Amendments for HB20-1065

House Journal, February 20
1 HB20-1065 be amended as follows, and as so amended, be referred to
2 the Committee on Appropriations with favorable
3 recommendation:
4
5 Amend printed bill, page 2, after line 12 insert:
6
7 "SECTION 2. In Colorado Revised Statutes, 12-280-123, add
8 (1)(c) as follows:
9 12-280-123. Prescription required - exception - dispensing
10 opiate antagonists. (1) (c) A PHARMACIST WHO DISPENSES A
11 PRESCRIPTION ORDER FOR A PRESCRIPTION DRUG THAT IS AN OPIOID SHALL
12 NOTIFY THE INDIVIDUAL TO WHOM THE OPIOID IS BEING DISPENSED ABOUT
13 THE AVAILABILITY OF AN OPIATE ANTAGONIST WHEN, IN THE
14 PHARMACIST'S PROFESSIONAL JUDGMENT, THE INDIVIDUAL WOULD
15 BENEFIT FROM THE NOTIFICATION.".
16
17 Renumber succeeding sections accordingly.
18
19 Page 4, strike lines 12 through 27 and substitute:
20
21 "SECTION 7. In Colorado Revised Statutes, 25-1-520, amend
22 (2.5) as follows:
23 25-1-520. Clean syringe exchange programs - operation -
24 approval - reporting requirements. (2.5) (a) A program developed
25 pursuant to this section may be operated in a hospital NONPROFIT
26 ORGANIZATION WITH EXPERIENCE OPERATING A CLEAN SYRINGE
27 EXCHANGE PROGRAM OR A HEALTH FACILITY licensed or certified by the
28 state department pursuant to section 25-1.5-103 (1)(a) MAY OPERATE A
29 CLEAN SYRINGE EXCHANGE PROGRAM WITHOUT PRIOR BOARD APPROVAL.
30 (b) A HEALTH FACILITY THAT OPERATES A CLEAN SYRINGE
31 EXCHANGE PROGRAM PURSUANT TO THIS SUBSECTION (2.5) SHALL REPORT
32 TO THE STATE DEPARTMENT EACH MONTH DETAILING THE DEMOGRAPHICS
33 OF THE CLIENTS THE FACILITY SERVED, THE NUMBER OF CLEAN SYRINGES
34 DISPENSED, AND THE NUMBER OF USED SYRINGES COLLECTED.
35 (c) PRIOR TO OPERATING A CLEAN SYRINGE EXCHANGE PROGRAM
36 PURSUANT TO THIS SUBSECTION (2.5), A NONPROFIT ORGANIZATION SHALL
37 CONSULT WITH INTERESTED STAKEHOLDERS AND DISCUSS THE ISSUES
38 DESCRIBED IN SUBSECTION (1) OF THIS SECTION. A NONPROFIT
39 ORGANIZATION THAT OPERATES A CLEAN SYRINGE EXCHANGE PROGRAM
40 PURSUANT TO THIS SUBSECTION (2.5) SHALL REPORT TO THE STATE
41 DEPARTMENT EACH MONTH DETAILING THE DEMOGRAPHICS OF THE
42 CLIENTS THE NONPROFIT ORGANIZATION SERVED, THE NUMBER OF CLEAN
43 SYRINGES DISPENSED, AND THE NUMBER OF USED SYRINGES COLLECTED.".
44
45 Strike page 5.
46
47 Page 6, strike lines 1 through 14.
48
49 Page 7, after line 2 insert:
50
51 "SECTION 9. In Colorado Revised Statutes, 12-280-123, add
52 (1)(c) as follows:
53 12-280-123. Prescription required - exception - dispensing
54 opiate antagonists. (1) (c) A PHARMACIST WHO DISPENSES A
55 PRESCRIPTION ORDER FOR A PRESCRIPTION DRUG THAT IS AN OPIOID SHALL
1 NOTIFY THE INDIVIDUAL TO WHOM THE OPIOID IS BEING DISPENSED ABOUT
2 THE AVAILABILITY OF AN OPIATE ANTAGONIST AT NO CHARGE TO THE
3 INDIVIDUAL WHEN, IN THE PHARMACIST'S PROFESSIONAL JUDGMENT, THE
4 INDIVIDUAL WOULD BENEFIT FROM THE NOTIFICATION.
5 SECTION 10. Effective date. (1) Except as otherwise provided
6 in this section, this act takes effect upon passage.
7 7 (2) Section 2 of this act takes effect only if Senate Bill 20-
8 does not become law.
7 9 (3) Section 10 of this act takes effect only if Senate Bill 20-
10 becomes law, in which case section 10 takes effect on the effective date
11 of this act or Senate Bill 20-007, whichever is later.".
12
13 Renumber succeeding section accordingly.
14
15 Page 1, line 101, strike "MEASURES" and substitute "THE USE OF
16 MEASURES THAT DO NOT INVOLVE SCHEDULE 1 CONTROLLED
17 SUBSTANCES".
18
19

