Sen. Melinda Bush

Filed: 4/5/2019





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2    AMENDMENT NO. ______. Amend Senate Bill 1828 by replacing
3everything after the enacting clause with the following:
4    "Section 1. Short title. This Act may be cited as the
5Overdose Prevention and Harm Reduction Act.
6    Section 5. Needle and hypodermic syringe access program.
7    (a) Any governmental or nongovernmental organization,
8including a local health department, community-based
9organization, or a person or entity, that promotes
10scientifically proven ways of mitigating health risks
11associated with drug use and other high-risk behaviors may
12establish and operate a needle and hypodermic syringe access
13program. The objective of the program shall be accomplishing
14all of the following:
15        (1) reducing the spread of HIV, AIDS, viral hepatitis,
16    and other bloodborne diseases;



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1        (2) reducing the potential for needle stick injuries
2    from discarded contaminated equipment; and
3        (3) facilitating connections or linkages to
4    evidence-based treatment.
5    (b) Programs established under this Act shall provide all
6of the following:
7        (1) Disposal of used needles and hypodermic syringes.
8        (2) Needles, hypodermic syringes, and other safer drug
9    consumption supplies, at no cost and in quantities
10    sufficient to ensure that needles, hypodermic syringes, or
11    other supplies are not shared or reused.
12        (3) Educational materials or training on:
13            (A) overdose prevention and intervention; and
14            (B) the prevention of HIV, AIDS, viral hepatitis,
15        and other common bloodborne diseases resulting from
16        shared drug consumption equipment and supplies.
17        (4) Access to opioid antagonists approved for the
18    reversal of an opioid overdose, or referrals to programs
19    that provide access to opioid antagonists approved for the
20    reversal of an opioid overdose.
21        (5) Linkages to needed services, including mental
22    health treatment, housing programs, substance use disorder
23    treatment, and other relevant community services.
24        (6) Individual consultations from a trained employee
25    tailored to individual needs.
26        (7) If feasible, a hygienic, separate space for



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1    individuals who need to administer a prescribed injectable
2    medication that can also be used as a quiet space to gather
3    composure in the event of an adverse on-site incident, such
4    as a nonfatal overdose.
5        (8) If feasible, access to on-site drug adulterant
6    testing supplies such as reagents, test strips, or
7    quantification instruments that provide critical real-time
8    information on the composition of substances obtained for
9    consumption.
10    (c) Notwithstanding any provision of the Illinois
11Controlled Substances Act, the Drug Paraphernalia Control Act,
12or any other law, no employee or volunteer of or participant in
13a program established under this Act shall be charged with or
14prosecuted for possession of any of the following:
15        (1) Needles, hypodermic syringes, or other drug
16    consumption paraphernalia obtained from or returned,
17    directly or indirectly, to a program established under this
18    Act.
19        (2) Residual amounts of a controlled substance
20    contained in used needles, used hypodermic syringes, or
21    other used drug consumption paraphernalia obtained from or
22    returned, directly or indirectly, to a program established
23    under this Act.
24        (3) Drug adulterant testing supplies such as reagents,
25    test strips, or quantification instruments obtained from
26    or returned, directly or indirectly, to a program



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1    established under this Act.
2        (4) Any residual amounts of controlled substances used
3    in the course of testing the controlled substance to
4    determine the chemical composition and potential threat of
5    the substances obtained for consumption that are obtained
6    from or returned, directly or indirectly, to a program
7    established under this Act.
8    In addition to any other applicable immunity or limitation
9on civil liability, a law enforcement officer who, acting on
10good faith, arrests or charges a person who is thereafter
11determined to be entitled to immunity from prosecution under
12this subsection (c) shall not be subject to civil liability for
13the arrest or filing of charges.
14    (d) Prior to the commencing of operations of a program
15established under this Act, the governmental or
16nongovernmental organization shall submit to the Illinois
17Department of Public Health all of the following information:
18        (1) the name of the organization, agency, group,
19    person, or entity operating the program;
20        (2) the areas and populations to be served by the
21    program; and
22        (3) the methods by which the program will meet the
23    requirements of subsection (b) of this Section.
24    The Department of Public Health may adopt rules to
25implement this subsection.



