FIRSTREGULARSESSION
HOUSECOMMITTEESUBSTITUTEFOR
HOUSEBILLNO.609
103RDGENERALASSEMBLY
1674H.02C JOSEPHENGLER,ChiefClerk
ANACT
Torepealsections195.010,195.030,and338.165,RSMo,andtoenactinlieuthereofthree
newsectionsrelatingtohealthcareproviders.
BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows:
SectionA.Sections195.010,195.030,and338.165,RSMo,arerepealedandthree
2newsectionsenactedinlieuthereof,tobeknownassections195.010,195.030,and338.165,
3toreadasfollows:
195.010.Thefollowingwordsandphrasesasusedinthischapterandchapter579,
2unlessthecontextotherwiserequires,mean:
3 (1)"Acutepain",pain,whetherresultingfromdisease,accidentalorintentional
4trauma,orothercauses,thatthepractitionerreasonablyexpectstolastonlyashortperiodof
5time.Acutepainshallnotincludechronicpain,painbeingtreatedaspartofcancercare,
6hospiceorotherend-of-lifecare,ormedication-assistedtreatmentforsubstanceuse
7disorders;
8 (2)"Addict",apersonwhohabituallyusesoneormorecontrolledsubstancestosuch
9anextentastocreateatoleranceforsuchdrugs,andwhodoesnothaveamedicalneedfor
10suchdrugs,orwhoissofaraddictedtotheuseofsuchdrugsastohavelostthepowerofself-
11controlwithreferencetohisorheraddiction;
12 (3)"Administer",toapplyacontrolledsubstance,whetherbyinjection,inhalation,
13ingestion,oranyothermeans,directlytothebodyofapatientorresearchsubjectby:
14 (a)Apractitioner(or,inhisorherpresence,byhisorherauthorizedagent);or
15 (b)Thepatientorresearchsubjectatthedirectionandinthepresenceofthe
16practitioner;
EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis
intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 17 (4)"Agent",anauthorizedpersonwhoactsonbehalfoforatthedirectionofa
18manufacturer,distributor,ordispenser.Thetermdoesnotincludeacommonorcontract
19carrier,publicwarehouseman,oremployeeofthecarrierorwarehousemanwhileactinginthe
20usualandlawfulcourseofthecarrier'sorwarehouseman'sbusiness;
21 (5)"Attorneyforthestate",anyprosecutingattorney,circuitattorney,orattorney
22generalauthorizedtoinvestigate,commenceandprosecuteanactionunderthischapter;
23 (6)"Controlledsubstance",adrug,substance,orimmediateprecursorinSchedulesI
24throughVlistedinthischapter;
25 (7)"Controlledsubstanceanalogue",asubstancethechemicalstructureofwhichis
26substantiallysimilartothechemicalstructureofacontrolledsubstanceinScheduleIorII
27and:
28 (a)Whichhasastimulant,depressant,orhallucinogeniceffectonthecentralnervous
29systemsubstantiallysimilartothestimulant,depressant,orhallucinogeniceffectonthe
30centralnervoussystemofacontrolledsubstanceincludedinScheduleIorII;or
31 (b)Withrespecttoaparticularindividual,whichthatindividualrepresentsorintends
32tohaveastimulant,depressant,orhallucinogeniceffectonthecentralnervoussystem
33substantiallysimilartothestimulant,depressant,orhallucinogeniceffectonthecentral
34nervoussystemofacontrolledsubstanceincludedinScheduleIorII.Thetermdoesnot
35includeacontrolledsubstance;anysubstanceforwhichthereisanapprovednewdrug
36application;anysubstanceforwhichanexemptionisineffectforinvestigationaluse,fora
37particularperson,underSection505ofthefederalFood,DrugandCosmeticAct(21U.S.C.
