TESTIMONY

PRESENTED TO THE

SENATEHEALTH AND HUMAN SERVICES

COMMITTEE

By: Phil Nunes, Chief Programs Officer

Representing Alvis, Inc.

May 18, 2016

Good morning Chairwoman Jones and members of the Senate Health and Human Services Committee. I am Phil Nunes, Chief Programs Officer at Alvis, a private nonprofit human services agency with facilities in Columbus, Dayton, Toledo, Lima and Chillicothe. I am also anImmediate Past President of the International Community Corrections Association (ICCA), and Past Presidents of the Ohio Community Corrections Association (OCCA) and the Ohio Justice Alliance for Community Corrections (OJACC).

Thank you for the opportunity to testify before you today on the topic of the need to expand access and the availability of Naloxone to halfway houses and other locations where there is a high prevalence of people residing who may have an opiate addiction. In addition to expanding access, equal protection must also be extended to the staff of these locations under Ohio’s Good Samaritan Laws.

Today’s Concerns, Barriers and Loopholes:

  1. Currently a prescription is required to obtain Naloxone from a pharmacist/pharmacy with the following exceptions, where Naloxone may be obtained directly from a pharmacist:
  2. (1) An individual who there is reason to believe is experiencing or at risk of experiencing an opioid-related overdose;
  3. (2) A family member, friend, or other person in a position to assist an individual who there is reason to believe is at risk of experiencing an opioid-related overdose; or
  4. (3) A peace officer as defined in section 2921.51 of the Revised Code.
  5. According to the Pharmacy Board, Alvis does not fall under #2 as an agency so the drug must be obtained by an individual staff member.
  6. Although today anyone can obtain Naloxone at various pharmacy locations,an agencycannot obtain Naloxone without a Terminal Dangerous Drug Distributor (TDDD) License.
  7. The person who obtains the Naloxone is the only approved user of the drug and is expected to have it in their possession. It cannot be made available to all staff for use, as it linked to the single staff member for their use. If the staff member is not on duty, that Naloxone is not available or present on site. As in Alvis’ case, this would mean we would have to buy Naloxone for more than 540 staff and ask them to carry it with them and to use if they saw a need… clearly this is not achievable.
  8. An attempt was made to obtain a Terminal Dangerous Drug Distributor (TDDD) License so that the Naloxone could be purchased by Alvis for use at Alvis by any trained staff member. During the process of applying for the TDDD License, we were instructed that this license can only be obtained and exist where there is a licensed medical staff on site who would be the person administering the drug. This is precisely the problem, in that Alvis (like other treatment and housing environments), does not have medical staff at the more than 30 locations state-wide. This would not only be impossible to accomplish for financial impact reasons but also would make it impossible to ensure medical staff are on site at all times.
  9. The “Good Samaritan” law would protect the person who was prescribed and obtained the Naloxone and used it in good faith, but it is possible that the person who used the Naloxone was another person, they might not be covered under the Good Samaritan law protection.

Action Needed to Close this Current Loophole:

Senate Bill 319, (Sponsored by Senator Eklund), will go far in closing this current dangerous loophole that exists in locations such as homeless shelters, halfway houses, schools and treatment centers. As one can imagine, facilities who may have in programs or housing people who are at high risk of overdose are in peril everyday under this current loophole that exists.

I am proposing the following be taken under consideration as Senate Bill 319 proceeds through the legislative process:

Proposal:

  1. Licensed Residential facilities will be able to obtain Naloxone for storage and use at each location by trained staff.
  2. Naloxone would be a supplemental part of the facility first aid kit and have the same availability to staff and residents as the first aid supplies, not being required to be kept under lock and key.
  3. Staff would be trained according to approved policy and procedure which would include: signs and symptoms of a Narcotic Overdose, proper use of Naloxone, and follow up procedures once Naloxone is administered, including emergency medical transport to the local hospital, and monitoring of supply including expiration date.
  4. The application for obtaining Naloxone would mirror Law Enforcement requirements. The Naloxone would not be connected to any individual staff member.
  5. There would be no ancillary costs to the facilities from the state pharmacy or medical board. Costs would only be incurred through purchasing the Naloxone, and any agreed upon fees for staff training and policy review and approval by a medical authority.
  6. Extend Good Samaritan law to reflect the ORC 2925.61(D) for protection for staff and the agency who act in good faith and according to approved (by medical authority) policy and procedure.
  7. UPON PASSAGE AND SIGNATURE FROM THE GOVERNOR, IT IS IMPERATIVE THAT THIS BILL TAKE EFFECT AS AN EMERGENCY MEASURE. (Every day that goes by without passage of Senate Bill 319 leaves countless agencies and clients at risk of dying from an overdose…as we know in these situations seconds and minutes count).

Thank you for your time and your focus on this very important topic. I would be glad to take any questions at this time.

References:

Per Ohio Revised Code Section 2925.61(D) a peace officer employed by a law enforcement agency is not subject to administrative action or criminal prosecution if the peace officer, acting in good faith, obtains naloxone from the peace officer's law enforcement agency and administers the naloxone to an individual who is apparently experiencing an opioid-related overdose.

Per Ohio Revised Code Section 4729.51, as enacted by, a law enforcement agency is not subject to licensure as a terminal distributor of dangerous drugs for the sole purpose of possessing naloxone. This recent change permits law enforcement agencies to purchase naloxone from wholesalers or other terminal distributors without a license by the State of Ohio Board of Pharmacy.

Additional questions may be directed to:

Phil NunesLusanne GreenKelly O’Reilly

Chief Programs OfficerExecutive DirectorLobbyist

Alvis OCCAGovernmental Policy Group

614.252.8402614.252.8402614.461.9335

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