SLS 18RS-460 REENGROSSED
2018 Regular Session
SENATE BILL NO. 90
BY SENATOR MILLS
HEALTH CARE. Provides relative to a voluntary nonopioid directive form. (8/1/18)
1 AN ACT
2 To enact Subpart D of Part 1 of Subchapter A of Chapter 5-D of Title 40 of the Louisiana
3 Revised Statutes of 1950, to be comprised of R.S. 40:1156.1, relative to a voluntary
4 nonopioid directive form; to provide for voluntary prescription opioid opt-out
5 opportunity for patients; to provide for a form; to provide for access to the form; to
6 provide for immunity; and to provide for related matters.
7 Be it enacted by the Legislature of Louisiana:
8 Section 1. Subpart D of Part 1 of Subchapter A of Chapter 5-D of Title 40 of the
9 Louisiana Revised Statutes of 1950, comprised of R.S. 40:1156.1, is hereby enacted to read
10 as follows:
11 SUBPART D. PRESCRIPTION NONOPIOID DIRECTIVE
12 ยง1156.1. Voluntary nonopioid directive; form; immunity
13 A. The Louisiana Department of Health, in consultation with the office
14 of behavioral health, shall establish a voluntary nonopioid directive form and
15 shall publish the form prominently on the department's website for public use.
16 B. A patient may execute and file a voluntary nonopioid directive form
17 with a prescribing practitioner when the patient does not wish to be issued a
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Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions. SB NO. 90
SLS 18RS-460 REENGROSSED
1 prescription or medication order for an opioid. Upon receipt of a voluntary
2 nonopioid directive form, a prescribing practitioner shall date and affix his
3 signature to the form in the presence of the patient as evidence of acceptance,
4 document the receipt in the patient's medical record, and provide a signed copy
5 of the form to the patient.
6 C. The voluntary nonopioid directive form established by the
7 department shall allow a patient or when the patient is unable to consent for
8 himself, any person duly authorized and empowered to provide medical consent
9 for the patient under the provisions of R.S. 40:1151.4, to revoke the directive,
10 orally or in writing, for any reason, at any time.
11 D. An electronically transmitted prescription to a pharmacy shall be
12 presumed to be valid for the purposes of this Section, and a pharmacist shall not
13 be held in violation of this Section for dispensing a controlled substance in
14 contradiction to a voluntary nonopioid form.
15 E. No prescribing practitioner who has signed and executed a nonopioid
16 directive form with a patient acting with reasonable care shall be liable for
17 damages in a civil action or subject to criminal prosecution or be deemed to
18 have violated the standard of care for such prescribing practitioner for refusing
19 to issue a prescription or medication order for an opioid pursuant to a
20 voluntary nonopioid directive form.
21 F. No person acting in good faith as a duly authorized guardian or health
22 care representative pursuant to Subsection C of this Section shall be liable for
23 damages in a civil action or subject to criminal prosecution for revoking or
24 overriding a voluntary nonopioid directive form.
25 G. No prescribing practitioner shall be liable for damages in a civil
26 action, subject to criminal prosecution, or deemed to have violated the standard
27 of care for a prescribing practitioner's profession for issuing a prescription for
28 or administering a controlled substance containing an opioid to a patient when
29 the patient and the prescribing practitioner have not executed and filed a
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1 voluntary nonopioid directive form under the provisions of this Subpart.
2 H. A prescribing practitioner who willfully fails to comply with a
3 patient's voluntary nonopioid directive form may be subject to disciplinary
4 action pursuant to rules promulgated by his health profession licensing board.
The original instrument was prepared by Christine Arbo Peck. The following
digest, which does not constitute a part of the legislative instrument, was
prepared by Cheryl M. Serrett.
DIGEST
SB 90 Reengrossed 2018 Regular Session Mills
Proposed law requires LDH to establish and post a voluntary nonopioid directive form on
its website to allow a patient to voluntarily opt-out of receiving opioid prescriptions from
his prescribing practitioner(s). Proposed law allows a patient and his prescribing practitioner
to sign, execute, and file the nonopioid directive. Proposed law allows a patient to appoint
a duly authorized guardian or health care representative to override an opt-out directive
orally or in writing, for any reason, at any time.
Proposed law provides immunity from civil, criminal, and professional licensure sanctions
for pharmacists who dispense an opioid based on an electronic prescription, prescribing
practitioners acting with reasonable care for refusing to issue an opioid prescription, an
authorized guardian or health care representative for revoking the nonopioid directive, and
a prescribing practitioner for issuing a prescription for or administering a controlled
substance containing an opioid when he was not a party to the executed and filed nonopioid
directive.
Proposed law authorizes health professional licensing boards that regulate prescribers to
promulgate rules regarding disciplinary action against a prescribing practitioner who
willfully fails to comply with a patient's voluntary nonopioid directive form.
Effective August 1, 2018.
(Adds R.S. 40:1156.1)
Summary of Amendments Adopted by Senate
Committee Amendments Proposed by Senate Committee on Health and Welfare to
the original bill
1. Provides additional clarification on the steps required to execute the
nonopioid directive to confirm that the directive is only applicable between
the prescriber and patient that executed the directive.
2. Provides that the duly authorized representative is empowered by provisions
of current law regarding medical consent.
3. Removes specific exemptions from liability for emergency department
prescribers and makes exemption applicable to all prescribers who are not a
party to the nonopioid directive.
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Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions. SB NO. 90
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Senate Floor Amendments to engrossed bill
1. Makes technical changes.
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Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.