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1    Section 100. The Substance Use Disorder Act is amended by
2changing Section 5-23 as follows:
3    (20 ILCS 301/5-23)
4    Sec. 5-23. Drug Overdose Prevention Program.
5    (a) Reports of drug overdose.
6        (1) The Department may publish annually a report on
7    drug overdose trends statewide that reviews State death
8    rates from available data to ascertain changes in the
9    causes or rates of fatal and nonfatal drug overdose. The
10    report shall also provide information on interventions
11    that would be effective in reducing the rate of fatal or
12    nonfatal drug overdose and on the current substance use
13    disorder treatment capacity within the State. The report
14    shall include an analysis of drug overdose information
15    reported to the Department of Public Health pursuant to
16    subsection (e) of Section 3-3013 of the Counties Code,
17    Section 6.14g of the Hospital Licensing Act, and subsection
18    (j) of Section 22-30 of the School Code.
19        (2) The report may include:
20            (A) Trends in drug overdose death rates.
21            (B) Trends in emergency room utilization related
22        to drug overdose and the cost impact of emergency room
23        utilization.
24            (C) Trends in utilization of pre-hospital and
25        emergency services and the cost impact of emergency



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1        services utilization.
2            (D) Suggested improvements in data collection.
3            (E) A description of other interventions effective
4        in reducing the rate of fatal or nonfatal drug
5        overdose.
6            (F) A description of efforts undertaken to educate
7        the public about unused medication and about how to
8        properly dispose of unused medication, including the
9        number of registered collection receptacles in this
10        State, mail-back programs, and drug take-back events.
11            (G) An inventory of the State's substance use
12        disorder treatment capacity, including, but not
13        limited to:
14                (i) The number and type of licensed treatment
15            programs in each geographic area of the State.
16                (ii) The availability of medication-assisted
17            treatment at each licensed program and which types
18            of medication-assisted treatment are available.
19                (iii) The number of recovery homes that accept
20            individuals using medication-assisted treatment in
21            their recovery.
22                (iv) The number of medical professionals
23            currently authorized to prescribe buprenorphine
24            and the number of individuals who fill
25            prescriptions for that medication at retail
26            pharmacies as prescribed.



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1                (v) Any partnerships between programs licensed
2            by the Department and other providers of
3            medication-assisted treatment.
4                (vi) Any challenges in providing
5            medication-assisted treatment reported by programs
6            licensed by the Department and any potential
7            solutions.
8    (b) Programs; drug overdose prevention.
9        (1) The Department may establish a program to provide
10    for the production and publication, in electronic and other
11    formats, of drug overdose prevention, recognition, and
12    response literature. The Department may develop and
13    disseminate curricula for use by professionals,
14    organizations, individuals, or committees interested in
15    the prevention of fatal and nonfatal drug overdose,
16    including, but not limited to, drug users, jail and prison
17    personnel, jail and prison inmates, drug treatment
18    professionals, emergency medical personnel, hospital
19    staff, families and associates of drug users, peace
20    officers, firefighters, public safety officers, needle
21    exchange program staff, and other persons. In addition to
22    information regarding drug overdose prevention,
23    recognition, and response, literature produced by the
24    Department shall stress that drug use remains illegal and
25    highly dangerous and that complete abstinence from illegal
26    drug use is the healthiest choice. The literature shall



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1    provide information and resources for substance use
2    disorder treatment.
3        The Department may establish or authorize programs for
4    prescribing, dispensing, or distributing opioid
5    antagonists for the treatment of drug overdose. Such
6    programs may include the prescribing of opioid antagonists
7    for the treatment of drug overdose to a person who is not
8    at risk of opioid overdose but who, in the judgment of the
9    health care professional, may be in a position to assist
10    another individual during an opioid-related drug overdose
11    and who has received basic instruction on how to administer
12    an opioid antagonist.
13        (2) The Department may provide advice to State and
14    local officials on the growing drug overdose crisis,
15    including the prevalence of drug overdose incidents,
16    programs promoting the disposal of unused prescription
17    drugs, trends in drug overdose incidents, and solutions to
18    the drug overdose crisis.
19        (3) The Department may support drug overdose
20    prevention, recognition, and response projects by
21    facilitating the acquisition of opioid antagonist
22    medication approved for opioid overdose reversal,
23    facilitating the acquisition of opioid antagonist
24    medication approved for opioid overdose reversal,
25    providing trainings in overdose prevention best practices,
26    connecting programs to medical resources, establishing a



