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h�bbd```b``^"O�H-�$"y��L�"L`��^�n���`�D�y��V`R ,� 1-833-4CA4ALL (916) 558-1784, COVID 19 Information Line: CDPH has issued a statewide standing order to help reduce morbidity and mortality associated with opioid overdose by facilitating the distribution and administration of Naloxone Hydrochloride (Naloxone) in California. Reset Board of Pharmacy Naloxone Text Page 1 of 3 16 CCR § 1746.3 §1746.3 Protocol for Pharmacists Furnishing Naloxone Hydrochloride. 63 0 obj <> endobj 97 0 obj <>/Filter/FlateDecode/ID[<5533C08FF2024149B0B6688AE04EED8B>]/Index[63 95]/Info 62 0 R/Length 144/Prev 490671/Root 64 0 R/Size 158/Type/XRef/W[1 3 1]>>stream State: California 3 rd Party: Yes Standing Order: Yes Pharmacy Access Notes: Law allows licensed healthcare providers (including pharmacists) to make naloxone available to anyone. Naloxone Statewide Standing Order. 3. 7. 4. The standing order was issued by the state Public Health Officer (authorized by California Civil Code Section 1714.22) to: 1) allow community organizations and other entities in California that are not currently working with a physician, to distribute naloxone to a person at risk of an opioid-related overdose or to a family member, Predicting pharmacy naloxone stocking and dispensing following a statewide standing order, Indiana 2016. (1-833-422-4255). California pharmacists do not need to use the standing order. A pharmacist furnishing naloxone hydrochloride pursuant to section 4052.01 of the Business and Professions Code shall satisfy the … ��������u�4���)� ��\a��"��!B�(oH$C1#0� �m'��.� L�$��:@�L��&:@��������K��0� This standing order will automatically expire one year from the date that it is signed. �5�HX� to Default, Methicillin-Resistant Staphylococcus Aureus Bloodstream Infection, Certificates, Licenses, Permits and Registrations, Registered Environmental Health Specialist, Mosquito Disease Surveillance and Control, California Health Facilities Information Database, Chronic Disease Surveillance and Research, Division of Food, Drug, and Cannabis Safety, Division of Radiation Safety and Environmental Management, Center for Health Statistics and Informatics, Medical Marijuana Identification Card Program, Office of State Public Health Laboratory Director, Center for Chronic Disease Prevention and Health Promotion, Division of Chronic Disease and Injury Control, Centers for Disease Control and Prevention. The standing order expands access to naloxone for California residents and allows organizations that cannot prescribe naloxone to distribute it to those who are at risk of experiencing an opioid-related overdose and those in a position to assist during an opioid-related overdose. Agrees to ensure that entities and individuals receiving and administering naloxone receive opioid overdose prevention and treatment training as defined. Pharmacists can dispense naloxone without a prescription from a health care provider as authorized and in compliance with Business and Profession Code Section 4052.01. ���J��V��� ��=����(R/�T��z�>�K��/����Lbb�ú[�Q� y�'�hT�0��]^��=y=F� U1M��$>�w�S�2*� e�8vo�Wo�UT%t�i����o]ݍ쿼�����q?��L����y�dUZ=��'0���1�1�P� �a���O*b�N��Y�>. PO Box 997377 Agrees to maintain and report, at the time of renewal, information regarding the number of doses of naloxone distributed under this standing order. Acknowledges that the standing order cannot be used to purchase or sell naloxone. The information submitted in this application should be publicly accessible information and may be subjected to the Public Records Act. If, after submitting your application, you do not receive a standing order, please contact NaloxoneStandingOrder@cdph.ca.gov. *. Meyerson BE, Agley JD, Davis A, et al. Certifies that the contact and location information provided is correct. California Civil Code. Agrees to allow the California Department of Public Health to use the information provided on the application form to track the use of the standing order and conduct other public health and epidemiological surveillance activities. Review the terms and conditions to determine if you should apply. 5. h��Ymo�8�+��@��E�o��=8q�d/i�q��C�%'jmɕ��_3��ږ��[2%r��)4��0$~@|ƈ/�>� For more information, contact: DHCSMATexpansion@dhcs.ca.gov . Local behavioral health 10. A family member, friend, or other individual, including law enforcement, fire 9. 2. By submitting the online application form, the entity: 1. ���ߑ�JJ�I��z�`�`�|�N��͵p��� Naloxone. You must certify and agree to the information in this section to receive a standing order. Agrees to re-register for the standing order if there is a change in the information required on this form. Decrease, Reset Agrees to ensure that entities and individuals receiving and administering naloxone … Agrees to maintain a copy of the standing order, which will include these terms and conditions. (California pharmacists do not need to use the standing order. REVIEW THE TERMS AND CONDITIONS TO DETERMINE IF YOU SHOULD APPLY After reviewing the terms and conditions, apply for a standing order in three easy steps: After submitting the application information below, a copy of the statewide standing order will be issued to the applicant. The standing order authorizes a pharmacist that is active and in good standing with the Texas State Board of Pharmacy to dispense an opioid antagonist to a recipient in any of the following formulations: Intramuscular Naloxone aqueous solution multi-dose vial or pre-filled syringe (EXCLUDING auto-injector such as Evzio or equivalent); [ND�� I�$��gE����(lZ������z|��Ra'� to Default, Domestic Violence/Intimate Partner Violence, Child Passenger Safety (CPS) In California, Drowning Prevention: Toddler Pool and Spa Safety. Naloxone Standing Order – FAQs Updated June 18, 2018 Page 2. Sacramento, CA 95899-7377, For General Public Information: 6. 