6
dispense, and deliver controlled substances, the health care entity 7
must annually obtain a license from the department in accordance with 8
the commission's rules. 9
(3) The receipt, administration, dispensing, and delivery of 10
legend drugs or controlled substances by a health care entity must be 11
performed under the supervision or at the direction of a pharmacist.12
(4) A health care entity may only administer, dispense, or 13
deliver legend drugs and controlled substances to patients who 14
receive care within the health care entity and in compliance with 15
rules of the commission. Nothing in this subsection shall prohibit a 16
practitioner, in carrying out his or her licensed responsibilities 17
within a health care entity, from dispensing or delivering to a 18
patient of the health care entity drugs for that patient's personal 19
use in an amount not to exceed ((seventy-two)) 72 hours of usage. The 20
72-hour limit does not apply when:21
(a) Community or hospital outpatient pharmacy services will not 22
be available within 72 hours;23
(b) Anti-infectives or human immunodeficiency virus postexposure 24
prophylaxis drugs or therapies are required; or25
(c) Drugs or therapies are packaged directly by the manufacturer 26
in quantities larger than a 72-hour supply.27
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