Ariz. Admin. Code § 9-4-602

Current through Register Vol. 30, No. 45, November 8, 2024

Section R9-4-602 - Opioid Poisoning-Related Reporting Requirements

A. A first response agency shall, either personally or through a representative, submit a report to the Department, in a Department-provided format and within five business days after an encounter with an individual with a suspected opioid overdose, that includes:

1. The following information about the first response agency:

a. Name;

b. Street address, city, county, and zip code;

c. Whether the first response agency reporting is:

i. An ambulance service,

ii. An emergency medical services provider, or

iii. A law enforcement agency; and

d. If applicable, the certificate number issued by the Department to the ambulance service;

2. The name, title, telephone number, and email address of a point of contact for the first response agency required to report;

3. The following information about the location at which the first response agency encountered the individual:

a. Street address or, if the location at which the first response agency encountered the individual does not have a street address, another indicator of the location at which the encounter occurred;

b. City, if applicable;

c. County;

d. State; and

e. Zip code;

4. If applicable, the date and time the first response agency was dispatched to the location specified according to subsection (A)(3);

5. The following information, as known, about the individual with a suspected opioid overdose or who died of a suspected opioid overdose:

a. Name,

b. Date of birth,

c. Age in years,

d. Gender,

e. Race and ethnicity, and

f. Reason for suspecting that the individual had an opioid overdose;

6. Whether naloxone or another opioid antagonist designated according to A.R.S. § 36-2228 was administered to the individual before the first response agency encountered the individual and, if so:

a. The number of doses of naloxone or other opioid antagonist administered to the individual; and

b. As applicable, that the naloxone or other opioid antagonist was administered to the individual by:

i. Another individual; or

ii. Another first response agency and, if so the type of first response agency that administered the naloxone or other opi-oid antagonist to the individual;

7. Whether naloxone or another opioid antagonist designated according to A.R.S. § 36-2228 was administered to the individual by the first response agency and, if so, the number of doses of naloxone or other opioid antagonist administered to the individual;

8. Whether the disposition of the individual was that the individual:

a. Survived the suspected opioid overdose; or

b. Was pronounced dead:

i. At the location specified according to subsection (A)(3), or

ii. After leaving the location specified according to subsection (A)(3);

9. If the individual was transported by a first response agency:

a. The type of first response agency that transported the individual; and

b. Whether the individual was transported to:

i. A hospital and, if so, the name of the hospital to which the individual was transported;

ii. Another class of health care institution and, if so, the name of the health care institution to which the individual was transported; or

iii. A correctional facility and, if so, the name of the correctional facility to which the individual was transported; and

10. The date of the report.

B. The following are not required to submit a report under this Article:

1. An administrator of a health care institution licensed under 9 A.A.C. 10, for an opioid overdose resulting from the administration of the opioid to a patient in the health care institution if the opioid overdose is addressed through the health care institution's quality management program; or

2. A pharmacist for naloxone or another opioid antagonist that is dispensed in connection with a surgical procedure, as defined in A.A.C. R9-10-101, or other invasive procedure performed in a health care institution.

C. Except as prohibited by Title 42 Code of Federal Regulations, Chapter I, Subchapter A, Part 2 or as specified in subsection (B), a health professional or the administrator of a health care institution licensed under 9 A.A.C. 10 shall, either personally or through a representative, submit a report to the Department, in a Department-provided format and within five business days after an encounter with an individual with a suspected opioid overdose, that includes:

1. The name, street address, city, county, zip code, and telephone number of the health professional or health care institution;

2. If different from the person in subsection (C)(1), the name, title, telephone number, and email address of the individual reporting on behalf of the person in subsection (C)(1);

3. The following information about the individual with a suspected opioid overdose:

a. The individual's name;

b. The individual's street address, city, county, state, and zip code;

c. The individual's date of birth;

d. The individual's gender;

e. The individual's race and ethnicity;

f. Whether the individual is pregnant and, if so, the expected date of delivery;

g. If applicable, the name of the individual's guardian; and

h. Whether naloxone or another opioid antagonist designated according to A.R.S. § 36-2228 was administered to the individual before the health professional or health care institution encountered the individual and, if so:

i. The type of first response agency that administered the naloxone or other opioid antagonist to the individual, or

ii. That the naloxone or other opioid antagonist was administered to the individual by another individual;

4. The following information about the diagnosis of opioid overdose:

a. The reason for suspecting that the individual had an opioid overdose;

b. The date of the suspected opioid overdose;

c. The date of diagnosis; and

d. If the diagnosis was confirmed through one or more tests performed by a clinical laboratory, for each test:

i. The name, address, and telephone number of the clinical laboratory;

ii. The date a specimen was collected from the individual;

iii. The type of specimen collected;

iv. The type of laboratory test performed; and

v. The laboratory test result and date of the result;

5. The following information about the suspected opioid overdose:

a. Whether the opioid overdose appeared to be intentional or unintentional;

b. The location where the opioid overdose took place;

c. Whether the individual was alone at the time of the opioid overdose;

d. Whether the individual was transported to the health professional or health care institution by a first response agency and, if so, the type of first response agency that transported the individual;

e. The specific opioid that appeared to be responsible for the opioid overdose; and

f. If known, whether:

i. The individual was prescribed an opioid within the 90 calendar days before the date of the suspected opioid overdose;

ii. The individual had been referred to receive behavioral health services, as defined in A.R.S. § 36-401; or

iii. The opioid overdose was the first time the individual had had an opioid overdose and, if not, the number of previous opioid overdoses the individual was known to have had;