38Section355)totheextentconductwithrespecttothesubstanceispursuanttotheexemption;
39oranysubstancetotheextentnotintendedforhumanconsumptionbeforesuchanexemption
40takeseffectwithrespecttothesubstance;
41 (8)"Counterfeitsubstance",acontrolledsubstancewhich,orthecontainerorlabeling
42ofwhich,withoutauthorization,bearsthetrademark,tradename,orotheridentifyingmark,
43imprint,numberordevice,oranylikenessthereof,ofamanufacturer,distributor,ordispenser
44otherthanthepersonwhoinfactmanufactured,distributed,ordispensedthesubstance;
45 (9)"Deliver"or"delivery",theactual,constructive,orattemptedtransferfromone
46persontoanotherofdrugparaphernaliaorofacontrolledsubstance,oranimitation
47controlledsubstance,whetherornotthereisanagencyrelationship,andincludesasale;
48 (10)"Dentist",apersonauthorizedbylawtopracticedentistryinthisstate;
49 (11)"Depressantorstimulantsubstance":
50 (a)Adrugcontaininganyquantityofbarbituricacidoranyofthesaltsofbarbituric
51acidoranyderivativeofbarbituricacidwhichhasbeendesignatedbytheUnitedStates
52SecretaryofHealthandHumanServicesashabitformingunder21U.S.C.Section352(d);
53 (b)Adrugcontaininganyquantityof:
HCSHB609 2 54 a.Amphetamineoranyofitsisomers;
55 b.Anysaltofamphetamineoranysaltofanisomerofamphetamine;or
56 c.AnysubstancetheUnitedStatesAttorneyGeneral,afterinvestigation,hasfoundto
57be,andbyregulationdesignatedas,habitformingbecauseofitsstimulanteffectonthe
58centralnervoussystem;
59 (c)Lysergicaciddiethylamide;or
60 (d)AnydrugcontaininganyquantityofasubstancethattheUnitedStatesAttorney
61General,afterinvestigation,hasfoundtohave,andbyregulationdesignatedashaving,a
62potentialforabusebecauseofitsdepressantorstimulanteffectonthecentralnervoussystem
63oritshallucinogeniceffect;
64 (12)"Dispense",todeliveranarcoticorcontrolleddangerousdrugtoanultimateuser
65orresearchsubjectbyorpursuanttothelawfulorderofapractitionerincludingthe
66prescribing,administering,packaging,labeling,orcompoundingnecessarytopreparethe
67substanceforsuchdelivery."Dispenser"meansapractitionerwhodispenses;
68 (13)"Distribute",todeliverotherthanbyadministeringordispensingacontrolled
69substance;
70 (14)"Distributor",apersonwhodistributes;
71 (15)"Drug":
72 (a)SubstancesrecognizedasdrugsintheofficialUnitedStatesPharmacopoeia,
73OfficialHomeopathicPharmacopoeiaoftheUnitedStates,orOfficialNationalFormulary,or
74anysupplementtoanyofthem;
75 (b)Substancesintendedforuseinthediagnosis,cure,mitigation,treatmentor
76preventionofdiseaseinhumansoranimals;
77 (c)Substances,otherthanfood,intendedtoaffectthestructureoranyfunctionofthe
78bodyofhumansoranimals;and
79 (d)Substancesintendedforuseasacomponentofanyarticlespecifiedinthis
80subdivision.Itdoesnotincludedevicesortheircomponents,partsoraccessories;
81 (16)"Drug-dependentperson",apersonwhoisusingacontrolledsubstanceandwho
82isinastateofpsychicorphysicaldependence,orboth,arisingfromtheuseofsuchsubstance
83onacontinuousbasis.Drugdependenceischaracterizedbybehavioralandotherresponses
84whichincludeastrongcompulsiontotakethesubstanceonacontinuousbasisinorderto
85experienceitspsychiceffectsortoavoidthediscomfortcausedbyitsabsence;
86 (17)"Drugenforcementagency",theDrugEnforcementAdministrationintheUnited
87StatesDepartmentofJustice,oritssuccessoragency;
88 (18)"Drugparaphernalia",allequipment,products,substancesandmaterialsofany
89kindwhichareused,intendedforuse,ordesignedforuse,inplanting,propagating,
90cultivating,growing,harvesting,manufacturing,compounding,converting,producing,
HCSHB609 3 91processing,preparing,storing,containing,concealing,injecting,ingesting,inhaling,or
92otherwiseintroducingintothehumanbodyacontrolledsubstanceoranimitationcontrolled
93substanceinviolationofthischapterorchapter579.Itincludes,butisnotlimitedto:
94 (a)Kitsused,intendedforuse,ordesignedforuseinplanting,propagating,
95cultivating,growingorharvestingofanyspeciesofplantwhichisacontrolledsubstanceor
96fromwhichacontrolledsubstancecanbederived;
97 (b)Kitsused,intendedforuse,ordesignedforuseinmanufacturing,compounding,
98converting,producing,processing,orpreparingcontrolledsubstancesorimitationcontrolled
99substances;
100 (c)Isomerizationdevicesused,intendedforuse,ordesignedforuseinincreasingthe
