Florida Senate - 2020 SENATOR AMENDMENT Bill No. CS for SB 58 Ì120012RÎ120012 LEGISLATIVE ACTION Senate . House . . . Floor: NC/2R . 02/12/2020 01:53 PM . ————————————————————————————————————————————————————————————————— ————————————————————————————————————————————————————————————————— Senator Book moved the following: 1 Senate Amendment (with title amendment) 2 3 Delete everything after the enacting clause 4 and insert: 5 Section 1. Section 465.1902, Florida Statutes, is created 6 to read: 7 465.1902 Prescription Drug Donation Repository Program.— 8 (1) SHORT TITLE.—This section may be cited as the 9 “Prescription Drug Donation Repository Program Act.” 10 (2) DEFINITIONS.—As used in this section, the term: 11 (a) “Closed drug delivery system” means a system in which 12 the actual control of the unit-dose medication package is 13 maintained by the facility, rather than by the individual 14 patient. 15 (b) “Controlled substance” means any substance listed in 16 Schedule II, Schedule III, Schedule IV, or Schedule V of s. 17 893.03. 18 (c) “Dispenser” means a health care practitioner who, 19 within the scope of his or her practice act, is authorized to 20 dispense medicinal drugs and who does so under this act. 21 (d) “Free clinic” means a clinic that delivers only medical 22 diagnostic services or nonsurgical medical treatment free of 23 charge to low-income recipients. 24 (e) “Health care practitioner” or “practitioner” means a 25 practitioner licensed under this chapter, chapter 458, chapter 26 459, chapter 461, chapter 463, chapter 464, or chapter 466. 27 (f) “Indigent” means having a family income during the 12 28 months preceding the determination of income that is below 200 29 percent of the federal poverty level as defined by the most 30 recently revised poverty income guidelines published by the 31 United States Department of Health and Human Services. 32 (g) “Nonprofit health clinic” means a nonprofit legal 33 entity that provides medical care to patients who are indigent, 34 uninsured, or underinsured. The term includes, but is not 35 limited to, a federally qualified health center as defined in 42 36 U.S.C. s. 1396d(l)(2)(B) and a rural health clinic as defined in 37 42 U.S.C. s. 1396d(l)(1). 38 (h) “Nursing home facility” has the same meaning as in s. 39 400.021. 40 (i) “Prescriber” means a health care practitioner who, 41 within the scope of his or her practice act, is authorized to 42 prescribe medicinal drugs. 43 (j) “Prescription drug” has the same meaning as the terms 44 “medicinal drugs” or “drugs,” as those terms are defined in s. 45 465.003(8), but does not include controlled substances, cancer 46 drugs donated under s. 499.029, or drugs with an approved United 47 States Food and Drug Administration risk evaluation and 48 mitigation strategy that includes elements to assure safe use. 49 (k) “Program” means the Prescription Drug Donation 50 Repository Program created by this section. 51 (l) “Supply” means a material or an instrument used to 52 administer a prescription drug. 53 (m) “Tamper-evident packaging” means a package that has one 54 or more indicators or barriers to access which, if breached or 55 missing, can reasonably be expected to provide visible evidence 56 to consumers that tampering has occurred. The term includes, but 57 is not limited to, unopened unit-dose packaging, multiple-dose 58 packaging, and medications with a seal on their immediate, 59 outer, secondary, or tertiary packaging. 60 (n) “Underinsured” means having health care coverage or 61 prescription drug coverage, but having exhausted these benefits 62 or not having prescription drug coverage for the drug 63 prescribed. 64 (o) “Uninsured” means not having health care coverage and 65 being ineligible for prescription drug coverage under a program 66 funded in whole or in part by the Federal Government. 67 (3) PRESCRIPTION DRUG DONATION REPOSITORY PROGRAM; 68 CREATION; PURPOSE.—The Prescription Drug Donation Repository 69 Program is created within the department to facilitate the 70 donation of prescription drugs and supplies to eligible 71 patients. 72 (4) REPOSITORIES.— 73 (a) A repository may accept and dispense eligible donations 74 to eligible patients under the program. The repository must 75 inspect, store, and dispense donations and report to the 76 department in accordance with this section. 77 (b) The following entities may participate as a repository: 78 1. A health care practitioner’s office. 79 2. A pharmacy. 80 3. A hospital with a closed drug delivery system. 