Prepacked medication distr.

AN ACT Relating to permitting medications packaged and delivered 1
from the manufacturer in quantities larger than 96 hours of doses to 2
be distributed under existing prepack medication law; and amending 3
RCW 70.41.480 and 18.64.450. 4
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:5
Sec. 1. RCW 70.41.480 and 2024 c 251 s 2 are each amended to 6
read as follows: 7
(1) The legislature finds that high quality, safe, and 8
compassionate health care services for patients of Washington state 9
must be available at all times. The legislature further finds that 10
there is a need for patients being released from hospital emergency 11
departments to maintain access to emergency medications when 12
community or hospital pharmacy services are not available, including 13
medication for opioid overdose reversal and for the treatment for 14
opioid use disorder as appropriate , human immunodeficiency virus 15
postexposure prophylaxis drugs, anti-infectives, and drugs that come 16
prepackaged by the manufacturer . It is the intent of the legislature 17
to accomplish this objective by allowing practitioners with 18
prescriptive authority to prescribe limited amounts of prepackaged 19
emergency medications to patients being discharged from hospital 20
S-0104.3
SENATE BILL 5019
State of Washington 69th Legislature 2025 Regular Session
By Senators Chapman, Bateman, Christian, Dhingra, Harris, Riccelli,
Saldaña, Slatter, and Wellman
Prefiled 12/09/24. Read first time 01/13/25. Referred to Committee
on Health & Long-Term Care.
p. 1 SB 5019
emergency departments when access to community or outpatient hospital 1
pharmacy services is not otherwise available. 2
(2) A hospital may allow a practitioner to prescribe prepackaged 3
emergency medications and allow a practitioner or a registered nurse 4
licensed under chapter 18.79 RCW to distribute prepackaged emergency 5
medications to patients being discharged from a hospital emergency 6
department in the following circumstances: 7
(a) During times when community or outpatient hospital pharmacy 8
services are not available within 15 miles within Washington by road;9
(b) When, in the judgment of the practitioner and consistent with 10
hospital policies and procedures, a patient has no reasonable ability 11
to reach the local community or outpatient pharmacy; or12
(c) When a patient is identified as needing human 13
immunodeficiency virus postexposure prophylaxis drugs or therapies.14
(3) A hospital may only allow this practice if ((: The )) the 15
director of the hospital pharmacy, in collaboration with appropriate 16
hospital medical staff, develops policies and procedures regarding 17
the following: 18
(a) Development of a list, preapproved by the pharmacy director, 19
of the types of emergency medications to be prepackaged and 20
distributed; 21
(b) Assurances that emergency medications to be prepackaged 22
pursuant to this section are prepared by a pharmacist or under the 23
supervision of a pharmacist licensed under chapter 18.64 RCW;24
(c) Development of specific criteria under which emergency 25
prepackaged medications may be prescribed and distributed consistent 26
with the limitations of this section; 27
(d) Assurances that any practitioner authorized to prescribe 28
prepackaged emergency medication or any nurse authorized to 29
distribute prepackaged emergency medication is trained on the types 30
of medications available and the circumstances under which they may 31
be distributed; 32
(e) Procedures to require practitioners intending to prescribe 33
prepackaged emergency medications pursuant to this section to 34
maintain a valid prescription either in writing or electronically in 35
the patient's records prior to a medication being distributed to a 36
patient; 37
(f) Establishment of a limit of no more than a 48 hour supply of 38
emergency medication as the maximum to be dispensed to a patient, 39
except when ((community)):40
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(i) Community or hospital outpatient pharmacy services will not 1
be available within 48 hours((, or when antibiotics));2
(ii) Anti-infectives or human immunodeficiency virus postexposure 3
prophylaxis drugs or therapies are required; or4
(iii) Drugs or therapies are packaged directly by the 5
manufacturer in quantities larger than 48 hours;6
(g) Assurances that prepackaged emergency medications will be 7
kept in a secure location in or near the emergency department in such 8
a manner as to preclude the necessity for entry into the pharmacy; 9
and 10
(h) Assurances that nurses or practitioners will distribute 11
prepackaged emergency medications to patients only after a 12
practitioner has counseled the patient on the medication.13
(4) The delivery of a single dose of medication for immediate 14
administration to the patient is not subject to the requirements of 15
this section. 16
(5) Nothing in this section restricts the authority of a 17
practitioner in a hospital emergency department to distribute opioid 18
overdose reversal medication under RCW 69.41.095. 19
(6) A practitioner or a nurse in a hospital emergency department 20
must dispense or distribute opioid overdose reversal medication in 21
compliance with RCW 70.41.485. 22
(7) For purposes of this section: 23
(a) "Emergency medication" means any medication commonly 24
prescribed to emergency department patients, including those drugs, 25
substances or immediate precursors listed in schedules II through V 26
of the uniform controlled substances act, chapter 69.50 RCW, as now 27
or hereafter amended((.)) ;28
(b) "Distribute" means the delivery of a drug or device other 29
than by administering or dispensing((.)) ;30
(c) "Manufacturer" has the same meaning as provided in RCW 31
18.64.011;32
(d) "Opioid overdose reversal medication" has the same meaning as 33
provided in RCW 69.41.095((.34
(d)));35
(e) "Practitioner" means any person duly authorized by law or 36
rule in the state of Washington to prescribe drugs as defined in RCW 37
18.64.011(((29).38
(e))); and39
p. 3 SB 5019
(f) "Nurse" means a registered nurse or licensed practical nurse 1
as defined in chapter 18.79 RCW. 2
Sec. 2. RCW 18.64.450 and 2013 c 19 s 26 are each amended to 3
read as follows: 4
(1) In order for a health care entity to purchase, administer, 5
dispense, and deliver legend drugs, the health care entity must be 6
licensed by the department. 7
(2) In order for a health care entity to purchase, administer, 8
dispense, and deliver controlled substances, the health care entity 9
must annually obtain a license from the department in accordance with 10
the commission's rules. 11
(3) The receipt, administration, dispensing, and delivery of 12
legend drugs or controlled substances by a health care entity must be 13
performed under the supervision or at the direction of a pharmacist.14
(4) A health care entity may only administer, dispense, or 15
deliver legend drugs and controlled substances to patients who 16
receive care within the health care entity and in compliance with 17
rules of the commission. Nothing in this subsection shall prohibit a 18
practitioner, in carrying out his or her licensed responsibilities 19
within a health care entity, from dispensing or delivering to a 20
patient of the health care entity drugs for that patient's personal 21
use in an amount not to exceed ((seventy-two)) 72 hours of usage. The 22
72-hour limit does not apply when:23
(a) Community or hospital outpatient pharmacy services will not 24
be available within 72 hours;25
(b) Anti-infectives or human immunodeficiency virus postexposure 26
prophylaxis drugs or therapies are required; or27
(c) Drugs or therapies are packaged directly by the manufacturer 28
in quantities larger than 72 hours.29
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p. 4 SB 5019