,,ii  #aag? ,,congress  #a/ ,session    
,s4 #abib  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,april #ba1 #bjba ,mr4 
,man*9 7= himself & ,mr4 ,scott ( ,s\?  
,c>ol9a7 introduc$ ! foll[+ bill2 :i* 0 
read twice & ref]r$ to ! ,committee on  
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to develop a non-opioid pa9 
managem5t directive indicat+ to heal?   
c>e pr(essionals & em]g5cy m$ical       
s]vices p]sonnel t an individual )      
respect to :om a =m has be5 execut$ mu/ 
n be adm9i/]$ an opioid or (f]$ a       
prescription = an opioid1 & = o!r       
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,non-,opioid ,directive    
,act4  #b4 ,non-opioid pa9 managem5t =m 
7a7 ,9 g5]al ,title ,v ( ! ,public      
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#bij;aa et seq47 is am5d$ by ins]t+ aft]
 section #eeb ( su* ,act ! foll[+3      
#eec4 ,non-opioid pa9 managem5t         
directive  7a7 ,developm5t ( =m  7#a7 ,9
 g5]al ,! ,secret>y %all develop a      
non-opioid pa9 managem5t =m indicat+ to 

heal? c>e pr(essionals1 provid]s (      
s]vices1 & em]g5cy m$ical s]vices       
p]sonnel t1 except z provid$ 9          
subsection 7c7 or 9 rules promulgat$ by 
! ,secret>y "u subsection 7e71 an       
individual :o has execut$ ! =m or :o has
 _h a =m execut$ on ! individual's      
behalf mu/ n be adm9i/]$ 7) ! exception 
( intraop]ative opioid use7 an opioid or
 (f]$ a prescription = an opioid = pa9  
managem5t1 includ+ po/-surgical pa94    
7#b7 ,cont5ts ( =m ,! ,secret>y %all    
include on ! non-opioid pa9 managem5t =m
 in/ructions on h[ ! =m may be revok$ & 
any o!r in=mation t ! ,secret>y det]m9es
 relevant4  7#c7 ,public availability ( 
=m ,! ,secret>y %all-- 7,a7 make ! =m   
available to ! public on ! website ( !  
,dep>tm5t ( ,heal? & ,human ,s]vices2   
7,b7 require ea* gr\p heal? plan or     
heal? insurance issu] to make ! =m      
available to ea* enrollee2 &  7,c7      
require ea* gr\p heal? plan or heal?    
insurance issu] to include a notice ( ! 
individual's *oice = non-opioid pa9     

managem5t to heal? c>e provid]s1        
pr(essionals1 & su* o!r entities z !    
,secret>y may require = use dur+ any    
preau?orization process1 includ+ any    
prior au?orization relat+ to an         
occupational injury or a work]s'        
comp5sation claim4  7b7 ,execution1 use1
 & revocation ( =m  7#a7 ,execution ,a  
non-opioid pa9 managem5t =m may be      
execut$ by-- 7,a7 an individual1 on 8 or
 h] own behalf2 or  7,b7 a gu>dian or   
pati5t advocate ( an individual on      
behalf ( ! individual1 9 ! case ( an    
individual :o is a m9or or :o is        
incapacitat$ 7z det]m9$ by ! ,secret>y74
  7#b7 ,inclusion 9 m$ical record  7,a7 
,9 g5]al ,if a non-opioid pa9 managem5t 
=m is execut$ by or on behalf ( an      
individual & is pres5t$ to a heal? c>e  
pr(essional1 ! heal? c>e pr(essional    
%all make a copy ( ! =m & include ! copy
 9 ! individual's m$ical record4  7,b7  
,electronic m$ical records  7i7 ,9 g5]al
 ,! ,secret>y %all e/abli% proc$ures to 
ensure t any execut$ =m is includ$ 9 any