101potencyofanyspeciesofplantwhichisacontrolledsubstanceoranimitationcontrolled
102substance;
103 (d)Testingequipmentused,intendedforuse,ordesignedforuseinidentifying,orin
104analyzingthestrength,effectivenessorpurityofcontrolledsubstancesorimitationcontrolled
105substances;
106 (e)Scalesandbalancesused,intendedforuse,ordesignedforuseinweighingor
107measuringcontrolledsubstancesorimitationcontrolledsubstances;
108 (f)Dilutentsandadulterants,suchasquininehydrochloride,mannitol,mannite,
109dextroseandlactose,used,intendedforuse,ordesignedforuseincuttingcontrolled
110substancesorimitationcontrolledsubstances;
111 (g)Separationginsandsiftersused,intendedforuse,ordesignedforuseinremoving
112twigsandseedsfrom,orinotherwisecleaningorrefining,marijuana;
113 (h)Blenders,bowls,containers,spoonsandmixingdevicesused,intendedforuse,or
114designedforuseincompoundingcontrolledsubstancesorimitationcontrolledsubstances;
115 (i)Capsules,balloons,envelopesandothercontainersused,intendedforuse,or
116designedforuseinpackagingsmallquantitiesofcontrolledsubstancesorimitationcontrolled
117substances;
118 (j)Containersandotherobjectsused,intendedforuse,ordesignedforuseinstoring
119orconcealingcontrolledsubstancesorimitationcontrolledsubstances;
120 (k)Hypodermicsyringes,needlesandotherobjectsused,intendedforuse,or
121designedforuseinparenterallyinjectingcontrolledsubstancesorimitationcontrolled
122substancesintothehumanbody;
123 (l)Objectsused,intendedforuse,ordesignedforuseiningesting,inhaling,or
124otherwiseintroducingmarijuana,cocaine,hashish,orhashishoilintothehumanbody,such
125as:
126 a.Metal,wooden,acrylic,glass,stone,plastic,orceramicpipeswithorwithout
127screens,permanentscreens,hashishheads,orpuncturedmetalbowls;
HCSHB609 4 128 b.Waterpipes;
129 c.Carburetiontubesanddevices;
130 d.Smokingandcarburetionmasks;
131 e.Roachclipsmeaningobjectsusedtoholdburningmaterial,suchasamarijuana
132cigarette,thathasbecometoosmallortooshorttobeheldinthehand;
133 f.Miniaturecocainespoonsandcocainevials;
134 g.Chamberpipes;
135 h.Carburetorpipes;
136 i.Electricpipes;
137 j.Air-drivenpipes;
138 k.Chillums;
139 l.Bongs;
140 m.Icepipesorchillers;
141 (m)Substancesused,intendedforuse,ordesignedforuseinthemanufactureofa
142controlledsubstance.
143
144Indeterminingwhetheranobject,product,substanceormaterialisdrugparaphernalia,a
145courtorotherauthorityshouldconsider,inadditiontoallotherlogicallyrelevantfactors,the
146following:
147 a.Statementsbyanownerorbyanyoneincontroloftheobjectconcerningitsuse;
148 b.Priorconvictions,ifany,ofanowner,orofanyoneincontroloftheobject,under
149anystateorfederallawrelatingtoanycontrolledsubstanceorimitationcontrolledsubstance;
150 c.Theproximityoftheobject,intimeandspace,toadirectviolationofthischapter
151orchapter579;
152 d.Theproximityoftheobjecttocontrolledsubstancesorimitationcontrolled
153substances;
154 e.Theexistenceofanyresidueofcontrolledsubstancesorimitationcontrolled
155substancesontheobject;
156 f.Directorcircumstantialevidenceoftheintentofanowner,orofanyoneincontrol
157oftheobject,todeliverittopersonswhoheorsheknows,orshouldreasonablyknow,intend
158tousetheobjecttofacilitateaviolationofthischapterorchapter579;theinnocenceofan
159owner,orofanyoneincontroloftheobject,astodirectviolationofthischapterorchapter
160579shallnotpreventafindingthattheobjectisintendedforuse,ordesignedforuseasdrug
161paraphernalia;
162 g.Instructions,oralorwritten,providedwiththeobjectconcerningitsuse;
163 h.Descriptivematerialsaccompanyingtheobjectwhichexplainordepictitsuse;
164 i.Nationalorlocaladvertisingconcerningitsuse;
HCSHB609 5 165 j.Themannerinwhichtheobjectisdisplayedforsale;
166 k.Whethertheowner,oranyoneincontroloftheobject,isalegitimatesupplierof
167likeorrelateditemstothecommunity,suchasalicenseddistributorordealeroftobacco
168products;
169 l.Directorcircumstantialevidenceoftheratioofsalesoftheobjecttothetotalsales
170ofthebusinessenterprise;
171 m.Theexistenceandscopeoflegitimateusesfortheobjectinthecommunity;
172 n.Experttestimonyconcerningitsuse;
173 o.Thequantity,formorpackagingoftheproduct,substanceormaterialinrelationto
174thequantity,formorpackagingassociatedwithanylegitimateusefortheproduct,substance
