HOUSE BILL No. 5547

 

October 27, 2009, Introduced by Reps. Liss, Roy Schmidt, Ball and Byrum and referred to the Committee on Ethics and Elections.

 

     A bill to amend 1978 PA 368, entitled

 

"Public health code,"

 

by amending sections 17703, 17704, 17706, and 17707 (MCL 333.17703,

 

333.17704, 333.17706, and 333.17707), section 17703 as amended by

 

2006 PA 672, section 17706 as amended by 1986 PA 304, and section

 

17707 as amended by 1990 PA 333, and by adding section 17746a.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 17703. (1) "Device" means an instrument, apparatus, or

 

contrivance, including its components, parts, and accessories,

 

intended for use in the diagnosis, cure, mitigation, treatment, or

 

prevention of disease in human beings or other animals, or to

 

affect the structure or function of the body of human beings or


 

other animals.

 

     (2) "Dispense" means to issue 1 or more doses of a drug for

 

subsequent administration to, or use by, a patient.

 

     (3) "Dispensing prescriber" means a prescriber, other than a

 

veterinarian, who dispenses prescription drugs.

 

     (4) "Drug" means any of the following:

 

     (a) A substance recognized or for which the standards or

 

specifications are prescribed in the official compendium.

 

     (b) A substance intended for use in the diagnosis, cure,

 

mitigation, treatment, or prevention of disease in human beings or

 

other animals.

 

     (c) A substance, other than food, intended to affect the

 

structure or a function of the body of human beings or other

 

animals.

 

     (d) A substance intended for use as a component of a substance

 

specified in subdivision (a), (b), or (c), but not including a

 

device or its components, parts, or accessories.

 

     (5) "Electronic signature" means an electronic sound, symbol,

 

or process attached to or logically associated with a record and

 

executed or adopted by a person with the intent to sign the record.

 

     (6) "Electronically transmitted prescription" means the

 

communication of an original prescription or refill authorization

 

by electronic means including computer to computer, computer to

 

facsimile machine, or electronic mail transmission that contains

 

the same information it contained when the prescriber or authorized

 

agent transmitted the prescription. Electronically transmitted

 

prescription does not include a prescription or refill


 

authorization transmitted by telephone or facsimile machine.

 

     (7) "Emergency drugs" are those drugs that are required to

 

meet the immediate therapeutic need of a resident of a medical

 

institution and that are to be administered by authorized personnel

 

to the resident before the interpretation and review by a

 

pharmacist when waiting for interpretation and review would cause a

 

medically unacceptable delay.

 

     Sec. 17704. (1) "Federal act" means the federal food, drug,

 

and cosmetic act, of 1938, 21 U.S.C. USC 301 to 392 399a.

 

     (2) "Generic name" means the established or official name of a

 

drug or drug product.

 

     (3) "Harmful drug" means a drug intended for use by human

 

beings which that is harmful because of its toxicity, habit-forming

 

nature, or other potential adverse effect, the method of its use,

 

or the collateral measures necessary to its safe and effective use,

 

and which that is designated as harmful by the board according to

 

rule.

 

     (4) "Institutional pharmacy" means a pharmacy licensed under

 

this part that is located in this state; that dispenses, compounds,

 

and distributes drugs, devices, and other materials; and that

 

engages in the practice of pharmacy for a medical institution.

 

     (5) (4) "Internship" means an educational program of

 

professional and practical experience for an intern.

 

     Sec. 17706. (1) "Manufacturer" means a person who prepares,

 

produces, derives, propagates, compounds, processes, packages, or

 

repackages a drug or device salable on prescription only, or

 

otherwise changes the container or the labeling of a drug or device


 

salable on prescription only, and who supplies, distributes, sells,

 

offers for sale, barters, or otherwise disposes of that drug or

 

device and any other drug or device salable on prescription only,

 

to another person for resale, compounding, or dispensing.

 

     (2) "Medical institution" means a federally- or state-licensed

 

organization or facility the primary purpose of which is to provide

 

a physical environment at which on-site medical care is provided to

 

individuals and a permanent medical record documenting the

 

provision of medical care, including medications ordered and

 

administered, to that individual is maintained. Medical institution

 

includes, but is not limited to, a hospital, convalescent home,

 

home for the aged, nursing home, skilled nursing facility, county

 

medical care facility, extended care facility, adult foster care

 

facility, assisted living facility, mental health facility,

 

psychiatric center, developmental disability center, and any other

 

health facility or agency that is licensed under article 17 and

 

that directly or indirectly provides or includes pharmacy services

 

to residents.

 

     (3) "Medication drug kits" are those drugs that may be

 

required to meet the therapeutic needs of a resident of a medical

 

institution when a pharmacist is not in personal charge of the

 

institutional pharmacy.