 electronic m$ical record relat+ to !   
individual4  7ii7 ,requirem5ts ,!       
proc$ures e/abli%$ "u clause 7i7 %all-- 
7,i7 require heal? c>e provid]s & su*   
o!r entities z ! ,secret>y may specify  
to include ea* individual's *oice to    
ex]cise a non-opioid pa9 managem5t      
directive 9 a cle> "p 9 ! m$ical records
 9 a simil> mann] z x w\ld display      
all]gies to treatm5ts2  7,,ii7 if an    
individual *ooses to use ! non-opioid   
directive1 p]mit ! individual to report 
! exi/5ce ( a non-opioid pa9 managem5t  
=m to _! employ] or gr\p heal? plan or  
heal? insurance issu] to s]ve z notice  
to ! heal? plan or issu] & any ph>macy  
b5efit manag]2 &  7,,iii7 require gr\p  
heal? plans & heal? insurance issu]s to 
provide a copy ( ! non-opioid pa9       
managem5t =m dur+ annual enrollm5t1     
specifically ask+ ! individual to opt 9 
or opt out4  7#c7 ,revocation  7,a7 ,by 
! individual ,an individual may revoke a
 non-opioid pa9 managem5t =m execut$ by 
!mselves at any "t & 9 any mann] by :i* 

!y are able to communicate _! int5t to  
revoke ! =m4  7,b7 ,by an au?oriz$      
repres5tative ,a pati5t advocate or     
gu>dian may revoke a non-opioid pa9     
managem5t =m on behalf ( an individual  
at any "t by issu+ ! revocation 9 writ+ 
& provid+ notice ( ! revocation to !    
individual's heal? c>e pr(essional4     
7#d7 ,notification requirem5t ,9 ! case 
( a non-opioid pa9 managem5t =m execut$ 
by a pati5t advocate or gu>dian on      
behalf ( an individual pursuant to      
p>agraph 7#a77;,b71 any heal? c>e       
pr(essional :o copi$ & includ$ ! =m 9 ! 
individual's m$ical record %all notify !
 pati5t ( su* =m ^u ! pati5t turn+ #ah1 
or rega9+ capacity1 z applicable4  7c7  
,exception = em]g5cies  7#a7 ,9 g5]al ,a
 heal? c>e pr(essional :o is au?oriz$ to
 disp5se a p>ticul> opioid "u !         
,controll$ ,sub/ances ,act & is au?oriz$
 to disp5se controll$ sub/ances by !    
,/ate 9 :i* ! heal? c>e pr(essional     
practices may adm9i/] t opioid to an    
individual :o has execut$ a non-opioid  

pa9 managem5t =m or :o has _h a         
non-opioid pa9 managem5t =m execut$ on  
_! behalf if-- 7,a7 ! individual is--   
7i7 receiv+ em]g5cy treatm5t 9 a        
hospital or outside ( a hospital2 or    
7ii7 receiv+ ! opioid ?r\gh             
intraop]ative use dur+ surg]y2 &  7,b7 9
 ! treat+ heal? c>e pr(essional's       
op9ion1 aft] due consid]ation ( o!r     
options & inquir+ ab\t a hi/ory ( opioid
 use1 ! adm9i/ration ( ! opioid is      
m$ically necess>y to treat ! individual4
  7#b7 ,provision ( in=mation on adv]se 
ev5ts1 opioid use disord]1 & treatm5t   
s]vices ,if an opioid is adm9i/]$ "u ?is
 subsection1 ! heal? c>e pr(essional    
%all ensure t ! individual is provid$ ) 
in=mation on adv]se ev5ts1 opioid use   
disord]1 & treatm5t s]vices ( opioid use
 disord]4  7d7 ,limitation on liability 
7#a7 ,9 g5]al ,except z o!rwise provid$ 
by law1 ! individuals & entities        
describ$ 9 p>agraph 7#b7 %all n be      
subject to civil or crim9al liability or
 pr(essional discipl9>y action = fail+  