House Journal, June 8
19 HB20-1065 be amended as follows, and as so amended, be referred to
20 the Committee of the Whole with favorable
21 recommendation:
22
23 Amend printed bill, page 6, strike lines 15 through 27.
24
25 Page 7, strike lines 1 and 2.
26
27

House Journal, June 8
29 Amendment No. 1, Appropriations Report, dated June 8, 2020, and
30 placed in member’s bill file; Report also printed in House Journal, June
31 8, 2020.
32
33 Amendment No. 2, Health & Insurance Report, dated February 19, 2020,
34 and placed in member’s bill file; Report also printed in House Journal,
35 February 20, 2020.
36
37 Amendment No. 3, by Representative Kennedy.
38
39 Amend the Health and Insurance Committee Report, dated February 19,
40 2020, page 2, strike lines 2 through 6.
41
42 Page 2 of the report, line 7, strike "(c)" and substitute "(b)".
43
44 Page 2 of the report, strike lines 10 through 15 and substitute "DESCRIBED
45 IN SUBSECTION (1) OF THIS SECTION.
46 (c) EACH NONPROFIT ORGANIZATION AND HEALTH FACILITY THAT
47 OPERATES A CLEAN SYRINGE EXCHANGE PROGRAM PURSUANT TO THIS
48 SUBSECTION (2.5) SHALL ANNUALLY REPORT TO THE STATE DEPARTMENT
49 SPECIFYING THE NONPROFIT ORGANIZATION'S OR HEALTH FACILITY'S
50 NUMBER OF SYRINGE ACCESS EPISODES IN THE PREVIOUS YEAR AND THE
51 NUMBER OF USED SYRINGES COLLECTED BY THE NONPROFIT
52 ORGANIZATION OR HEALTH FACILITY.".".
53
54 Page 2 of the report, after line 17 insert:
55
56 "Renumber succeeding sections accordingly.".
1 Page 2 of the report, strike line 18 and substitute:
2
3 "Page 7 of the bill, strike lines 3 through 5 and substitute:".
4
5 Page 2 of the report, line 19, strike "9." and substitute "8.".
6
7 Page 2 of the report, strike lines 28 through 35 and substitute:
8 "SECTION 9. Act subject to petition - effective date.
9 (1) Except as otherwise provided in this section, this act takes effect at
10 12:01 a.m. on the day following the expiration of the ninety-day period
11 after final adjournment of the general assembly; except that, if a
12 referendum petition is filed pursuant to section 1 (3) of article V of the
13 state constitution against this act or an item, section, or part of this act
14 within such period, then the act, item, section, or part will not take effect
15 unless approved by the people at the general election to be held in
16 November 2022 and, in such case, will take effect on the date of the
17 official declaration of the vote thereon by the governor.
7 18 (2) Section 2 of this act takes effect only if Senate Bill 20-
19 does not become law.
7 20 (3) Section 8 of this act takes effect only if Senate Bill 20-
21 becomes law, in which case section 8 takes effect on the effective date of
22 this act or Senate Bill 20-007, whichever is later.".".
23
24 Page 3 of the report, line 2, strike "1" and substitute "I".
25
26 As amended, ordered engrossed and placed on the Calendar for Third
27 Reading and Final Passage.
28

Senate Journal, June 10
After consideration on the merits, the Committee recommends that HB20-1065 be
amended as follows, and as so amended, be referred to the Committee of the Whole with
favorable recommendation.

Amend reengrossed bill, page 2, lines 4 and 5, strike "antagonists
provided by a hospital - definition." and substitute "antagonists -
definition.".

Page 2, after line 12 insert:

