Illinois Governor Rod Blagojevich signed The Home Health and Hospice Drug Dispensation and Administration Act, commonly referred to as the “Home Infusion Bill,” on August 22, 2005. This Act allows registered nurses and advanced practice nurses employed by a licensed home health agency or a “full hospice” (as defined in the Hospice Program Licensing Act signed into law on August 12, 2005), to carry injectable sterile saline, sterile water, Heparin, Epinephrine and Benadryl in their nursing bags to be used in a patient’s residence pursuant to an order in connection with emergency treatment or the adjustment of parenteral drug therapy. Proper policies and procedures must be established before these drugs are purchased or transported. This Act also lists certain responsibilities for the pharmacy that dispenses these drugs.

The Act specifically defines the nurses able to administer these drugs as registered nurses or advanced practice nurses who are employed by licensed home health agencies and “full hospices.” The Hospice Program Licensing Act signed into law on August 12, 2005, defines “full hospice” as a “coordinated program of home and inpatient care providing directly, or through agreement, palliative and supportive medical, health and other services to terminally ill patients and their families utilizing a team of professionals and volunteers…” This is distinguished from the term “volunteer hospice.” The definition of “volunteer hospice” is defined as a program to provide hospice services to patients with emphasis on the utilization of volunteers to provide services…”

The drugs permitted under the Act must be in portable containers with tamper-proof seals. Each container must be labeled with the identity of the drug and its expiration date. The drugs permitted under the Act are as follows:

1. Sterile saline
2. Sterile water
3. Not more than 5 dosage units of Heparin sodium lock flush in a concentration of 10 units per milliliter or 100 units per milliliter
4. Not more than 5 dosage units of Epinephrine HCl solution in a concentration of one to 1,000
5. Not more than 2 dosage units of Benadryl 50 milligrams IV

Proper policies and procedures must be established by the home health agency or hospice before they purchase or transport these drugs. The policies and procedures must address the following:

1. Proper handling of the drugs with respect to storage, transportation and temperature stability
2. The requirement of a written or verbal order before administration of the drug
3. The requirement that a drug be administered in accordance with a specific treatment protocol
4. The requirement that a written signature record of the dates and times that a container was in the possession of an authorized nurse be maintained by the agency or hospice.

These drugs can only be administered upon receipt of an order from a “treating health care professional.” The Act defines a health care professional as a licensed physician, an advanced practice nurse who has a written collaborative agreement with a physician, or a physician’s assistant who has been delegated the authority to perform services by his or her supervising physician. If the order for the drug is a verbal order, it must be put in writing, and written confirmation must be sent to the treating health care professional by mail or fax within 24 hours after receipt of the order.

Nurses may administer these drugs “only in the patient’s residence” even though these nurses may provide their services in other locations such as in a skilled nursing facility.

The pharmacy that dispenses these drugs must do so in properly labeled containers with tamper-proof seals. The pharmacy shall provide written instructions and counsel the nursing employees on safe storage, transportation and temperature stability of these drugs.

Similar laws are already in effect in Georgia, Indiana, Kentucky, Missouri, New Hampshire, Oklahoma, Texas and Vermont. The bill was initiated and supported by the Illinois Home Care Council.

For further information, please contact Alice K. Kush or your regular Hinshaw attorney.

This alert has been prepared by Hinshaw & Culbertson LLP to provide information on recent legal developments of interest to our readers. It is not intended to provide legal advice for a specific situation or to create an attorney-client relationship.