6. Malloy statement on outbreak of overdose cases in … Naloxone. This standing order is current as of DATEand issued in accordance with Section 1714.22 of the. 5. Complete the application below. `�HX̗>1F�����spc@x)I(�� %GbMB��� �F�H�F �Mh@_��Q(�1 Yǃ���8���$�����U���_h/)��h&q���-�Y�p-�[Q��nU�� ���m�Z�^ϯ�����z=߮w�t�n�������IB��"N Gov. STANDING ORDER TO DISPENSE NALOXONE HYDROCHLORIDE. "Yj�vł�9�&�Hޣ �+DrKI��`��;�e��^�)۸��!��Lu@�W�:�G���``%iB�g`�;` jqS endstream endobj startxref 0 %%EOF 157 0 obj <>stream Español, - 4. Pharmacists can dispense naloxone without a … 5�W�4���|X��qA� An individual at risk of experiencing an opioid‐related overdose; or B. Please turn on JavaScript and try again. Naloxone. This standing order is intended to ensure that naloxone is readily obtainable by any person who is: A. Agrees to allow the California Department of Public Health to contact the entity using the information provided on the application form. Drug Alcohol Depend. h�b``�```na`e`8��A���b�,;vN8���‐�hK���U���� It may be delivered intranasally or intramuscularly. AB 2760 (Wood, Chapter 324) was signed into law in 2018 and becomes effective on January 1, 2019. is indicated for treatment of opioid overdose. The California State Public Health Officer has issued a statewide standing order to help reduce morbidity and mortality associated with opioid overdose by facilitating the distribution and administration of Naloxone in California. MS 0500 AB 2760 (Wood, Chapter 324) was signed into law in 2018 and becomes effective on January 1, 2019. Agrees to allow the California Department of Public Health to use the information provided on the application form to track the use of the standing order and conduct other public health and epidemiological surveillance activities. This standing order is issued pursuant to paragraphs (1) and (2) of subdivision (c) of Section 1714.22 of the California Civil Code, which allows a licensed health care provider authorized to prescribe an opioid antagonist to issue a standing order for the distribution and administration of naloxone. Starting in early 2019, $19.7 million of naloxone will be distributed in California to a broad array of organizations with a simple application process. %PDF-1.7 %���� ���1�n +N��@Z��"�@3-�Z0m�)`�Őw���>�����y�> ��\ӀF�Y2,����P����0AAe�f���0x�Q`�u{�'�f�V ���A�{�����*�g� 0 ��0 endstream endobj 64 0 obj <>>> endobj 65 0 obj <> endobj 66 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text]/XObject<>>>/Rotate 0/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 67 0 obj <>stream en zC�����-.���}G��Au+��@B�π)I�< �k�=���O�+\�";�U�Y�W�_�|Ł|A�� �0˗��`�ʄ����c� ��1��cp�*л1V2�Fx��h ��C�p����>t��#i� ZぽIa��@��Q<0Wɍݪ�G�[��n�5/�,������jE�#��El�Q��ړ�2� fZ�*v0tp��k����������~E͖��N����0�4xOd��y This standing order should be reviewed carefully against the most recent recommendations, and may be revised or updated if there is new information about naloxone administration. The standing order can be renewed by completing another online application form. Acknowledges that the standing order cannot be used to purchase or sell naloxone. STANDING ORDER OF THE STATE HEALTH OFFICER NALOXONE DISTRIBUTION FOR OVERDOSE PREVENTION Naloxone Hydrochloride (naloxone) is an opioid antagonist indicated for the reversal of an opioid overdose, whether from legally prescribed opioids or from illegal opioids such as heroin If known/available, agrees to maintain and report information, upon renewal, regarding the number of reversals that occurred using naloxone distributed under this standing order. 8. Please carefully consider quantities needed before ordering, as the shelf life of naloxone is 18 to 24 months. Solve the captcha to validate you are human if it appears. It looks like your browser does not have JavaScript enabled. Eligible entities and organizations to administer or distribute naloxone through a California Public Health standing order, and to individuals with a valid prescription include, but are not limited to: First Responders ; Emergency medical services; Fire authorities; Law enforcement, courts, & criminal justice partners; Veteran organizations Will ensure that any of its affiliates or subcontractors apply for their own standing order. 2018:18; 187-19 doi: 10.1016/j.drugalcdep.2018.03.032. `��:��v�� Please ensure the person applying is authorized to be the representation of your organization to apply for and receive this standing order. Naloxone Statewide Standing Order. The California Department of Public Health (CDPH) has issued a statewide standing order for naloxone, an antidote medication that reverses an opioid overdose. Of Public health to contact the entity using the information in this Section to a... 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