6. Whether the individual with the suspected opioid overdose:

a. Survived the suspected opioid overdose and:

i. Was admitted to the health care institution;

ii. Was transferred to another health care institution and, if so, the name of the health care institution;

iii. Was discharged to a law enforcement agency or correctional facility and, if so, the name of the law enforcement agency or correctional facility;

iv. Was discharged to home; or

v. Left the health care institution against medical advice; or

b. Died and, if so, the date of death; and

7. The date of the report.

D. Except as prohibited by Title 42 Code of Federal Regulations, Chapter I, Subchapter A, Part 2, a health professional or the administrator of a health care institution licensed under 9 A.A.C. 10 shall, either personally or through a representative, submit a report to the Department, in a Department-provided format and within five business days after an encounter with an individual with suspected neonatal abstinence syndrome, that includes:

1. The name, street address, city, county, zip code, and telephone number of the health professional or health care institution;

2. If different from the person in subsection (D)(1), the name, title, telephone number, and email address of the individual reporting on behalf of the person in subsection (D)(1);

3. The following information about the individual with suspected neonatal abstinence syndrome:

a. The individual's name;

b. The individual's date of birth;

c. The individual's gender;

d. The individual's race and ethnicity;

e. The name of the individual's mother; and

f. If not the individual's mother, the name of the individual's guardian;

4. The following information about a diagnosis of neonatal abstinence syndrome:

a. The reason for suspecting that the individual has neonatal abstinence syndrome;

b. The date of the onset of signs of neonatal abstinence syndrome;

c. The date of diagnosis;

d. If the diagnosis was confirmed through one or more tests performed by a clinical laboratory, for each test:

i. The name, address, and telephone number of the clinical laboratory;

ii. The date a specimen was collected from the individual;

iii. The type of specimen collected;

iv. The type of laboratory test performed; and

v. The laboratory test result and date of the result; and

e. Whether any of the following supported a diagnosis of neonatal abstinence syndrome:

i. A maternal history of opioid use,

ii. A positive laboratory test for opioid use by the individual's mother, or

iii. A positive laboratory test for opioids in the individual;

5. If known, the following information about the suspected neonatal abstinence syndrome:

a. The source of the opioid believed to have caused the neonatal abstinence syndrome; and

b. If the source of the opioid used by the individual's mother was not through a prescription order, as defined in A.R.S. § 32-1901, the specific opioid used by the individual's mother; and

6. The date of the report.

E. A pharmacist who dispenses naloxone or another opioid antagonist to an individual according to A.R.S. § 32-1979 shall, either personally or through a representative, submit a report as required in A.R.S. § 32-1979 to document the dispensing.

F. A medical examiner shall, either personally or through a representative, submit a report to the Department, in a Department-provided format and within five business days after the completion of the death investigation required in A.R.S. § 11-594 on the human remains of a deceased individual with a suspected opioid overdose, that includes:

1. The following information about the medical examiner:

a. Name; and

b. Street address, city, county, and zip code;

2. The following information about the deceased individual with a suspected opioid overdose:

a. The deceased individual's name;

b. The deceased individual's date of birth;

c. The deceased individual's gender;

d. The deceased individual's race and ethnicity;

e. Whether the deceased individual was pregnant and, if so, the expected date of delivery;

f. If applicable, the name of the deceased individual's guardian; and

g. Whether naloxone or another opioid antagonist was administered to the deceased individual before the deceased individual's death and, if known:

i. The type of first response agency that administered the naloxone or other opioid antagonist to the deceased individual, or

ii. That the naloxone or other opioid antagonist was administered to the deceased individual by another individual;

3. The following information about the diagnosis of opioid overdose:

a. The reason for suspecting that the deceased individual had an opioid overdose;

b. The date of the opioid overdose;

c. The date of diagnosis; and

d. If the diagnosis was confirmed by clinical laboratory tests:

i. The name, address, and telephone number of the clinical laboratory;

ii. The date a specimen was collected from the deceased individual;

iii. The type of specimen collected;

iv. The type of laboratory test performed; and

v. The laboratory test result and date of the result;

4. If applicable, a copy of the clinical laboratory test results;

5. If known, the following information about the suspected opioid overdose:

a. Whether the opioid overdose appeared to be intentional or unintentional;

b. The location where the opioid overdose took place;

c. Whether the deceased individual was alone at the time of the opioid overdose;

d. The specific opioid that appeared to be responsible for the opioid overdose;

e. Whether the deceased individual was prescribed an opioid within the 90 calendar days before the date of the opioid overdose; and

f. Whether the opioid overdose was the first time the deceased individual was known to have had an opioid overdose and, if not, the number of previous opioid overdoses the deceased individual had had;

6. Whether the deceased individual with the suspected opioid overdose:

a. Died from the suspected opioid overdose and, if so, the date of death; or

b. Died from another cause after experiencing a suspected opioid overdose and, if so, the date of death; and

7. The date of the report.

G. Information collected on individuals pursuant to this Article is confidential according to:

1. A.R.S. § 36-133(F); and

2. If applicable, A.R.S. §§ 36-2401 through 36-2403.

Ariz. Admin. Code § R9-4-602

New Section made by final rulemaking at 24 A.A.R. 783, effective 4/5/2018.