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1    statewide standing order for the acquisition of needed
2    medication, establishing learning collaboratives between
3    localities and programs, and assisting programs in
4    navigating any regulatory requirements for establishing or
5    expanding such programs.
6        (4) In supporting best practices in drug overdose
7    prevention programming, the Department may promote the
8    following programmatic elements:
9            (A) Training individuals who currently use drugs
10        in the administration of opioid antagonists approved
11        for the reversal of an opioid overdose.
12            (B) Directly distributing opioid antagonists
13        approved for the reversal of an opioid overdose rather
14        than providing prescriptions to be filled at a
15        pharmacy.
16            (C) Conducting street and community outreach to
17        work directly with individuals who are using drugs.
18            (D) Employing community health workers or peer
19        recovery specialists who are familiar with the
20        communities served and can provide culturally
21        competent services.
22            (E) Collaborating with other community-based
23        organizations, substance use disorder treatment
24        centers, or other health care providers engaged in
25        treating individuals who are using drugs.
26            (F) Providing linkages for individuals to obtain



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1        evidence-based substance use disorder treatment.
2            (G) Engaging individuals exiting jails or prisons
3        who are at a high risk of overdose.
4            (H) Providing education and training to
5        community-based organizations who work directly with
6        individuals who are using drugs and those individuals'
7        families and communities.
8            (I) Providing education and training on drug
9        overdose prevention and response to emergency
10        personnel and law enforcement.
11            (J) Informing communities of the important role
12        emergency personnel play in responding to accidental
13        overdose.
14            (K) Producing and distributing targeted mass media
15        materials on drug overdose prevention and response,
16        the potential dangers of leaving unused prescription
17        drugs in the home, and the proper methods for disposing
18        of unused prescription drugs.
19    (c) Grants.
20        (1) The Department may award grants, in accordance with
21    this subsection, to create or support local drug overdose
22    prevention, recognition, and response projects. Local
23    health departments, correctional institutions, hospitals,
24    universities, community-based organizations, and
25    faith-based organizations may apply to the Department for a
26    grant under this subsection at the time and in the manner



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1    the Department prescribes.
2        (2) In awarding grants, the Department shall consider
3    the necessity for overdose prevention projects in various
4    settings and shall encourage all grant applicants to
5    develop interventions that will be effective and viable in
6    their local areas.
7        (3) (Blank). The Department shall give preference for
8    grants to proposals that, in addition to providing
9    life-saving interventions and responses, provide
10    information to drug users on how to access substance use
11    disorder treatment or other strategies for abstaining from
12    illegal drugs. The Department shall give preference to
13    proposals that include one or more of the following
14    elements:
15            (A) Policies and projects to encourage persons,
16        including drug users, to call 911 when they witness a
17        potentially fatal drug overdose.
18            (B) Drug overdose prevention, recognition, and
19        response education projects in drug treatment centers,
20        outreach programs, and other organizations that work
21        with, or have access to, drug users and their families
22        and communities.
23            (C) Drug overdose recognition and response
24        training, including rescue breathing, in drug
25        treatment centers and for other organizations that
26        work with, or have access to, drug users and their



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1        families and communities.
2            (D) The production and distribution of targeted or
3        mass media materials on drug overdose prevention and
4        response, the potential dangers of keeping unused
5        prescription drugs in the home, and methods to properly
6        dispose of unused prescription drugs.
7            (E) Prescription and distribution of opioid
8        antagonists.
9            (F) The institution of education and training
10        projects on drug overdose response and treatment for
11        emergency services and law enforcement personnel.
12            (G) A system of parent, family, and survivor
13        education and mutual support groups.
14        (4) In addition to moneys appropriated by the General
15    Assembly, the Department may seek grants from private
16    foundations, the federal government, and other sources to
17    fund the grants under this Section and to fund an
18    evaluation of the programs supported by the grants.
19    (d) Health care professional prescription of opioid
21        (1) A health care professional who, acting in good
22    faith, directly or by standing order, prescribes or
23    dispenses an opioid antagonist to: (a) a patient who, in
24    the judgment of the health care professional, is capable of
25    administering the drug in an emergency, or (b) a person who
26    is not at risk of opioid overdose but who, in the judgment