175ormaterial;
176 (19)"Federalnarcoticlaws",thelawsoftheUnitedStatesrelatingtocontrolled
177substances;
178 (20)"Hospital",aplacedevotedprimarilytothemaintenanceandoperationof
179facilitiesforthediagnosis,treatmentorcare,fornotlessthantwenty-fourhoursinanyweek,
180ofthreeormorenonrelatedindividualssufferingfromillness,disease,injury,deformityor
181otherabnormalphysicalconditions;oraplacedevotedprimarilytoprovide,fornotlessthan
182twenty-fourconsecutivehoursinanyweek,medicalornursingcareforthreeormore
183nonrelatedindividuals.Thetermhospitaldoesnotincludeconvalescent,nursing,shelteror
184boardinghomesasdefinedinchapter198,butshallincludeoutpatientfacilitiesownedand
185operatedbyahospital;
186 (21)"Illegalindustrialhemp":
187 (a)AllnonseedpartsandvarietiesoftheCannabissativaL.plant,growingornot,
188thatcontainanaveragedelta-9tetrahydrocannabinol(THC)concentrationexceedingthree-
189tenthsofonepercentonadryweightbasis;
190 (b)Illegalindustrialhempshallbedestroyedinthemosteffectivemannerpossible,
191andsuchdestructionshallbeverifiedbytheMissouristatehighwaypatrol;
192 (22)"Immediateprecursor",asubstancewhich:
193 (a)Thestatedepartmentofhealthandseniorserviceshasfoundtobeandbyrule
194designatesasbeingtheprincipalcompoundcommonlyusedorproducedprimarilyforusein
195themanufactureofacontrolledsubstance;
196 (b)Isanimmediatechemicalintermediaryusedorlikelytobeusedinthe
197manufactureofacontrolledsubstance;and
198 (c)Thecontrolofwhichisnecessarytoprevent,curtailorlimitthemanufactureof
199thecontrolledsubstance;
200 (23)"Imitationcontrolledsubstance",asubstancethatisnotacontrolledsubstance,
201whichbydosageunitappearance(includingcolor,shape,sizeandmarkings),orby
HCSHB609 6 202representationsmade,wouldleadareasonablepersontobelievethatthesubstanceisa
203controlledsubstance.Indeterminingwhetherthesubstanceisanimitationcontrolled
204substancethecourtorauthorityconcernedshouldconsider,inadditiontoallotherlogically
205relevantfactors,thefollowing:
206 (a)WhetherthesubstancewasapprovedbythefederalFoodandDrug
207Administrationforover-the-counter(nonprescriptionornonlegend)salesandwassoldin
208thefederalFoodandDrugAdministration-approvedpackage,withthefederalFoodandDrug
209Administration-approvedlabelinginformation;
210 (b)Statementsmadebyanownerorbyanyoneelseincontrolofthesubstance
211concerningthenatureofthesubstance,oritsuseoreffect;
212 (c)Whetherthesubstanceispackagedinamannernormallyusedforillicitcontrolled
213substances;
214 (d)Priorconvictions,ifany,ofanowner,oranyoneincontroloftheobject,under
215stateorfederallawrelatedtocontrolledsubstancesorfraud;
216 (e)Theproximityofthesubstancestocontrolledsubstances;
217 (f)Whethertheconsiderationtenderedinexchangeforthenoncontrolledsubstance
218substantiallyexceedsthereasonablevalueofthesubstanceconsideringtheactualchemical
219compositionofthesubstanceand,whereapplicable,thepriceatwhichover-the-counter
220substancesoflikechemicalcompositionsell.Animitationcontrolledsubstancedoesnot
221includeaplaceboorregisteredinvestigationaldrugeitherofwhichwasmanufactured,
222distributed,possessedordeliveredintheordinarycourseofprofessionalpracticeorresearch;
223 (24)"Industrialhemp":
224 (a)AllnonseedpartsandvarietiesoftheCannabissativaL.plant,growingornot,
225thatcontainanaveragedelta-9tetrahydrocannabinol(THC)concentrationthatdoesnot
226exceedthree-tenthsofonepercentonadryweightbasisorthemaximumconcentration
227allowedunderfederallaw,whicheverisgreater;
228 (b)AnyCannabissativaL.seedthatispartofagrowingcrop,retainedbyagrower
229forfutureplanting,orusedforprocessingintooruseasagriculturalhempseed;
230 (c)Industrialhempincludesindustrialhempcommoditiesandproductsandtopicalor
231ingestibleanimalandconsumerproductsderivedfromindustrialhempwithadelta-9
232tetrahydrocannabinolconcentrationofnotmorethanthree-tenthsofonepercentonadry
233weightbasis;
234 (25)"Initialprescription",aprescriptionissuedtoapatientwhohasneverpreviously
235beenissuedaprescriptionforthedrugoritspharmaceuticalequivalentorwhowaspreviously
236issuedaprescriptionforthedrugoritspharmaceuticalequivalent,butthedateonwhichthe
237currentprescriptionisbeingissuedismorethanfivemonthsafterthedatethepatientlast
