LRB-3626/1
MED:kjf
2015 - 2016 LEGISLATURE
October 20, 2015 - Introduced by Representative Nygren, cosponsored by Senator
Darling. Referred to Committee on Health.
AB427,1,4 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), 450.11 (1i) (a) 1. and 450.11 (4) (a) 5. c.; and to
3create
441.18 (2) (a) 2. and 448.037 (2) (a) 2. of the statutes; relating to:
4prescription, dispensing, and delivery of opioid antagonists.
Analysis by the Legislative Reference Bureau
Under current law, 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. 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 bill makes a number of changes and clarifications to the provisions in
current law, including the following:
1. Explicitly providing that a practitioner may prescribe an opioid antagonist
to one or more licensed pharmacies, and that a licensed pharmacist may, upon and
in accordance with the prescription order, deliver an opioid antagonist to an
individual as specified in the order.
2. Clarifying current law to provide that a practitioner who prescribes an opioid
antagonist, either under current law or to one or more pharmacies under the bill,
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:
AB427,1 1Section 1. 441.18 (2) (a) of the statutes is renumbered 441.18 (2) (a) (intro.)
2and amended to read:
AB427,2,53 441.18 (2) (a) (intro.) An advanced practice nurse certified to issue prescription
4orders under s. 441.16 may, directly or by the use of a standing order, prescribe do
5any of the following:
AB427,2,11 61. Prescribe an opioid antagonist to a person in a position to assist an individual
7at risk of undergoing an opioid-related drug overdose and may deliver the opioid
8antagonist to that person. A prescription order under this paragraph subdivision
9need not specify the name and address of the individual to whom the opioid
10antagonist will be administered, but shall instead specify the name of the person to
11whom the opioid antagonist will be delivered is prescribed.
AB427,2 12Section 2. 441.18 (2) (a) 2. of the statutes is created to read:
AB427,3,213 441.18 (2) (a) 2. Prescribe an opioid antagonist to one or more pharmacies
14licensed under ch. 450. A prescription order under this subdivision need not specify
15the name and address of the individual to whom the opioid antagonist will be

1administered, but shall instead specify the name of the pharmacies to whom the
2opioid antagonist is prescribed.
AB427,3 3Section 3. 441.18 (2) (b) of the statutes is amended to read:
AB427,3,104 441.18 (2) (b) An advanced practice nurse who prescribes or delivers an opioid
5antagonist under par. (a) shall ensure that the person to whom the opioid antagonist
6will be delivered is prescribed has or has the capacity to provide the knowledge and
7training necessary to safely administer the opioid antagonist to an individual
8undergoing an opioid-related overdose and that the person demonstrates the
9capacity to ensure that any individual to whom the person further delivers the opioid
10antagonist has or receives that knowledge and training.
AB427,4 11Section 4. 448.037 (2) (a) of the statutes is renumbered 448.037 (2) (a) (intro.)
12and amended to read:
AB427,3,1413 448.037 (2) (a) (intro.) A physician or physician assistant may, directly or by
14the use of a standing order, prescribe do any of the following:
AB427,3,20 151. Prescribe an opioid antagonist to a person in a position to assist an individual
16at risk of undergoing an opioid-related drug overdose and may deliver the opioid
17antagonist to that person. A prescription order under this paragraph subdivision
18need not specify the name and address of the individual to whom the opioid
19antagonist will be administered, but shall instead specify the name of the person to
20whom the opioid antagonist will be delivered is prescribed.
AB427,5 21Section 5. 448.037 (2) (a) 2. of the statutes is created to read:
AB427,4,222 448.037 (2) (a) 2. Prescribe an opioid antagonist to one or more pharmacies
23licensed under ch. 450. A prescription order under this subdivision need not specify
24the name and address of the individual to whom the opioid antagonist will be

1administered, but shall instead specify the name of the pharmacies to whom the
2opioid antagonist is prescribed.
AB427,6 3Section 6. 448.037 (2) (b) of the statutes is amended to read:
AB427,4,104 448.037 (2) (b) A physician or physician assistant who prescribes or delivers
5an opioid antagonist under par. (a) shall ensure that the person to whom the opioid
6antagonist will be delivered is prescribed has or has the capacity to provide the
7knowledge and training necessary to safely administer the opioid antagonist to an
8individual undergoing an opioid-related overdose and that the person demonstrates
9the capacity to ensure that any individual to whom the person further delivers the
10opioid antagonist has or receives that knowledge and training.
AB427,7 11Section 7. 450.11 (1i) (a) 1. of the statutes is amended to read:
AB427,4,2212 450.11 (1i) (a) 1. A pharmacist may, upon and in accordance with the
13prescription order of an advanced practice nurse prescriber under s. 441.18 (2) (a) 1.,
14or of a physician or physician assistant under s. 448.037 (2) (a) 1., that complies with
15the requirements of sub. (1), deliver an opioid antagonist to the a person specified in
16the prescription order and may, upon and in accordance with the prescription order
17of an advanced practice nurse prescriber under s. 441.18 (2) (a) 2., or of a physician
18or physician assistant under s. 448.037 (2) (a) 2., that complies with the
19requirements of sub. (1), deliver an opioid antagonist to an individual as specified in
20the order
. The pharmacist shall provide a consultation in accordance with rules
21promulgated by the board for the delivery of a prescription to the person to whom the
22opioid antagonist is delivered.
AB427,8 23Section 8. 450.11 (4) (a) 5. c. of the statutes is amended to read:
AB427,5,3
1450.11 (4) (a) 5. c. For an opioid antagonist when delivered under sub. (1i) (a),
2the name of the person to whom the opioid antagonist will be is delivered as specified
3in s. 441.18 (2) (a) or 448.037 (2) (a)
.
AB427,5,44 (End)
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