to adm9i/]1 prescribe1 or disp5se an    
opioid1 or = ! inadv]t5t adm9i/ration ( 
an opioid1 to an individual :o has      
execut$ a non-opioid pa9 managem5t =m or
 :o has _h a non-opioid pa9 managem5t =m
 execut$ on 8 or h] behalf1 if ! failure
 to act or act 0 done reasonably & 9    
good fai?4  7#b7 ,individuals & entities
 describ$ ,! individuals & entities     
describ$ 9 ?is p>agraph are ! foll[+3   
7,a7 ,a heal? c>e pr(essional ^: scope (
 practice includes ! prescrib+1         
adm9i/]+1 or disp5s+ ( a controll$      
sub/ance4  7,b7 ,a provid] ( s]vices4   
7,c7 ,an employee ( a heal? c>e         
pr(essional4  7,d7 ,an employee ( a     
provid] ( s]vices4  7,e7 ,em]g5cy &     
intraop]ative m$ical s]vices p]sonnel4  
7e7 ,regulations ,! ,secret>y %all      
promulgate su* rules & regulations z may
 be requir$ to implem5t ?is section1    
includ+ ! foll[+3  7#a7 ,proc$ures to   
record a non-opioid pa9 managem5t =m 9 a
 m$ical record1 includ+ an electronic   
m$ical record4  7#b7 ,proc$ures to      

revoke a non-opioid pa9 managem5t =m4   
7#c7 ,proc$ures to ensure t ! record+1  
disclosure1 or di/ribution ( data relat+
 to a non-opioid pa9 managem5t =m or !  
transmission ( a non-opioid pa9         
managem5t =m complies ) ,/ate & ,f$]al  
confid5tiality & cons5t laws1 rules1 &  
regulations4  7#d7 ,exceptions =        
adm9i/]+ or prescrib+ an opioid to an   
individual :o has execut$ a non-opioid  
pa9 managem5t =m or :o has _h a         
non-opioid pa9 managem5t =m execut$ on 8
 or h] behalf if ! opioid is adm9i/]$ or
 prescrib$ to treat ! individual = a    
sub/ance use disord]4  7#e7 ,exceptions 
= adm9i/]+ or prescrib+ an opioid to an 
individual :o has execut$ a non-opioid  
pa9 managem5t =m or :o has _h a         
non-opioid pa9 managem5t =m execut$ on 8
 or h] behalf if ! individual is a      
hospice pati5t4  7#f7 ,! rules          
promulgat$ "u ?is section mu/ all[ a    
heal? c>e pr(essional or provid] (      
s]vices to incorporate a non-opioid pa9 
managem5t =m into an exi/+ pati5t =m or 

into o!r docum5tation us$ by ! heal? c>e
 pr(essional or provid] ( s]vices4  7f7 
,def9itions ,9 ?is section3 7#a7 ,gr\p  
heal? plan2 heal? insurance issu] ,!    
t]ms gr\p heal? plan & heal? insurance  
issu] h ! mean+s giv5 su* t]ms 9 section
 #bgia4  7#b7 ,gu>dian ,! t]m gu>dian   
means a p]son ) ! p[]s & duties to make 
m$ical treatm5t decisions on behalf ( a 
pati5t to ! ext5t grant$ by c\rt ord]4  
7#c7 ,non-opioid pa9 managem5t =m ,! t]m
 non-opioid pa9 managem5t =m means !    
non-opioid pa9 managem5t =m develop$ by 
! ,secret>y "u subsection 7a74  7#d7    
,pati5t advocate ,! t]m pati5t advocate 
means an individual designat$ to make   
m$ical treatm5t decisions = a pati5t4   
7#e7 ,provid] ( s]vices ,! t]m provid] (
 s]vices has ! mean+ giv5 su* t]m 9     
section #ahfa7u7 ( ! ,social ,security  
,act4  4  7b7 ,effective date ,section  
#eec ( ! ,public ,heal? ,s]vice ,act1 z 
add$ by subsection 7a71 %all take effect
 on ,janu>y #a1 #bjbb4