FINAL BILL REPORT

SHB 1625

C 255 L 15

Synopsis as Enacted

Brief Description: Concerning provision of drugs to ambulance or aid services.

Sponsors: House Committee on Health Care & Wellness (originally sponsored by Representatives Schmick and Wylie).

House Committee on Health Care & Wellness

Senate Committee on Health Care

Background:

Pharmacy Services.

In hospitals that have pharmaceutical services, the director of pharmacy is responsible for the distribution of drugs throughout the hospital. Hospital pharmacies must be licensed by the Pharmacy Quality Assurance Commission (Commission). They provide pharmaceutical services that include procuring, preparing, storing, distributing, and controlling all drugs in the hospital; inspecting nursing care units where medications are dispensed, administered, or stored; monitoring drug therapy; providing drug information to patients and providers; and surveying and reporting adverse drug reactions.

Regulations adopted by the Commission define "wholesale distribution" as the sale of prescription drugs to a person who is not a consumer or patient. Hospital pharmacies are generally not engaged in wholesale drug distribution activities; however, they may perform some similar functions that have been specifically exempted from the term. These exemptions include certain intracompany transfers to affiliated entities and the sale of a drug for emergency medical reasons. The term "emergency medical reasons" is not defined, but includes transfers of drugs between retail pharmacies to alleviate temporary shortages.

Emergency Medical Personnel.Emergency medical personnel may provide patient care that is included within training curricula, approved specialized training, and local medical program director protocols. The four categories of emergency medical service personnel in descending order of training are: paramedics, intermediate life support technicians, emergency medical technicians, and first responders. Emergency medical service personnel may only provide services within the scope of care established in the curriculum of the person's level of certification or any specialized training. In addition, the services must be included in the protocols of each county's medical program director. With the exception of the administration of epinephrine, an emergency medical technician may not administer injections.

Summary:

Pharmacies operated by a hospital may provide medications to ambulance and aid services for uses associated with providing emergency medical services. The pharmacies may provide the medications if:

• the hospital is located in the same county or an adjacent county to the ambulance or aid service's area of operation;

• the medical program director requests the medications for the ambulance or aid service and the types of medications provided (1) correspond to the level of service provided by the ambulance or aid service and the training of its emergency medical personnel and (2) are identified by the medical program director through patient care protocols; and

• the provision of the medications is not contingent upon arrangements to transport patients to the hospital other than for reasons related to the medical needs of patients and patient care procedures.

The Emergency Medical Services and Trauma Care Steering Committee (Steering Committee) must review the appropriateness of allowing emergency medical technicians to use hydrocortisone sodium succinate or similar medications for the treatment of adrenal insufficiency and glucagon emergency kits. The review must consider the adequacy of current training, the feasibility of supplementing training, the costs and likely utilization of stocking ambulances with the medications, and options for localized solutions to specific community needs. The Steering Committee must report to the Governor and the appropriate committees of the Legislature by December 15, 2016, with the results of its review and any recommendations.

Votes on Final Passage: