AB427-ASA1,1,5 1An Act to renumber and amend 441.18 (2) (a) and 448.037 (2) (a); to amend
2441.18 (2) (b), 448.037 (2) (b), 450.01 (21), 450.11 (1), 450.11 (1i) (a) 1. and 450.11
3(4) (a) 5. c.; and to create 441.18 (1) (f), 441.18 (2) (a) 2., 448.037 (1) (f), 448.037
4(2) (a) 2. and 450.01 (21p) of the statutes; relating to: prescription, dispensing,
5and delivery of opioid antagonists.
Analysis by the Legislative Reference Bureau
This substitute amendment makes changes and clarifications to the laws
governing the prescribing, dispensing, and delivery of opioid antagonists.
Current law provides that a licensed physician, a licensed physician assistant,
or an advanced practice nurse certified to issue prescription orders (practitioner)
may, directly or by the use of a standing order, prescribe an opioid antagonist to a
person in a position to assist an individual at risk of undergoing an opioid-related
drug overdose (third party). Opioid antagonists are prescription drugs, such as the
drug naloxone, some of which can, when administered to a person undergoing an
overdose on drugs such as heroin or prescription narcotics, have the effect of
countering the effects of the overdose. A practitioner who prescribes an opioid
antagonist in this manner must ensure that the person to whom the opioid
antagonist will be delivered (i.e., the person to whom it is prescribed) has the

knowledge and training necessary to safely administer the opioid antagonist to an
individual undergoing an opioid-related overdose and that the person demonstrates
the capacity to ensure that any individual to whom the person further delivers or
dispenses the opioid antagonist has or receives that knowledge and training. A
licensed pharmacist may, upon the prescription order of a practitioner issued in
accordance with the provisions described above, deliver (provide) the opioid
antagonist to the person specified in the prescription order and may only deliver an
opioid antagonist in accordance with those provisions or in accordance with his or her
other legal authority to dispense prescription drugs.
This substitute amendment makes a number of changes and clarifications to
the provisions in current law regarding opioid antagonists, including the following:
1. Further distinguishing between prescriptions for opioid antagonists written
to third parties and standing orders issued for opioid antagonists. The substitute
amendment creates separate provisions allowing for a standing order, as defined in
the substitute amendment, to be issued by a practitioner to one or more persons
authorizing the dispensing of opioid antagonists and allows a pharmacist to deliver
an opioid antagonist to a person in accordance with such a standing order. The
substitute amendment also expressly provides that a standing order for an opioid
antagonist is considered a prescription order where applicable, for purposes of
various requirements and prohibitions contained in the pharmacy law.
2. Clarifying current law to provide that a practitioner who prescribes an opioid
antagonist to a third party must ensure that the person to whom the opioid
antagonist is prescribed has or has the capacity to provide the knowledge and
training described under current law.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB427-ASA1,1 1Section 1. 441.18 (1) (f) of the statutes is created to read:
AB427-ASA1,2,22 441.18 (1) (f) "Standing order" has the meaning given in s. 450.01 (21p).
AB427-ASA1,2 3Section 2. 441.18 (2) (a) of the statutes is renumbered 441.18 (2) (a) (intro.)
4and amended to read:
AB427-ASA1,2,75 441.18 (2) (a) (intro.) An advanced practice nurse certified to issue prescription
6orders under s. 441.16 may, directly or by the use of a standing order, prescribe do
7any of the following:
AB427-ASA1,3,4 81. Prescribe an opioid antagonist to a person in a position to assist an individual
9at risk of undergoing an opioid-related drug overdose and may deliver the opioid

1antagonist to that person. A prescription order under this paragraph subdivision
2need not specify the name and address of the individual to whom the opioid
3antagonist will be administered, but shall instead specify the name of the person to
4whom the opioid antagonist will be delivered is prescribed.
AB427-ASA1,3 5Section 3. 441.18 (2) (a) 2. of the statutes is created to read:
AB427-ASA1,3,76 441.18 (2) (a) 2. Issue a standing order to one or more persons authorizing the
7dispensing of an opioid antagonist.
AB427-ASA1,4 8Section 4. 441.18 (2) (b) of the statutes is amended to read:
AB427-ASA1,3,159 441.18 (2) (b) An advanced practice nurse who prescribes or delivers an opioid
10antagonist under par. (a) 1. shall ensure that the person to whom the opioid
11antagonist will be delivered is prescribed has or has the capacity to provide the
12knowledge and training necessary to safely administer the opioid antagonist to an
13individual undergoing an opioid-related overdose and that the person demonstrates
14the capacity to ensure that any individual to whom the person further delivers the
15opioid antagonist has or receives that knowledge and training.
AB427-ASA1,5 16Section 5. 448.037 (1) (f) of the statutes is created to read:
AB427-ASA1,3,1717 448.037 (1) (f) "Standing order" has the meaning given in s. 450.01 (21p).
AB427-ASA1,6 18Section 6. 448.037 (2) (a) of the statutes is renumbered 448.037 (2) (a) (intro.)
19and amended to read:
AB427-ASA1,3,2120 448.037 (2) (a) (intro.) A physician or physician assistant may, directly or by
21the use of a standing order, prescribe
do any of the following:
AB427-ASA1,4,2 221. Prescribe an opioid antagonist to a person in a position to assist an individual
23at risk of undergoing an opioid-related drug overdose and may deliver the opioid
24antagonist to that person. A prescription order under this paragraph subdivision
25need not specify the name and address of the individual to whom the opioid