 

     (4) "Medication order" means a lawful order entered on the

 

permanent medical record of a resident of a medical institution by

 

a prescriber and is considered a prescription drug order. If

 

written, the medication order shall include the signature of the

 

prescriber or personnel authorized by the medical institution or,


 

if electronically transmitted, the appropriate electronic

 

signature.

 

     (5) (2) "Official compendium" means the United States

 

pharmacopoeia and national formulary, homeopathic pharmacopoeia of

 

the United States, or a supplement thereof existing on July 1,

 

1983.

 

     Sec. 17707. (1) "Personal charge" means the immediate physical

 

presence of a pharmacist or dispensing prescriber.

 

     (2) "Pharmacist" means an individual licensed under this

 

article to engage in the practice of pharmacy.

 

     (3) "Pharmacist intern" or "intern" means an individual who

 

satisfactorily completes the requirements set forth in rules

 

promulgated by the board and is licensed by the board for the

 

purpose of obtaining instruction in the practice of pharmacy from a

 

preceptor approved by the board.

 

     (4) "Pharmacy" means a building or part of a building in which

 

the practice of pharmacy is conducted.

 

     (5) "Practice of pharmacy" means a health service, the

 

clinical application of which includes the encouragement of safety

 

and efficacy in the prescribing, dispensing, administering, and use

 

of drugs and related articles for the prevention of illness, and

 

the maintenance and management of health. Practice of pharmacy

 

includes the direct or indirect provision of patient care services

 

associated with the practice of pharmacy to medical institutions.

 

Professional functions associated with the practice of pharmacy

 

include:

 

     (a) The interpretation and evaluation of the prescription.


 

     (b) Drug product selection.

 

     (c) The compounding, dispensing, safe storage, and

 

distribution of drugs and devices.

 

     (d) The maintenance of legally required records.

 

     (e) Advising the prescriber and the patient as required as to

 

contents, therapeutic action, utilization, and possible adverse

 

reactions or interactions of drugs.

 

     Sec. 17746a. (1) A pharmacist in charge of an institutional

 

pharmacy shall make arrangement in advance for the period of time

 

during which a pharmacist is not in personal charge of the

 

institutional pharmacy. A pharmacist shall be on call and available

 

to the medical staff and other authorized personnel of the medical

 

institution for the period of time during which a pharmacist is not

 

in personal charge of the institutional pharmacy. A pharmacist in

 

charge shall include in the arrangement under this subsection a

 

method to provide drugs to the medical staff and other authorized

 

personnel of a medical institution by use of emergency drugs or

 

medication drug kits, or both. A pharmacist in charge may include

 

in emergency drugs or medication drug kits those drugs that may be

 

required to meet the immediate therapeutic needs of a resident of

 

the medical institution and that are not available from any other

 

authorized source in sufficient time to prevent risk of harm to the

 

resident because of delay resulting from obtaining the drugs from

 

other sources.

 

     (2) When a pharmacist is not in personal charge of the

 

institutional pharmacy, emergency drugs and medication drug kits

 

shall be stored in secured areas of the medical institution to


 

prevent unauthorized access and in areas designed to ensure a

 

proper environment for preservation of the drugs. The pharmacist in

 

charge, in conjunction with the appropriate committee of the

 

medical institution, shall do all of the following:

 

     (a) Develop inventory listings of the drugs contained in the

 

emergency drugs and medication drug kits, including name, strength,

 

quantity, and expiration date of the contents.

 

     (b) Determine who is authorized access to the emergency drugs

 

and medication drugs kits and under what circumstances.

 

     (c) Ensure that all of the emergency drugs and medication

 

drugs kits are properly labeled.

 

     (d) Ensure that only a limited number of drugs in unit dose or

 

unit-of-use packaging are available in amounts sufficient for

 

immediate therapeutic requirements of residents.

 

     (e) To prevent diversion of the emergency drugs and medication

 

drug kits, institute controls and record-keeping procedures to

 

adequately account for the drugs and to ensure that all of the

 

following occur:

 

     (i) That emergency drugs and medication drug kits are removed

 

from the secure area only pursuant to a valid medication order.

 

     (ii) That only authorized individuals are able to access the

 

emergency drugs and medication drug kits and that documentation of

 

that access is maintained.

 

     (iii) That documentation of proof-of-use by residents or return

 

of the unused emergency drugs and medication drug kits to the

 

secure area is provided.

 

     (iv) That any other record-keeping requirement determined


 

necessary under this section is met.

 

     (f) Provide procedures for the inspection of the inventory of

 

the emergency drugs and medication drug kits to assure proper

 

utilization and replacement of the drug supply.

 

     (g) Upon notification that an emergency drug or medication

 

drug kit is used, restock emergency drugs and medication drug kits

 

within a reasonable time so as to prevent risk of harm to

 

residents.

 

     (h) Establish any other written policies and procedures

 

necessary to implement the requirements of this section.