238usedorwasadministeredthedrugoritsequivalent;
HCSHB609 7 239 (26)"Laboratory",alaboratoryapprovedbythedepartmentofhealthandsenior
240servicesaspropertobeentrustedwiththecustodyofcontrolledsubstancesbutdoesnot
241includeapharmacistwhocompoundscontrolledsubstancestobesoldordispensedon
242prescriptions;
243 (27)"Manufacture",theproduction,preparation,propagation,compoundingor
244processingofdrugparaphernaliaorofacontrolledsubstance,oranimitationcontrolled
245substance,eitherdirectlyorbyextractionfromsubstancesofnaturalorigin,orindependently
246bymeansofchemicalsynthesis,orbyacombinationofextractionandchemicalsynthesis,
247andincludesanypackagingorrepackagingofthesubstanceorlabelingorrelabelingofits
248container.Thistermdoesnotincludethepreparationorcompoundingofacontrolled
249substanceoranimitationcontrolledsubstanceorthepreparation,compounding,packagingor
250labelingofanarcoticordangerousdrug:
251 (a)Byapractitionerasanincidenttohisorheradministeringordispensingofa
252controlledsubstanceoranimitationcontrolledsubstanceinthecourseofhisorher
253professionalpractice;or
254 (b)Byapractitionerorhisorherauthorizedagentunderhisorhersupervision,for
255thepurposeof,orasanincidentto,research,teachingorchemicalanalysisandnotforsale;
256 (28)"Marijuana",allpartsoftheplantgenusCannabisinanyspeciesorformthereof,
257including,butnotlimitedtoCannabisSativaL.,exceptindustrialhemp,CannabisIndica,
258CannabisAmericana, CannabisRuderalis, andCannabisGigantea, whethergrowingornot,
259theseedsthereof,theresinextractedfromanypartoftheplant;andeverycompound,
260manufacture,salt,derivative,mixture,orpreparationoftheplant,itsseedsorresin.Itdoes
261notincludethematurestalksoftheplant,fiberproducedfromthestalks,oilorcakemade
262fromtheseedsoftheplant,anyothercompound,manufacture,salt,derivative,mixtureor
263preparationofthematurestalks(excepttheresinextractedtherefrom),fiber,oilorcake,or
264thesterilizedseedoftheplantwhichisincapableofgermination;
265 (29)"Methamphetamineprecursordrug",anydrugcontainingephedrine,
266pseudoephedrine,phenylpropanolamine,oranyoftheirsalts,opticalisomers,orsaltsof
267opticalisomers;
268 (30)"Narcoticdrug",anyofthefollowing,whetherproduceddirectlyorindirectlyby
269extractionfromsubstancesofvegetableorigin,orindependentlybymeansofchemical
270synthesis,orbyacombinationofextractionandchemicalanalysis:
271 (a)Opium,opiate,andanyderivative,ofopiumoropiate,includingtheirisomers,
272esters,ethers,salts,andsaltsofisomers,esters,andethers,whenevertheexistenceofthe
273isomers,esters,ethers,andsaltsispossiblewithinthespecificchemicaldesignation.The
274termdoesnotincludetheisoquinolinealkaloidsofopium;
HCSHB609 8 275 (b)Cocaleaves,butnotincludingextractsofcocaleavesfromwhichcocaine,
276ecgonine,andderivativesofecgonineortheirsaltshavebeenremoved;
277 (c)Cocaineoranysalt,isomer,orsaltofisomerthereof;
278 (d)Ecgonine,oranyderivative,salt,isomer,orsaltofisomerthereof;
279 (e)Anycompound,mixture,orpreparationcontaininganyquantityofanysubstance
280referredtoinparagraphs(a)to(d)ofthissubdivision;
281 (31)"Officialwrittenorder",anorderwrittenonaformprovidedforthatpurposeby
282theUnitedStatesCommissionerofNarcotics,underanylawsoftheUnitedStatesmaking
283provisiontherefor,ifsuchorderformsareauthorizedandrequiredbyfederallaw,andifno
284suchorderformisprovided,thenonanofficialformprovidedforthatpurposebythe
285departmentofhealthandseniorservices;
286 (32)"Opiate"or"opioid",anysubstancehavinganaddiction-formingoraddiction-
287sustainingliabilitysimilartomorphineorbeingcapableofconversionintoadrughaving
288addiction-formingoraddiction-sustainingliability.Thetermincludesitsracemicand
289levorotatoryforms.Itdoesnotinclude,unlessspecificallycontrolledundersection195.017,
290thedextrorotatoryisomerof3-methoxy-n-methyl-morphinananditssalts
291(dextromethorphan);
292 (33)"Opiumpoppy",theplantofthespeciesPapaversomniferumL.,exceptits
293seeds;
294 (34)"Over-the-countersale",aretailsalelicensedpursuanttochapter144ofadrug
295otherthanacontrolledsubstance;
296 (35)"Person",anindividual,corporation,governmentorgovernmentalsubdivisionor
297agency,businesstrust,estate,trust,partnership,jointventure,association,oranyotherlegal