"(3) A CARRIER SHALL REIMBURSE A PHARMACIST EMPLOYED BY
AN IN-NETWORK PHARMACY FOR PRESCRIBING AND DISPENSING AN
OPIATE ANTAGONIST IN ACCORDANCE WITH SECTION 12-30-111 TO A
COVERED PERSON. A CARRIER SHALL PROVIDE A PHARMACIST WHO
PRESCRIBES AND DISPENSES AN OPIATE ANTAGONIST PURSUANT TO
SECTION 12-30-111:
(a) IF MEDICAL BILLING IS AVAILABLE, AN ADEQUATE
CONSULTATIVE FEE EQUIVALENT TO THE CONSULTATIVE FEE PROVIDED TO
A PHYSICIAN LICENSED PURSUANT TO ARTICLE 240 OF TITLE 12 OR AN
ADVANCED PRACTICE NURSE LICENSED PURSUANT TO ARTICLE 255 OF
TITLE 12; OR
(b) IF MEDICAL BILLING IS NOT AVAILABLE, AN ENHANCED
DISPENSING FEE THAT IS EQUIVALENT TO THE CONSULTATIVE FEE
SPECIFIED IN SUBSECTION (3)(a) OF THIS SECTION.
SECTION 2. In Colorado Revised Statutes, 12-30-110, amend
(1)(a) introductory portion, (2)(a), (3) introductory portion, (4)(a), and
(7)(h); and repeal (7)(g) as follows:
12-30-110. Prescribing or dispensing opiate antagonists -
authorized recipients - definitions. (1) (a) A prescriber may prescribe
or dispense, directly or in accordance with standing orders and protocols,
and a pharmacist may dispense, pursuant to an order or standing orders
and protocols, an opiate antagonist to:
(2) (a) A prescriber who prescribes or dispenses, or a pharmacist
who dispenses, DISPENSES an opiate antagonist pursuant to this section
is strongly encouraged to educate persons receiving the opiate antagonist
on the use of an opiate antagonist for overdose, including instruction
concerning risk factors for overdose, recognizing an overdose, calling
emergency medical services, rescue breathing, and administering an
opiate antagonist.
(3) Neither A prescriber described in subsection (7)(h)(I)of this
section nor a pharmacist engages DOES NOT ENGAGE in unprofessional
conduct pursuant to section 12-240-121, or 12-280-126, respectively, and
a prescriber described in subsection (7)(h)(II) of this section does not
engage in conduct that is grounds for discipline pursuant to section OR
12-255-120, RESPECTIVELY, if the prescriber issues standing orders and
protocols regarding opiate antagonists or prescribes or dispenses, or the
pharmacist dispenses, pursuant to an order or standing orders and
protocols, an opiate antagonist in a good-faith effort to assist:
(4) (a) A prescriber or pharmacist who prescribes or dispenses an
opiate antagonist in accordance with this section is not subject to civil
liability or criminal prosecution, as specified in sections 13-21-108.7 (4)
and 18-1-712 (3), respectively.
(7) As used in this section:
(g) "Pharmacist" means an individual licensed by the state
pursuant to article 280 of this title 12 to engage in the practice of
pharmacy.
(h) "Prescriber" means:
(I) A physician or physician assistant licensed pursuant to article
240 of this title 12; or
(II) An advanced practice nurse, as defined in section 12-255-104
(1), with prescriptive authority pursuant to section 12-255-112; OR
(III) A PHARMACIST LICENSED PURSUANT TO SECTION
12-280-114.".

Renumber succeeding sections accordingly.

Page 2, lines 13 and 14, strike "add (1)(c)" and substitute "amend (3);
and add (1)(c) and (4)".

Page 3, strike lines 1 through 11 and substitute "opiate antagonists -
selling nonprescription syringes and needles. (1) (c) (I) A
PHARMACIST WHO DISPENSES A PRESCRIPTION ORDER FOR A PRESCRIPTION
DRUG THAT IS AN OPIOID SHALL INFORM THE INDIVIDUAL TO WHOM THE
OPIOID IS BEING DISPENSED OF THE POTENTIAL DANGERS OF A HIGH DOSE
OF OPIOID AND OFFER TO PRESCRIBE THE INDIVIDUAL, ON AT LEAST AN
ANNUAL BASIS, AN OPIATE ANTAGONIST APPROVED BY THE FEDERAL FOOD
AND DRUG ADMINISTRATION FOR THE REVERSAL OF AN OPIOID OVERDOSE
IF:
(A) IN THE PHARMACIST'S PROFESSIONAL JUDGMENT, THE
INDIVIDUAL WOULD BENEFIT FROM THE NOTIFICATION; OR
(B) THE OPIOID PRESCRIPTION IS AT OR IN EXCESS OF NINETY
MORPHINE MILLIGRAM EQUIVALENT, AS DESCRIBED IN THE GUIDELINES OF
THE FEDERAL CENTERS FOR DISEASE CONTROL AND PREVENTION.
(II) IF AN INDIVIDUAL TO WHOM AN OPIOID IS BEING DISPENSED
CHOOSES TO ACCEPT THE PHARMACIST'S PRESCRIPTION FOR AN OPIATE
ANTAGONIST, THE PHARMACIST SHALL COUNSEL THE INDIVIDUAL ON HOW
TO USE THE OPIATE ANTAGONIST IN THE EVENT OF AN OVERDOSE.
(III) AN IN-NETWORK PHARMACIST WHO PRESCRIBES AN OPIOID
ANTAGONIST TO AN INDIVIDUAL PURSUANT TO THIS SECTION IS ENTITLED
TO AN ADEQUATE CONSULTATIVE FEE OR AN ENHANCED DISPENSING FEE
AS SPECIFIED IN SECTION 10-16-152 (3).
(3) A pharmacist may PRESCRIBE AND dispense an opiate
antagonist in accordance with section 12-30-110.
(4) A PHARMACIST OR PHARMACY TECHNICIAN MAY SELL A".

Renumber succeeding sections accordingly.

Page 5, strike lines 16 through 27.

Page 6, strike lines 1 through 12 and substitute:

"SECTION 8. Act subject to petition - effective date. This act
takes effect at 12:01 a.m. on the day following the expiration of the
ninety-day period after final adjournment of the general assembly; except
that, if a referendum petition is filed pursuant to section 1 (3) of article
V of the state constitution against this act or an item, section, or part of
this act within such period, then the act, item, section, or part will not
take effect unless approved by the people at the general election to be
held in November 2022 and, in such case, will take effect on the date of
the official declaration of the vote thereon by the governor.".


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