81 4. A nursing home facility with a closed drug delivery 82 system. 83 5. A free clinic or nonprofit health clinic that is 84 licensed or permitted to dispense medicinal drugs in this state. 85 (c) An eligible entity must notify the department of its 86 intent to participate in the program as a repository before 87 accepting or dispensing any donations under the program. The 88 notification must be made on a physical or an electronic form 89 prescribed by the department in rule and must, at a minimum, 90 include: 91 1. The name, street address, website, and telephone number 92 of the intended repository and any license or registration 93 number issued by the state to the intended repository, including 94 the name of the issuing agency. 95 2. The name and telephone number of the pharmacist employed 96 by or under contract with the intended repository who is 97 responsible for the inspection of donated prescription drugs and 98 supplies. 99 3. A signed and dated statement by the responsible 100 pharmacist affirming that the intended repository meets the 101 eligibility requirements of this subsection. 102 (d) A repository may withdraw from participation in the 103 program at any time by providing written notice to the 104 department, as appropriate, on a physical or an electronic form 105 prescribed by department rule. The department shall adopt rules 106 addressing the disposition of prescription drugs and supplies in 107 the possession of the withdrawing repository. 108 (5) ELIGIBLE DONORS.—The following entities may donate 109 prescription drugs or supplies to a repository under the 110 program: 111 (a) Nursing home facilities with closed drug delivery 112 systems. 113 (b) Hospices that have maintained control of a patient’s 114 prescription drugs. 115 (c) Hospitals with closed drug delivery systems. 116 (d) Pharmacies. 117 (e) Drug manufacturers or wholesale distributors. 118 (f) Medical device manufacturers or suppliers. 119 (g) Prescribers who receive prescription drugs or supplies 120 directly from a drug manufacturer, wholesale distributor, or 121 pharmacy. 122 (6) ELIGIBLE DONATIONS; DONATION REQUIREMENTS; PROHIBITED 123 DONATIONS.— 124 (a) An eligible donor may donate a prescription drug to a 125 repository only if: 126 1. The drug is approved for medical use in the United 127 States. 128 2. The drug is in unopened, tamper-evident packaging. 129 3. The drug requires storage at normal room temperature per 130 the manufacturer or federal storage requirements. 131 4. The drug has been stored according to manufacturer or 132 federal storage requirements. 133 5. The drug does not have any physical signs of tampering 134 or adulteration and there is no reason to believe that the drug 135 is adulterated. 136 6. The packaging does not have any physical signs of 137 tampering, misbranding, deterioration, compromised integrity, or 138 adulteration. 139 7. The packaging indicates the expiration date of the drug. 140 All specified medications must be destroyed in the event of a 141 recall if the lot number is not retrievable. 142 8. The drug has an expiration date that is more than 3 143 months after the date on which the drug was donated. 144 (b) An eligible donor may donate a prescription drug or 145 supply to a repository only if it is in unopened, tamper-evident 146 packaging. 147 (c) Donations must be made on the premises of a repository 148 to a person designated by the repository. A drop box may not be 149 used to accept donations. 150 (d) A prescription drug or supply may not be donated to a 151 specific patient. 152 (7) INSPECTION AND STORAGE.— 153 (a) Upon receipt of a proposed donation, a licensed 154 pharmacist employed by or under contract with a repository shall 155 inspect the donation to determine whether it meets the 156 requirements of subsections (5) and (6). The repository shall 157 quarantine a donation until such inspection is complete and the 158 donation is approved for dispensing. 159 (b) If a donation is approved for dispensing, the 160 inspecting pharmacist shall sign an inspection record on a 161 physical or an electronic form prescribed by the department in 162 rule which verifies that the prescription drug or supply meets 163 the criteria of subsections (5) and (6) and shall attach the 164 record to the inventory required in paragraph (d). A repository 165 that receives prescription drugs and supplies from another 166 repository is not required to reinspect such drugs and supplies. 