Reference is to Printer's Date 5/3/17--H.
Amend the bill, as and if amended, by adding an appropriately numbered SECTION to read:
SECTION __. A. Article 3, Chapter 53, Title 44 of the 1976 Code is amended by adding:
"Section 44-53-362.
(A) Except as provided in subsection
(C), before issuing, for a minor, the first prescription in a
single course of treatment for an opioid analgesic, regardless
of whether the dosage is modified during that course of
treatment, a prescriber shall:
(1)
as part of the prescriber's examination of the minor,
assess whether the minor has ever suffered from or is currently
suffering from a mental health or substance abuse disorder and
whether the minor has taken or is currently taking prescription
drugs for treatment of a mental health or substance abuse
disorder;
(2)
discuss with the minor and the minor's parent, guardian,
or another adult authorized to consent to the minor's medical
treatment all of the following:
(a)
the risks of addiction and overdose associated with opioid
analgesics;
(b)
the increased risk of addiction to controlled substances
of individuals suffering from both mental health and substance
abuse disorders;
(c)
the dangers of taking opioid analgesics with
benzodiazepines, alcohol, or other central nervous system
depressants;
(d)
any other information in the patient counseling
information section of the labeling for the opioid analgesic
required pursuant to 21 C.F.R. 201.57(c)(18); and
(3)
obtain written consent for the prescription from the
minor's parent, guardian, or, subject to subsection (E), another
adult authorized to consent to the minor's medical
treatment.
(B) The prescriber
shall record the consent required pursuant to subsection (A)(3)
on a 'Start Talking!' consent form developed by the State Board
of Medical Examiners. The form must be separate from any other
document the prescriber uses to obtain informed consent for
other treatment provided to the minor and must contain:
(1)
the name and quantity of the opioid analgesic being
prescribed and the amount of the initial dose;
(2)
a statement indicating that a controlled substance is a
drug or other substance that the United States Drug Enforcement
Administration has identified as having a potential for
abuse;
(3)
a statement certifying that the prescriber discussed with
the minor and the minor's parent, guardian, or another adult
authorized to consent to the minor's medical treatment the
matters described in subsection (A)(2);
(4)
the number of refills, if any, authorized by the
prescription; and
(5)
the signature of the minor's parent, guardian, or another
adult authorized to consent to the minor's medical treatment and
the date of signing.
(C)(1) The requirements
set forth in subsection (A) do not apply if the minor's
treatment with an opioid analgesic:
(a)
is associated with or incident to a medical emergency;
(b)
is associated with or incident to surgery, regardless of
whether the surgery is performed on an inpatient or outpatient
basis;
(c)
is associated with pain management treatment for cancer
and hematological disorders including, but not limited to,
sickle cell disease;
(d)
is associated with treatment of neonatal abstinence
syndrome;
(e)
is limited to liquid antitussive medication;
(f)
in the prescriber's professional judgment, fulfilling the
requirements of subsection (A) would be a detriment to the
minor's health or safety;
(g)
except as provided in subsection (D), the treatment is
rendered in a hospital; emergency facility; ambulatory surgical
facility; nursing home; pediatric respite, hospice, or
palliative care program provided in an in-patient or out-patient
setting; residential care facility; freestanding rehabilitation
facility; or similar institutional facility;
(h)
is ordered by a practitioner issuing a prescription for a
Schedule II controlled substance to treat a hospice-certified
patient;
(i)
is ordered by a practitioner issuing a prescription for a
Schedule II controlled substance that does not exceed a five-day
supply for a patient;
(j)
is ordered by a practitioner prescribing a Schedule II
controlled substance for a patient with whom the practitioner
has an established relationship for the treatment of a chronic
condition; however, the practitioner must review the patient's
controlled substance history maintained in the prescription
monitoring program at least every three months; or
(k)
is ordered by a practitioner approving the administration
of a Schedule II controlled substance by a healthcare provider
licensed in South Carolina.
(2)
The requirements of subsection (A) do not apply to a
prescription for an opioid analgesic that a prescriber issues to
a minor at the time of discharge from a facility or other
location described in subsection (C)(1)(g).
(D) The exemption
provided pursuant to subsection (C)(1)(g) does not apply to
treatment rendered in a prescriber's office that is located on
the premises of or adjacent to a facility or other location
described in that subsection.
(E) If the individual
who signs the consent form required pursuant to subsection
(A)(3) is another adult authorized to consent to the minor's
medical treatment, the prescriber shall prescribe not more than
a single, seventy-two-hour supply and indicate on the
prescription the quantity that is to be dispensed pursuant to
the prescription.
(F) A signed 'Start
Talking!' consent form obtained pursuant to this section must be
maintained in the minor's medical record.
(G)(1) As used in this
section:
(a)
'Another adult authorized to consent to the minor's
medical treatment' means an adult to whom a minor's parent or
guardian has given written authorization to consent to the
minor's medical treatment.
(b)
'Medical emergency' means a situation that in a
prescriber's good faith medical judgment creates an immediate
threat of serious risk to the life or physical health of a
minor.
(c)
'Minor' means an individual under eighteen years of age
who is not emancipated.
(2)
For purposes of this section, an individual under eighteen
years of age is emancipated only if the individual has married,
has entered the armed services of the United States, has become
employed and self-sustaining, or otherwise has become
independent from the care and control of the individual's
parent, guardian, or custodian."
B. This SECTION takes effect December 31, 2017.
Renumber sections to conform.
Amend title to conform.