73rd OREGON LEGISLATIVE ASSEMBLY--2005 Regular Session
NOTE: Matter within { + braces and plus signs + } in an
amended section is new. Matter within { - braces and minus
signs - } is existing law to be omitted. New sections are within
{ + braces and plus signs + } .
LC 2528
Senate Bill 849
Sponsored by Senator DEVLIN; Senators BATES, JOHNSON, WESTLUND,
Representatives BARKER, MACPHERSON (at the request of Attorney
General's Sexual Assault Task Force)
SUMMARY
The following summary is not prepared by the sponsors of the
measure and is not a part of the body thereof subject to
consideration by the Legislative Assembly. It is an editor's
brief statement of the essential features of the measure as
introduced.
Modifies definition of 'practice of pharmacy' to include
authority to prescribe and dispense emergency contraceptives in
accordance with written protocol established by physician or
nurse practitioner authorized to prescribe drugs.
A BILL FOR AN ACT
Relating to emergency contraceptives; creating new provisions;
and amending ORS 677.190, 678.111 and 689.015.
Be It Enacted by the People of the State of Oregon:
SECTION 1. ORS 689.015 is amended to read:
689.015. The 'practice of pharmacy' means the interpretation
and evaluation of prescription orders; the compounding,
dispensing { - , - } { + and + } labeling of drugs and devices
(except labeling by a manufacturer, packer or distributor of
nonprescription drugs and commercially packaged legend drugs and
devices); the administering of vaccines and immunizations
pursuant to ORS 689.645; the administering of drugs and devices
to the extent permitted under ORS 689.655; { + the initiating or
modifying of drug therapy involving emergency contraceptive pills
in accordance with a written protocol previously established by a
physician or nurse practitioner authorized to prescribe drugs and
with rules for collaborative drug therapy management adopted by
the State Board of Pharmacy; + } the participation in drug
selection and drug utilization reviews; the proper and safe
storage of drugs and devices and the maintenance of proper
records therefor; the responsibility for advising, where
necessary or where regulated, of therapeutic values, content,
hazards and use of drugs and devices; the monitoring of
therapeutic response or adverse effect to drug therapy; and the
offering or performing of those acts, services, operations or
transactions necessary in the conduct, operation, management and
control of pharmacy.
SECTION 2. { + Section 3 of this 2005 Act is added to and made
a part of ORS chapter 689. + }
SECTION 3. { + (1) As used in this section, 'protocol' means a
written agreement in which a physician or nurse practitioner
authorized to prescribe drugs delegates to a pharmacist or group
of pharmacists licensed to practice in this state the limited
authority to initiate or modify drug therapy involving emergency
contraceptive pills.
(2) Prior to dispensing emergency contraceptive pills pursuant
to ORS 689.015, a pharmacist must have on file at the place of
practice of the pharmacist a written protocol from a physician or
nurse practitioner authorized to prescribe drugs that grants
approval to the pharmacist to initiate or modify drug therapy
involving emergency contraceptive pills. Copies of the protocol
must be on file with the authorizing practitioner, the Board of
Medical Examiners for the State of Oregon, the State Board of
Pharmacy and, if the authorizing practitioner is a nurse
practitioner, the Oregon State Board of Nursing.
(3) A pharmacist may not delegate any of the duties or
responsibilities authorized under this section.
(4) The protocol required under subsection (2) of this section
must include:
(a) Identification of the physician or nurse practitioner
authorized to prescribe drugs and of the pharmacist to whom the
prescriptive authority for emergency contraceptive pills is
delegated. The physician or nurse practitioner authorized to
prescribe drugs must hold an unrestricted license and must be in
active practice. The authority delegated must be within the scope
of the current practice of the physician or nurse practitioner.
(b) Specification of the period, not to exceed two years, that
the protocol is in effect and a declaration that the agreement
may be terminated by written notice at any time within the
effective period for any reason, or for no reason, by the
authorizing physician or nurse practitioner or by the
participating pharmacist.
(c) A written statement of the nature of the prescriptive
authority decisions for emergency contraceptive pills that the
pharmacist is authorized to make, including the procedures and
decision-making criteria the pharmacist must follow in initiating
or modifying drug therapy involving emergency contraceptive
pills.
(d) Requirements for documentation that must be maintained by
the pharmacist for the decisions made, including a method for
communication of such decisions to the authorizing practitioner
and a statement that the documentation shall be made available to
the authorizing practitioner upon request.
(5) Any modification of the protocol required under subsection
(2) of this section shall be considered a new protocol that
requires a new written agreement between the authorizing
physician or nurse practitioner and the participating pharmacist.