298orcommercialentity;
299 (36)"Pharmacist",alicensedpharmacistasdefinedbythelawsofthisstate,and
300wherethecontextsorequires,theownerofastoreorotherplaceofbusinesswherecontrolled
301substancesarecompoundedordispensedbyalicensedpharmacist;butnothinginthischapter
302shallbeconstruedasconferringonapersonwhoisnotregisterednorlicensedasapharmacist
303anyauthority,rightorprivilegethatisnotgrantedtohimbythepharmacylawsofthisstate;
304 (37)"Poppystraw",allparts,excepttheseeds,oftheopiumpoppy,aftermowing;
305 (38)"Possessed"or"possessingacontrolledsubstance",aperson,withthe
306knowledgeofthepresenceandnatureofasubstance,hasactualorconstructivepossessionof
307thesubstance.Apersonhasactualpossessionifhehasthesubstanceonhisorherpersonor
308withineasyreachandconvenientcontrol.Apersonwho,althoughnotinactualpossession,
309hasthepowerandtheintentionatagiventimetoexercisedominionorcontroloverthe
310substanceeitherdirectlyorthroughanotherpersonorpersonsisinconstructivepossessionof
311it.Possessionmayalsobesoleorjoint.Ifonepersonalonehaspossessionofasubstance
HCSHB609 9 312possessionissole.Iftwoormorepersonssharepossessionofasubstance,possessionis
313joint;
314 (39)"Practitioner",aphysician,dentist,optometrist,podiatrist,veterinarian,scientific
315investigator,pharmacy,hospitalorotherpersonlicensed,registeredorotherwisepermittedby
316thisstatetodistribute,dispense,conductresearchwithrespecttooradministerortousein
317teachingorchemicalanalysis,acontrolledsubstanceinthecourseofprofessionalpracticeor
318researchinthisstate,orapharmacy,hospitalorotherinstitutionlicensed,registered,or
319otherwisepermittedtodistribute,dispense,conductresearchwithrespecttooradministera
320controlledsubstanceinthecourseofprofessionalpracticeorresearch;
321 (40)"Production",includesthemanufacture,planting,cultivation,growing,or
322harvestingofdrugparaphernaliaorofacontrolledsubstanceoranimitationcontrolled
323substance;
324 (41)"Registrynumber",thenumberassignedtoeachpersonregisteredunderthe
325federalcontrolledsubstanceslaws;
326 (42)"Sale",includesbarter,exchange,orgift,oroffertherefor,andeachsuch
327transactionmadebyanyperson,whetherasprincipal,proprietor,agent,servantoremployee;
328 (43)"State"whenappliedtoapartoftheUnitedStates,includesanystate,district,
329commonwealth,territory,insularpossessionthereof,andanyareasubjecttothelegal
330authorityoftheUnitedStatesofAmerica;
331 (44)"Syntheticcannabinoid",includesunlessspecificallyexceptedorunlesslistedin
332anotherschedule,anynaturalorsyntheticmaterial,compound,mixture,orpreparationthat
333containsanyquantityofasubstancethatisacannabinoidreceptoragonist,includingbutnot
334limitedtoanysubstancelistedinparagraph(ll)ofsubdivision(4)ofsubsection2ofsection
335195.017andanyanalogues;homologues;isomers,whetheroptical,positional,orgeometric;
336esters;ethers;salts;andsaltsofisomers,esters,andethers,whenevertheexistenceofthe
337isomers,esters,ethers,orsaltsispossiblewithinthespecificchemicaldesignation,however,
338itshallnotincludeanyapprovedpharmaceuticalauthorizedbytheUnitedStatesFoodand
339DrugAdministration;
340 (45)"Ultimateuser",apersonwholawfullypossessesacontrolledsubstanceoran
341imitationcontrolledsubstanceforhisorherownuseorfortheuseofamemberofhisorher
342householdorimmediatefamily,regardlessofwhethertheyliveinthesamehousehold,orfor
343administeringtoananimalownedbyhimorbyamemberofhisorherhousehold.For
344purposesofthissection,thephrase"immediatefamily"meansahusband,wife,parent,child,
345sibling,stepparent,stepchild,stepbrother,stepsister,grandparent,orgrandchild;
346 (46)"Wholesaler",apersonwhosuppliesdrugparaphernaliaorcontrolledsubstances
347orimitationcontrolledsubstancesthathehimselfhasnotproducedorprepared,onofficial
348writtenorders,butnotonprescriptions.
HCSHB609 10 195.030.1.Thedepartmentofhealthandseniorservicesuponpublicnoticeand
2hearingpursuanttothissectionandchapter536maypromulgaterulesandchargereasonable
3feesrelatingtotheregistrationandcontrolofthemanufacture,distributionanddispensingof
4controlledsubstanceswithinthisstate.Noruleorportionofarulepromulgatedpursuantto
5theauthorityofthischaptershallbecomeeffectiveunlessithasbeenpromulgatedpursuantto
6theprovisionsofsection536.024.