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1    of the health care professional, may be in a position to
2    assist another individual during an opioid-related drug
3    overdose and who has received basic instruction on how to
4    administer an opioid antagonist shall not, as a result of
5    his or her acts or omissions, be subject to: (i) any
6    disciplinary or other adverse action under the Medical
7    Practice Act of 1987, the Physician Assistant Practice Act
8    of 1987, the Nurse Practice Act, the Pharmacy Practice Act,
9    or any other professional licensing statute or (ii) any
10    criminal liability, except for willful and wanton
11    misconduct.
12        (2) A person who is not otherwise licensed to
13    administer an opioid antagonist may in an emergency
14    administer without fee an opioid antagonist if the person
15    has received the patient information specified in
16    paragraph (4) of this subsection and believes in good faith
17    that another person is experiencing a drug overdose. The
18    person shall not, as a result of his or her acts or
19    omissions, be (i) liable for any violation of the Medical
20    Practice Act of 1987, the Physician Assistant Practice Act
21    of 1987, the Nurse Practice Act, the Pharmacy Practice Act,
22    or any other professional licensing statute, or (ii)
23    subject to any criminal prosecution or civil liability,
24    except for willful and wanton misconduct.
25        (3) A health care professional prescribing an opioid
26    antagonist to a patient shall ensure that the patient



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1    receives the patient information specified in paragraph
2    (4) of this subsection. Patient information may be provided
3    by the health care professional or a community-based
4    organization, substance use disorder program, or other
5    organization with which the health care professional
6    establishes a written agreement that includes a
7    description of how the organization will provide patient
8    information, how employees or volunteers providing
9    information will be trained, and standards for documenting
10    the provision of patient information to patients.
11    Provision of patient information shall be documented in the
12    patient's medical record or through similar means as
13    determined by agreement between the health care
14    professional and the organization. The Department, in
15    consultation with statewide organizations representing
16    physicians, pharmacists, advanced practice registered
17    nurses, physician assistants, substance use disorder
18    programs, and other interested groups, shall develop and
19    disseminate to health care professionals, community-based
20    organizations, substance use disorder programs, and other
21    organizations training materials in video, electronic, or
22    other formats to facilitate the provision of such patient
23    information.
24        (4) For the purposes of this subsection:
25        "Opioid antagonist" means a drug that binds to opioid
26    receptors and blocks or inhibits the effect of opioids



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1    acting on those receptors, including, but not limited to,
2    naloxone hydrochloride or any other similarly acting drug
3    approved by the U.S. Food and Drug Administration.
4        "Health care professional" means a physician licensed
5    to practice medicine in all its branches, a licensed
6    physician assistant with prescriptive authority, a
7    licensed advanced practice registered nurse with
8    prescriptive authority, an advanced practice registered
9    nurse or physician assistant who practices in a hospital,
10    hospital affiliate, or ambulatory surgical treatment
11    center and possesses appropriate clinical privileges in
12    accordance with the Nurse Practice Act, or a pharmacist
13    licensed to practice pharmacy under the Pharmacy Practice
14    Act.
15        "Patient" includes a person who is not at risk of
16    opioid overdose but who, in the judgment of the physician,
17    advanced practice registered nurse, or physician
18    assistant, may be in a position to assist another
19    individual during an overdose and who has received patient
20    information as required in paragraph (2) of this subsection
21    on the indications for and administration of an opioid
22    antagonist.
23        "Patient information" includes information provided to
24    the patient on drug overdose prevention and recognition;
25    how to perform rescue breathing and resuscitation; opioid
26    antagonist dosage and administration; the importance of