(6) No compensation or consideration of any type shall be given
to or received by an authorized physician or nurse practitioner
for entering into or issuing a written protocol for initiating or
modifying drug therapy involving emergency contraceptive pills
under the provisions of this section.
(7)(a) The Board of Medical Examiners for the State of Oregon,
in consultation with the State Board of Pharmacy and the Oregon
State Board of Nursing, shall adopt rules for the implementation
and administration of this section.
(b) The Board of Medical Examiners for the State of Oregon
shall, by rule, approve the types of drugs that may be dispensed
or the drug therapy that may be initiated or modified under a
written protocol involving emergency contraceptive pills. + }
SECTION 4. ORS 677.190 is amended to read:
677.190. The Board of Medical Examiners for the State of Oregon
may refuse to grant, or may suspend or revoke a license to
practice for any of the following reasons:
(1)(a) Unprofessional or dishonorable conduct.
(b) For purposes of this subsection, the use of an alternative
medical treatment shall not by itself constitute unprofessional
conduct. For purposes of this paragraph:
(A) 'Alternative medical treatment' means:
(i) A treatment that the treating physician, based on the
physician's professional experience, has an objective basis to
believe has a reasonable probability for effectiveness in its
intended use even if the treatment is outside recognized
scientific guidelines, is unproven, is no longer used as a
generally recognized or standard treatment or lacks the approval
of the United States Food and Drug Administration;
(ii) A treatment that is supported for specific usages or
outcomes by at least one other physician licensed by the board
{ - of Medical Examiners - } ; and
(iii) A treatment that poses no greater risk to a patient than
the generally recognized or standard treatment.
(B) 'Alternative medical treatment' does not include use by a
physician of controlled substances in the treatment of a person
for chemical dependency resulting from the use of controlled
substances.
(2) Employing any person to solicit patients for the licensee.
However, a managed care organization, independent practice
association, preferred provider organization or other medical
service provider organization may contract for patients on behalf
of physicians.
(3) Representing to a patient that a manifestly incurable
condition of sickness, disease or injury can be cured.
(4) Obtaining any fee by fraud or misrepresentation.
(5) Willfully or negligently divulging a professional secret
without the written consent of the patient.
(6) Conviction of any offense punishable by incarceration in a
Department of Corrections institution or in a federal prison,
subject to ORS 670.280. A copy of the record of conviction,
certified to by the clerk of the court entering the conviction,
shall be conclusive evidence of the conviction.
(7) Habitual or excessive use of intoxicants, drugs or
controlled substances.
(8) Fraud or misrepresentation in applying for or procuring a
license to practice in this state, or in connection with applying
for or procuring registration.
(9) Making statements that the licensee knows, or with the
exercise of reasonable care should know, are false or misleading,
regarding skill or the efficacy or value of the medicine,
treatment or remedy prescribed or administered by the licensee or
at the direction of the licensee in the treatment of any disease
or other condition of the human body or mind.
(10) Impersonating another licensee licensed under this chapter
or permitting or allowing any person to use the license.
(11) Aiding or abetting the practice of medicine or podiatry by
a person not licensed by the board, when the licensee knows, or
with the exercise of reasonable care should know, that the person
is not licensed.
(12) Using the name of the licensee under the designation '
doctor,' 'Dr.,' 'D.O.' or 'M.D.,' 'D.P.M., ' ' Acupuncturist,'
'P.A.' or any similar designation in any form of advertising that
is untruthful or is intended to deceive or mislead the public.
(13) Insanity or mental disease as evidenced by an adjudication
or voluntary commitment to an institution for the treatment of a
mental disease that affects the ability of the licensee to safely
practice medicine, or as determined by an examination conducted
by three impartial psychiatrists retained by the board.
(14) Gross negligence or repeated negligence in the practice of
medicine or podiatry.
(15) Incapacity to practice medicine or podiatry. If the board
has evidence indicating incapacity, the board may order a
licensee to submit to a standardized competency examination. The
licensee shall have access to the result of the examination and
to the criteria used for grading and evaluating the examination.
If the examination is given orally, the licensee shall have the
right to have the examination recorded.
(16) Disciplinary action by another state of a license to
practice, based upon acts by the licensee similar to acts
described in this section. A certified copy of the record of the
disciplinary action of the state is conclusive evidence thereof.
(17) Failing to designate the degree appearing on the license
under circumstances described in ORS 677.184 (3).
(18) Willfully violating any provision of this chapter or any
rule adopted by the board, board order, or failing to comply with
a board request pursuant to ORS 677.320.
