Scheduling Medications and Patient Care

From drug shortages to tight budgets, fire departments often face many challenges when trying to keep medical supplies fully stocked on their apparatus. The Drug Enforcement Administration (DEA) may be added to that list as a new challenge: they’re considering regulatory changes that would prevent fire departments from using standing orders from their agency’s medical director.

To prevent this detrimental change by the DEA, the IAFC is urging Congress to pass the Protecting Patient Access to Emergency Medications Act of 2016 (H.R. 4365).

Fire departments across the nation commonly use many medications that fall under DEA regulation or scheduling. Patients experiencing a wide range of conditions, such as seizures and traumatic injuries, can expect to receive controlled substances from the EMS personnel caring for them. Though these EMS personnel are not physicians, they’re able to provide these medications based on their adherence to standing orders from their agency’s medical director.

However, the DEA has recently indicated that they may eliminate their longstanding policy of permitting EMS personnel to act under standing orders. Draft regulations circulated by the DEA in 2015 suggest the agency may be working on regulatory update to prohibit the administration of controlled substances under standing orders.

Though these new regulations haven’t been released yet, the threat of DEA action has caused fire service advocates and supporters on Capitol Hill to act. In January, Rep. Richard Hudson (R-N.C.) introduced legislation (H.R. 4365) that would codify the ability of EMS personnel to rely on standing orders when administering controlled substances in the course of providing patient care.

H.R. 4365 would make two additional changes to the DEA’s regulations to simplify the registration process for fire departments nationwide. If passed, the legislation would permit agencies to register directly with the DEA and to maintain a single registration for the entire agency.

DEA prohibition of standing orders would create many formidable obstacles to providing effective patient care. The IAFC has joined with nearly every other national fire and EMS association to urge Congress to pass H.R. 4365 and protect the use of standing orders by EMS agencies across the United States.

While the legislation already has strong, bipartisan list of cosponsors and supporters, more are needed. If your agency uses standing orders to administer controlled substances to patients, consider contacting your member of the House of Representatives and urge them to become a cosponsor and active supporter of H.R. 4365.

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