1antagonist will be administered, but shall instead specify the name of the person to
2whom the opioid antagonist will be delivered is prescribed.
AB427-ASA1,7 3Section 7. 448.037 (2) (a) 2. of the statutes is created to read:
AB427-ASA1,4,54 448.037 (2) (a) 2. Issue a standing order to one or more persons authorizing the
5dispensing of an opioid antagonist.
AB427-ASA1,8 6Section 8. 448.037 (2) (b) of the statutes is amended to read:
AB427-ASA1,4,137 448.037 (2) (b) A physician or physician assistant who prescribes or delivers
8an opioid antagonist under par. (a) 1. shall ensure that the person to whom the opioid
9antagonist will be delivered is prescribed has or has the capacity to provide the
10knowledge and training necessary to safely administer the opioid antagonist to an
11individual undergoing an opioid-related overdose and that the person demonstrates
12the capacity to ensure that any individual to whom the person further delivers the
13opioid antagonist has or receives that knowledge and training.
AB427-ASA1,9 14Section 9. 450.01 (21) of the statutes is amended to read:
AB427-ASA1,4,1815 450.01 (21) "Prescription order" means an order transmitted orally,
16electronically or in writing by a practitioner for a drug or device for a particular
17patient and also includes a standing order issued under s. 441.18 (2) (a) 2. or 448.037
18(2) (a) 2
.
AB427-ASA1,10 19Section 10. 450.01 (21p) of the statutes is created to read:
AB427-ASA1,4,2220 450.01 (21p) "Standing order" means an order transmitted electronically or in
21writing by a practitioner for a drug or device for multiple patients or for one or more
22groups of patients.
AB427-ASA1,11 23Section 11. 450.11 (1) of the statutes, as affected by 2015 Wisconsin Act 35,
24is amended to read:
AB427-ASA1,5,14
1450.11 (1) Dispensing. Except as provided in sub. (1i) (b) 2., no person may
2dispense any prescribed drug or device except upon the prescription order of a
3practitioner. All prescription orders shall specify the date of issue, the name and
4address of the practitioner, the name and quantity of the drug product or device
5prescribed, directions for the use of the drug product or device, the symptom or
6purpose for which the drug is being prescribed if required under sub. (4) (a) 8., and,
7if the order is written by the practitioner, the signature of the practitioner. Except
8as provided in ss. 118.2925 (3), 255.07 (2), 441.18 (2) (a) 1., 448.035 (2), and 448.037
9(2) (a) 1. and except for standing orders issued under s. 441.18 (2) (a) 2. or 448.037
10(2) (a) 2.
, all prescription orders shall also specify the name and address of the
11patient. A prescription order issued under s. 118.2925 (3) shall specify the name and
12address of the school. A prescription order issued under s. 255.07 (2) shall specify
13the name and address of the authorized entity. Any oral prescription order shall be
14immediately reduced to writing by the pharmacist and filed according to sub. (2).
AB427-ASA1,12 15Section 12. 450.11 (1i) (a) 1. of the statutes is amended to read:
AB427-ASA1,6,216 450.11 (1i) (a) 1. A pharmacist may, upon and in accordance with the
17prescription order of an advanced practice nurse prescriber under s. 441.18 (2) (a) 1.,
18or of a physician or physician assistant under s. 448.037 (2) (a) 1., that complies with
19the requirements of sub. (1), deliver an opioid antagonist to the a person specified in
20the prescription order and may, upon and in accordance with the standing order of
21an advanced practice nurse prescriber under s. 441.18 (2) (a) 2., or of a physician or
22physician assistant under s. 448.037 (2) (a) 2., that complies with the requirements
23of sub. (1), deliver an opioid antagonist to an individual in accordance with the order
.
24The pharmacist shall provide a consultation in accordance with rules promulgated

1by the board for the delivery of a prescription to the person to whom the opioid
2antagonist is delivered.
AB427-ASA1,13 3Section 13. 450.11 (4) (a) 5. c. of the statutes is amended to read:
AB427-ASA1,6,64 450.11 (4) (a) 5. c. For an opioid antagonist when delivered under sub. (1i) (a),
5the name of the person to whom the opioid antagonist will be is delivered as specified
6in s. 441.18 (2) (a) or 448.037 (2) (a)
.
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