7 2.Nopersonshallmanufacture,compound,mix,cultivate,grow,orbyanyother
8processproduceorprepare,distribute,dispenseorprescribeanycontrolledsubstanceandno
9personasawholesalershallsupplythesame,withouthavingfirstobtainedaregistration
10issuedbythedepartmentofhealthandseniorservicesinaccordancewithrulesand
11regulationspromulgatedbyit.Noregistrationshallbegrantedforatermexceedingthree
12years.
13 3.Personsregisteredbythedepartmentofhealthandseniorservicespursuanttothis
14chaptertomanufacture,distribute,ordispenseorconductresearchwithcontrolledsubstances
15areauthorizedtopossess,manufacture,distributeordispensesuchsubstances,includingany
16suchactivityintheconductofresearch,totheextentauthorizedbytheirregistrationandin
17conformitywithotherprovisionsofthischapterandchapter579.
18 4.Thefollowingpersonsshallnotberequiredtoregisterandmaylawfullypossess
19controlledsubstancespursuanttothischapterandchapter579:
20 (1)Anagentoremployee,excludingphysicians,dentists,optometrists,podiatristsor
21veterinarians,ofanyregisteredmanufacturer,distributor,ordispenserofanycontrolled
22substanceifsuchagentisactingintheusualcourseofhisorherbusinessoremployment;
23 (2)Acommonorcontractcarrierorwarehouseman,oranemployeethereof,whose
24possessionofanycontrolledsubstanceisintheusualcourseofbusinessoremployment;
25 (3)Anultimateuserorapersoninpossessionofanycontrolledsubstancepursuantto
26alawfulorderofapractitionerorinlawfulpossessionofaScheduleVsubstance.
27 5.Thedepartmentofhealthandseniorservicesmay,byregulation,waivethe
28requirementforregistrationofcertainmanufacturers,distributors,ordispensersifitfindsit
29consistentwiththepublichealthandsafety.
30 6.Aseparateregistrationshallberequiredateachprincipalplaceofbusinessor
31professionalpracticewheretheapplicantmanufactures,distributes,ordispensescontrolled
32substances.Ahospitalmayobtainaseparateregistrationforeachoutpatientfacility
33ownedoroperatedbythehospitalinwhichbehavioralhealthorsubstanceabuse
34servicesaredelivered.Suchoutpatientfacilitymaydistributeordispensedrugstothe
35extentallowedunderahospitalregistration.
36 7.Thedepartmentofhealthandseniorservicesisauthorizedtoinspectthe
37establishmentofaregistrantorapplicantinaccordancewiththeprovisionsofthischapter.
HCSHB609 11 338.165.1.Asusedinthissection,thefollowingtermsmean:
2 (1)"Board",theMissouriboardofpharmacy;
3 (2)"Hospital",ahospitalasdefinedinsection197.020;
4 (3)"Hospitalclinicorfacility",aclinicorfacilityunderthecommoncontrol,
5management,orownershipofthesamehospitalorhospitalsystem;
6 (4)"Medicalstaffcommittee",thecommitteeorotherbodyofahospitalorhospital
7systemresponsibleforformulatingpoliciesregardingpharmacyservicesandmedication
8management;
9 (5)"Medicationorder",anorderforalegenddrugordevicethatis:
10 (a)Authorizedorissuedbyanauthorizedprescriberactingwithinthescopeofhisor
11herprofessionalpracticeorpursuanttoaprotocolorstandingorderapprovedbythemedical
12staffcommittee;and
13 (b)Tobedistributedoradministeredtothepatientbyahealthcarepractitioneror
14lawfullyauthorizeddesigneeatahospitalorahospitalclinicorfacility;
15 (6)"Patient",anindividualreceivingmedicaldiagnosis,treatmentorcareata
16hospitalorahospitalclinicorfacility.
17 2.Thedepartmentofhealthandseniorservicesshallhavesoleauthorityand
18responsibilityfortheinspectionandlicensureofhospitalsasprovidedbychapter197
19including,butnotlimitedtoallparts,services,functions,supportfunctionsandactivities
20whichcontributedirectlyorindirectlytopatientcareofanykindwhatsoever.However,the
21boardmayinspectaclassBpharmacyoranyportionthereofthatisnotundertheinspection
22authorityvestedinthedepartmentofhealthandseniorservicesbychapter197todetermine
23compliancewiththischapterortherulesoftheboard.Thissectionshallnotbeconstruedto
24bartheboardfromconductinganinvestigationpursuanttoapublicorgovernmental
25complainttodeterminecompliancebyanindividuallicenseeorregistrantoftheboardwith
26anyapplicableprovisionsofthischapterortherulesoftheboard.
27 3.Thedepartmentofhealthandseniorservicesshallhavethesoleauthorityto
28promulgaterulesgoverningpharmacyservicesinhospitals,butmaypromulgaterulesin
29conjunctionwiththeboardgoverningmedicationdistributionandtheprovisionofmedication
30therapyservices, asdescribedinsection338.010,byapharmacistatorwithinahospital.