(19) Failing to report the change of the location of practice
of the licensee as required by ORS 677.172.
(20) Adjudication of or admission to a hospital for mental
illness or imprisonment as provided in ORS 677.225.
(21) Making a fraudulent claim.
(22)(a) Performing psychosurgery.
(b) For purposes of this subsection and ORS 426.385, '
psychosurgery' means any operation designed to produce an
irreversible lesion or destroy brain tissue for the primary
purpose of altering the thoughts, emotions or behavior of a human
being. 'Psychosurgery' does not include procedures which may
produce an irreversible lesion or destroy brain tissues when
undertaken to cure well-defined disease states such as brain
tumor, epileptic foci and certain chronic pain syndromes.
(23) Refusing an invitation for an informal interview with the
board requested under ORS 677.415.
(24) Violation of the federal Controlled Substances Act.
(25) Prescribing controlled substances without a legitimate
medical purpose, or prescribing controlled substances without
following accepted procedures for examination of patients, or
prescribing controlled substances without following accepted
procedures for record keeping or without giving the notice
required under ORS 677.485.
(26) Failure by the licensee to report to the board any adverse
action taken against the licensee by another licensing
jurisdiction or any peer review body, health care institution,
professional or medical society or association, governmental
agency, law enforcement agency or court for acts or conduct
similar to acts or conduct that would constitute grounds for
disciplinary action as described in this section.
(27) Failure by the licensee to notify the board of the
licensee's voluntary resignation from the staff of a health care
institution or voluntary limitation of a licensee's staff
privileges at the institution if that action occurs while the
licensee is under investigation by the institution or a committee
thereof for any reason related to medical incompetence,
unprofessional conduct or mental or physical impairment.
{ + (28) Failure by a licensee who delegates to a pharmacist
or group of pharmacists the authority to initiate or modify drug
therapy involving emergency contraceptive pills to issue and
maintain a written protocol as required by section 3 of this 2005
Act and rules adopted by the board. + }
SECTION 5. ORS 678.111 is amended to read:
678.111. In the manner prescribed in ORS chapter 183 for a
contested case:
(1) Issuance of the license to practice nursing, whether by
examination or by indorsement, of any person may be refused or
the license may be revoked or suspended or the licensee may be
placed on probation for a period specified by the Oregon State
Board of Nursing and subject to such condition as the board may
impose or may be issued a limited license or may be reprimanded
or censured by the board, for any of the following causes:
(a) Conviction of the licensee of crime where such crime bears
demonstrable relationship to the practice of nursing. A copy of
the record of such conviction, certified to by the clerk of the
court entering the conviction, shall be conclusive evidence of
the conviction.
(b) Gross incompetence or gross negligence of the licensee in
the practice of nursing at the level for which the licensee is
licensed.
(c) Any willful fraud or misrepresentation in applying for or
procuring a license or renewal thereof.
(d) Fraud or deceit of the licensee in the practice of nursing
or in admission to such practice.
(e) Use of any controlled substance or intoxicating liquor to
an extent or in a manner dangerous or injurious to the licensee
or others or to an extent that such use impairs the ability to
conduct safely the practice for which the licensee is licensed.
(f) Conduct derogatory to the standards of nursing.
(g) Violation of any provision of ORS 678.010 to 678.445 or
rules adopted thereunder.
(h) Revocation or suspension of a license to practice nursing
by any state or territory of the United States, or any foreign
jurisdiction authorized to issue nursing credentials whether or
not that license or credential was relied upon in issuing that
license in this state. A certified copy of the order of
revocation or suspension shall be conclusive evidence of such
revocation or suspension.
(i) Physical or mental condition that makes the licensee unable
to conduct safely the practice for which the licensee is
licensed.
(j) Violation of any condition imposed by the board when
issuing a limited license.
{ + (k) Failure by a licensee who is a certified nurse
practitioner authorized to write prescriptions under ORS 678.390
who delegates to a pharmacist or group of pharmacists the
authority to initiate or modify drug therapy involving emergency
contraceptive pills, to issue and maintain a written protocol as
required by section 3 of this 2005 Act and rules adopted by the
Board of Medical Examiners for the State of Oregon. + }
(2) A certificate of special competence may be denied or
suspended or revoked for the reasons stated in subsection (1) of
this section.
(3) A license or certificate in inactive status may be denied
or suspended or revoked for the reasons stated in subsection (1)
of this section.
(4) A license or certificate in retired status may be denied or
suspended or revoked for any cause stated in subsection (1) of
this section.
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