167 (c) A repository shall store donations in a secure storage 168 area under the environmental conditions specified by the 169 manufacturer or federal storage requirements. Donations may not 170 be stored with other inventory. 171 (d) A repository shall maintain an inventory of the name, 172 strength, available quantity, and expiration date of donations; 173 the transaction date; and the name, street address, and 174 telephone number of the donor. The repository shall record such 175 inventory on a physical or an electronic form prescribed by 176 department rule. 177 (e) By the 5th day of each month, a repository shall submit 178 to the department its inventory records of donations received 179 during the previous month. 180 (f) The department may facilitate the redistribution of 181 donations between repositories. A repository that receives 182 donations may, after notifying the department, distribute the 183 donations to another repository. 184 (8) ELIGIBLE PATIENTS; DISPENSING REQUIREMENTS; PATIENT 185 NOTICE; PROHIBITIONS.— 186 (a) A repository may dispense an eligible donation to a 187 state resident who is indigent, uninsured, or underinsured and 188 who has a valid prescription for such donation, as applicable. 189 (b) Each new eligible patient must submit an intake 190 collection form to a repository to receive a donation using a 191 physical or an electronic form prescribed by the department in 192 rule. Such form shall, at a minimum, include: 193 1. The name, street address, and telephone number of the 194 eligible patient. 195 2. The basis for the patient’s eligibility, which must 196 specify that the patient is indigent, uninsured, or 197 underinsured. 198 3. A statement physically or electronically signed and 199 dated by the patient affirming that the patient meets the 200 eligibility requirements of this section and will inform the 201 repository if the patient’s eligibility changes. 202 4. Notice that the prescription drug or supply was donated 203 to the program, that the donors and participants in the program 204 are immune from civil or criminal liability or disciplinary 205 action, and that the eligible patient is not required to pay for 206 the prescription drug or supply. 207 5. A statement physically or electronically signed and 208 dated by the eligible patient acknowledging receipt of notice 209 required under this paragraph. 210 (c) By the 5th day of each month, a repository shall submit 211 to the department a summary of each intake collection form 212 received during the previous month. 213 (d) A dispenser may dispense donations, if available, only 214 to an eligible patient who has submitted a completed intake 215 collection form. 216 (e) A dispenser may provide dispensing and consulting 217 services to an eligible patient. 218 (f) Donations may not be sold or resold. 219 (g) A dispenser may not submit a claim or otherwise seek 220 reimbursement from any public or private third-party payor for 221 donations. 222 (9) RECALLED PRESCRIPTION DRUGS.— 223 (a) Each repository shall establish and follow a protocol 224 for notifying recipients in the event that a prescription drug 225 donated under the program is recalled. 226 (b) A repository shall destroy all donated prescription 227 drugs that are recalled, expired, or unsuitable for dispensing. 228 A repository shall complete a destruction form for all such 229 drugs using a physical or an electronic form prescribed by the 230 department in rule. 231 (10) RECORDKEEPING.— 232 (a) A repository shall maintain records of prescription 233 drugs and supplies that are accepted, donated, dispensed, 234 distributed, or destroyed under the program using a physical or 235 an electronic form prescribed by department rule. 236 (b) All required records must be maintained in accordance 237 with any applicable practice act. A repository shall submit 238 these records monthly to the department for data collection. 239 (11) REGISTRIES; PUBLICATION OF FORMS.— 240 (a) The department shall establish and maintain registries 241 of all repositories and prescription drugs and supplies 242 available under the program. The registry of repositories must 243 include each repository’s name, street address, website, and 244 telephone number. The registry of available prescription drugs 245 and supplies must include the name, strength, available 246 quantity, and expiration date of the prescription drugs or 247 supplies and the name and contact information of each repository 248 where such drugs or supplies are available. The department shall 249 publish the registries on its website. 250 (b) The department shall publish all forms required by this 251 section on its website. 