31[Rulesmayinclude,butarenotlimitedto,medicationmanagement,preparation,
32compounding,administration,storage,distribution,packagingandlabeling.Untilsuch
33rulesarejointlypromulgated,hospitalsshallcomplywithallapplicablestatelawand
34departmentofhealthandseniorservicesrulesgoverningpharmacyservicesandmedication
35managementinhospitals.] Theboardshallhavethesoleauthoritytopromulgaterules
36governinginspectionandlicensureofclassBpharmacies.Therulemakingauthority
HCSHB609 12 37grantedhereintothedepartmentofhealthandseniorservicesshallnotincludethedispensing
38ofmedicationbyprescription.
39 4.Allpharmacistsprovidingmedicationtherapyservicesshallobtainacertificateof
40medicationtherapeuticplanauthorityasprovidedbyruleoftheboard.Medicationtherapy
41servicesmaybeprovidedbyapharmacistforpatientsofahospitalpursuanttoaprotocol
42withaphysicianasrequiredbysection338.010orpursuanttoaprotocolapprovedbythe
43medicalstaffcommittee.However,themedicalstaffprotocolshallincludeaprocess
44wherebyanexemptiontotheprotocolforapatientmaybegrantedforclinicalefficacyshould
45thepatient'sphysicianmakesuchrequest.Themedicalstaffprotocolshallalsoincludean
46appealsprocesstorequestachangeinaspecificprotocolbasedonmedicalevidence
47presentedbyaphysicianonstaff.
48 5.MedicationmaybedispensedbyaclassBhospitalpharmacypursuanttoa
49prescriptionoramedicationorder.
50 6.Adrugdistributorlicenseshallnotberequiredtotransfermedicationfromaclass
51Bhospitalpharmacytoahospitalclinicorfacilityforpatientcareortreatment.
52 7.MedicationdispensedbyaclassApharmacylocatedinahospitaltoahospital
53patientforuseoradministrationoutsideofthehospitalunderamedicalstaff-approved
54protocolformedicationtherapyshallbedispensedonlybyaprescriptionorderformedication
55therapyfromanindividualphysicianforaspecificpatient.
56 8.Medicationdispensedbyahospitaltoahospitalpatientforuseoradministration
57outsideofthehospitalshallbelabeledasprovidedbyrulesjointlypromulgatedbythe
58departmentofhealthandseniorservicesandtheboardincludingmedicationdistributedfor
59administrationbyorunderthesupervisionofahealthcarepractitioneratahospitalclinicor
60facility.
61 9.Thissectionshallnotbeconstruedtopreemptanylaworrulegoverningcontrolled
62substances.
63 10.Anyrule,asthattermisdefinedinsection536.010,thatiscreatedunderthe
64authoritydelegatedinthissectionshallonlybecomeeffectiveifitcomplieswithandis
65subjecttoalloftheprovisionsofchapter536and,ifapplicable,section536.028.Thissection
66andchapter536arenonseverableandifanyofthepowersvestedwiththegeneralassembly
67underchapter536toreview,todelaytheeffectivedate,ortodisapproveandannularuleare
68subsequentlyheldunconstitutional,thenthegrantofrulemakingauthorityandanyrule
69proposedoradoptedafterAugust28,2014,shallbeinvalidandvoid.
70 11.Theboardshallappointanadvisorycommitteetoreviewandmake
71recommendationstotheboardonthemeritofallrulesandregulationstobejointly
72promulgatedbytheboardandthedepartmentofhealthandseniorservicespursuanttothe
73jointrulemakingauthoritygrantedbythissection.Theadvisorycommitteeshallconsistof:
HCSHB609 13 74 (1)TworepresentativesdesignatedbytheMissouriHospitalAssociation,oneof
75whomshallbeapharmacist;
76 (2)OnepharmacistdesignatedbytheMissouriSocietyofHealthSystem
77Pharmacists;
78 (3)OnepharmacistdesignatedbytheMissouriPharmacyAssociation;
79 (4)Onepharmacistdesignatedbythedepartmentofhealthandseniorservicesfroma
80hospitalwithalicensedbedcountthatdoesnotexceedfiftybedsorfromacriticalaccess
81hospitalasdefinedbythedepartmentofsocialservicesforpurposesofMOHealthNet
82reimbursement;
83 (5)Onepharmacistdesignatedbythedepartmentofhealthandseniorservicesfroma
84hospitalwithalicensedbedcountthatexceedstwohundredbeds;and
85 (6)Onepharmacistdesignatedbytheboardwithexperienceintheprovisionof
86hospitalpharmacyservices.
87 12.Nothinginthissectionshallbeconstruedtolimittheauthorityofalicensed
88healthcareprovidertoprescribe,administer,ordispensemedicationsandtreatmentswithin
89thescopeoftheirprofessionalpractice.
âś”
HCSHB609 14