Session of 2000
By Committee on Appropriations

10             AN  ACT concerning hospice; relating to hospice homes and pain man-
11             agement, emergency medication kits; amending K.S.A. 1999 Supp. 65-
12             1659 and repealing the existing section.
14       Be it enacted by the Legislature of the State of Kansas:
15             Section  1. K.S.A. 1999 Supp. 65-1659 is hereby amended to read as
16       follows: 65-1659. (a) A pharmacy will be allowed to place certain drugs
17       with a home health agency's authorized employees and with a hospice's
18       authorized employees for the betterment of public health. The pharmacy
19       shall remain the legal owner of the drugs. A written agreement between
20       the pharmacy and home health agency or hospice shall document the
21       protocol for handling and storage of these drugs by authorized employees
22       and shall be approved by the pharmacist in charge. The pharmacist in
23       charge shall review the protocol to assure that safe, secure and account-
24       able handling of legend drugs is maintained under the protocol before
25       giving approval. The pharmacist in charge or a pharmacist designee shall
26       physically inspect and review the drug storage and handling at the home
27       health agency and the hospice at least quarterly during the year.
28             (b) The home health agency protocol and the hospice protocol shall
29       include, but not be limited to, the following:
30             (1) Safe and secure storage of drugs;
31             (2) access to drugs limited to authorized employees;
32             (3) records of drugs checked out to authorized employees and re-
33       cords of drugs, amounts, to whom and by whom administered;
34             (4) prompt notification of the pharmacy when a drug is used, includ-
35       ing the prescriber, patient, drug, dosage form, directions for use and other
36       pertinent information;
37             (5) billing information;
38             (6) procedures for handling drugs beyond their expiration date; and
39             (7) inventory control.
40             (c) The following legend drugs shall be allowed under these
41       agreements:
42             (1) Sterile water for injection or irrigation;
43             (2) sterile saline solution for injection or irrigation;


  1             (3) heparin flush solution;
  2             (4) diphenhydramine injectable; and
  3             (5) epinephrine injectable.
  4             (d)  (1) Nothing contained in this act shall be construed as prohibiting
  5       a hospice home which has a written agreement with a pharmacy as set
  6       forth in subsection (a), and amendments thereto, from maintaining an
  7       emergency medication kit for pain management of a patient in the home.
  8             (2) The hospice protocol of subsection (b) and paragraph (4) of sub-
  9       section (d), and amendments thereto, shall be utilized for management of
10       the emergency medication kit.
11             (3) The emergency medication kit may contain schedule II, III and
12       IV controlled substances and must be approved by a licensed practitioner
13       who cares for the terminally ill and the pharmacist. The emergency med-
14       ication kit shall be used only in emergency cases under the direction of a
15       licensed practitioner or a mid-level practitioner. The pharmacist shall
16       have supervisory responsibility of maintaining the emergency medication
17       kit.
18             (4) Every hospice home which maintains an emergency medication
19       kit shall comply with the following requirements:
20             (A) Administration of controlled substances contained within the
21       emergency medication kit shall be in compliance with the provisions of
22       the uniform controlled substances act.
23             (B) The pharmacist of the hospice home shall be responsible for de-
24       veloping procedures, proper control and accountability for the emergency
25       medication kit and shall maintain complete and accurate records of the
26       controlled substances, if any, placed in the emergency kit. Periodic phys-
27       ical inventory of the kit shall be required.
28             (e)   (1) The hospice home, when registered by the board of phar-
29       macy, may keep drugs for the purpose of distributing drugs to patients
30       being treated by that hospice home. A designated registered nurse or
31       nurses approved by the pharmacist in charge shall be in charge of distri-
32       bution and control of the emergency medication kit drugs in the hospice
33       home at the direction of a licensed practitioner or mid-level practitioner
34       when a pharmacist is not on the premises. Drugs supplied to patients
35       when a pharmacist is not on the premises shall be limited to the quantity
36       necessary to control the patient's pain as ordered by the practitioner until
37       the patient's own medication arrives at the hospice home.
38             (2) The board of pharmacy shall adopt rules and regulations relating
39       to specific emergency medication kit drugs to be used, to recordkeeping
40       and to storage of the drugs by the hospice home as are necessary for
41       proper control of such drugs.
42             (d) (f) As used in this section: (1) ``Authorized employee'' means any
43       employee of a home health agency or hospice who, in the course of the


  1       employee's duties, is licensed by the employee's appropriate licensing
  2       agency to administer legend drugs; (2) ``home health agency'' means an
  3       entity required to be licensed under K.S.A. 65-5102 and amendments
  4       thereto; and (3) hospice means an entity authorized to hold itself out to
  5       the public as a hospice or as a licensed hospice under K.S.A. 1999 Supp.
  6       65-6202 and amendments thereto.
  7             (e) (g) This section shall be part of and supplemental to the pharmacy
  8       act of the state of Kansas. 
  9       Sec.  2. K.S.A. 1999 Supp. 65-1659 is hereby repealed.
10        Sec.  3. This act shall take effect and be in force from and after its
11       publication in the statute book.