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1    calling 911; care for the overdose victim after
2    administration of the overdose antagonist; and other
3    issues as necessary.
4    (e) Drug overdose response policy.
5        (1) Every State and local government agency that
6    employs a law enforcement officer or fireman as those terms
7    are defined in the Line of Duty Compensation Act must
8    possess opioid antagonists and must establish a policy to
9    control the acquisition, storage, transportation, and
10    administration of such opioid antagonists and to provide
11    training in the administration of opioid antagonists. A
12    State or local government agency that employs a fireman as
13    defined in the Line of Duty Compensation Act but does not
14    respond to emergency medical calls or provide medical
15    services shall be exempt from this subsection.
16        (2) Every publicly or privately owned ambulance,
17    special emergency medical services vehicle, non-transport
18    vehicle, or ambulance assist vehicle, as described in the
19    Emergency Medical Services (EMS) Systems Act, that
20    responds to requests for emergency services or transports
21    patients between hospitals in emergency situations must
22    possess opioid antagonists.
23        (3) Entities that are required under paragraphs (1) and
24    (2) to possess opioid antagonists may also apply to the
25    Department for a grant to fund the acquisition of opioid
26    antagonists and training programs on the administration of



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1    opioid antagonists.
2(Source: P.A. 99-173, eff. 7-29-15; 99-480, eff. 9-9-15;
399-581, eff. 1-1-17; 99-642, eff. 7-28-16; 100-201, eff.
48-18-17; 100-513, eff. 1-1-18; 100-759, eff. 1-1-19.)
5    Section 200. The Hypodermic Syringes and Needles Act is
6amended by changing Sections 1 and 2 as follows:
7    (720 ILCS 635/1)  (from Ch. 38, par. 22-50)
8    Sec. 1. Possession of hypodermic syringes and needles.
9    (a) Except as provided in subsection (b), no person, not
10being a physician, dentist, chiropodist or veterinarian
11licensed under the laws of this State or of the state where he
12resides, or a registered professional nurse, or a registered
13embalmer, manufacturer or dealer in embalming supplies,
14wholesale druggist, manufacturing pharmacist, registered
15pharmacist, manufacturer of surgical instruments, industrial
16user, official of any government having possession of the
17articles hereinafter mentioned by reason of his or her official
18duties, nurse or a medical laboratory technician acting under
19the direction of a physician or dentist, employee of an
20incorporated hospital acting under the direction of its
21superintendent or officer in immediate charge, or a carrier or
22messenger engaged in the transportation of the articles, or the
23holder of a permit issued under Section 5 of this Act, or a
24farmer engaged in the use of the instruments on livestock, or a



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1person engaged in chemical, clinical, pharmaceutical or other
2scientific research, or a staff person, volunteer, or
3participant in a needle or hypodermic syringe access program,
4shall have in his or her possession a hypodermic syringe,
5hypodermic needle, or any instrument adapted for the use of
6controlled substances or cannabis by subcutaneous injection.
7    (b) A person who is at least 18 years of age may purchase
8from a pharmacy and have in his or her possession up to 100
9hypodermic syringes or needles.
10(Source: P.A. 100-326, eff. 1-1-18.)
11    (720 ILCS 635/2)  (from Ch. 38, par. 22-51)
12    Sec. 2. Sale of hypodermic syringes and needles.
13    (a) Except as provided in subsection (b), no syringe,
14needle or instrument shall be delivered or sold to, or
15exchanged with, any person except a registered pharmacist,
16physician, dentist, veterinarian, registered embalmer,
17manufacturer or dealer in embalming supplies, wholesale
18druggist, manufacturing pharmacist, industrial user, a nurse
19upon the written order of a physician or dentist, the holder of
20a permit issued under Section 5 of this Act, a registered
21chiropodist, or an employee of an incorporated hospital upon
22the written order of its superintendent or officer in immediate
23charge; provided that the provisions of this Act shall not
24prohibit the sale, possession or use of hypodermic syringes or
25hypodermic needles for treatment of livestock or poultry by the



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1owner or keeper thereof or a person engaged in chemical,
2clinical, pharmaceutical or other scientific research, or a
3staff person, volunteer, or participant in a needle or
4hypodermic syringe access program.
5    (b) A pharmacist may sell up to 100 sterile hypodermic
6syringes or needles to a person who is at least 18 years of
7age. A syringe or needle sold under this subsection (b) must be
8stored at a pharmacy and in a manner that limits access to the
9syringes or needles to pharmacists employed at the pharmacy and
10any persons designated by the pharmacists. A syringe or needle
11sold at a pharmacy under this subsection (b) may be sold only
12from the pharmacy department of the pharmacy.
13(Source: P.A. 100-326, eff. 1-1-18.)
14    Section 999. Effective date. This Act takes effect upon
15becoming law.".