252 (12) IMMUNITY FROM LIABILITY; DISCIPLINARY ACTION.— 253 (a) Any donor of prescription drugs or supplies and any 254 participant in the program who exercises reasonable care in 255 donating, accepting, distributing, or dispensing prescription 256 drugs or supplies under the program is immune from civil or 257 criminal liability and professional disciplinary action by the 258 state for any injury, death, or loss to person or property 259 relating to such activities. 260 (b) A pharmaceutical manufacturer who exercises reasonable 261 care is not liable for any claim or injury arising from the 262 donation of any prescription drug or supply under this section, 263 including, but not limited to, liability for failure to transfer 264 or communicate product or consumer information regarding the 265 donated prescription drug or supply, including its expiration 266 date. 267 (13) RULEMAKING.—The department shall adopt rules necessary 268 to administer this section. 269 Section 2. Paragraph (o) is added to subsection (5) of 270 section 252.36, Florida Statutes, to read: 271 252.36 Emergency management powers of the Governor.— 272 (5) In addition to any other powers conferred upon the 273 Governor by law, she or he may: 274 (o) Waive the patient eligibility requirements of s. 275 465.1902. 276 Section 3. This act shall take effect July 1, 2020. 277 278 ================= T I T L E A M E N D M E N T ================ 279 And the title is amended as follows: 280 Delete everything before the enacting clause 281 and insert: 282 A bill to be entitled 283 An act relating to the Prescription Drug Donation 284 Repository Program; creating s. 465.1902, F.S.; 285 providing a short title; defining terms; creating the 286 Prescription Drug Donation Repository Program within 287 the Department of Health; specifying the purpose of 288 the program; specifying entities that may participate 289 as repositories; requiring a repository to notify the 290 department of its intent to participate in the 291 program; providing notification requirements; 292 providing a procedure for a repository to withdraw 293 from participation in the program; requiring the 294 department to adopt rules regarding the disposition of 295 prescription drugs and supplies of a withdrawing 296 repository; specifying entities that may donate 297 prescription drugs or supplies under the program; 298 providing criteria and procedures for eligible 299 donations; prohibiting donations to specific patients; 300 providing inspection, inventory, and storage 301 requirements for repositories; requiring inspection of 302 donated prescription drugs and supplies by a licensed 303 pharmacist; requiring a repository to submit its 304 inventory records to the department monthly; 305 authorizing the department to facilitate the 306 redistribution of donated prescription drugs and 307 supplies; authorizing a repository to transfer 308 prescription drugs and supplies to another repository 309 after notifying the department; specifying patients 310 eligible to receive donated prescription drugs and 311 supplies; specifying conditions for dispensing donated 312 prescription drugs and supplies to eligible patients; 313 providing intake collection form requirements; 314 requiring that such form provide certain notice to 315 patients; prohibiting the sale of donated prescription 316 drugs and supplies under the program; prohibiting 317 dispensers from seeking reimbursement from public or 318 private third-party payors for donations dispensed 319 under the program; requiring repositories to establish 320 a protocol for notifying recipients of a prescription 321 drug recall; providing for destruction of donated 322 prescription drugs under certain circumstances; 323 providing recordkeeping requirements; requiring the 324 department to establish, maintain, and publish a 325 registry of participating repositories and available 326 donated prescription drugs and supplies; requiring the 327 department to publish certain information and forms on 328 its website; providing immunity from civil and 329 criminal liability and professional disciplinary 330 action for program donors and participants under 331 certain circumstances; providing specified immunity to 332 pharmaceutical manufacturers under certain 333 circumstances; requiring the department to adopt 334 rules; amending s. 252.36, F.S.; authorizing the 335 Governor to waive program patient eligibility 336 requirements during a declared state of emergency; 337 providing an effective date.