CA Bus & Prof Code Section 4065


“Injection card system,” as used in this section, means a system that enables a facility to authorize an outpatient to receive injections of controlled substances at the facility pursuant to a prior written order by a physician, through the use of a card that is maintained at the location in the facility where the injections are administered.


The injection card shall include, at a minimum, the following information: the date of authorization, the number and frequency of injections authorized, the name of the drug including the strength and amount authorized, the names of the prescribing physician and the patient, the date and time of each injection, and the signature of the person administering the injection.


In addition, the patient’s medical record maintained by the facility shall contain all of the information required under Sections 4040 and 4070 and Chapter 1 (commencing with Section 70001) of Division 5 of Title 22 of the California Code of Regulations.


Notwithstanding any other provision of law, a licensed health care facility may provide for the administration of controlled substances through the use of an injection card system for controlled substances.


A facility that employs an injection card system shall have a written protocol for the use of this system. The protocol shall be developed by a team of health care professionals, including at least one physician, one registered nurse, and one pharmacist. The protocol shall provide for, but not be limited to, the following:


Identification of drugs to be included in the injection card system.


Distinction among classes of drugs.


Periodic review of the efficacy of the injection card system, including, but not limited to, its effectiveness and safety for different classes of drugs.


Determination as to whether each drug included in the injection card system requires the presence of a physician or only the ready availability of a physician.


Implementation of recordkeeping systems that, at a minimum, record each injection and each visit, provide for the immediate entry of the injection in the patient’s medical record, provide a system for discontinuance of the order by the prescribing physician, and allow for ready identification of patterns of possible or actual patient abuse of controlled substances and other potential adverse drug interactions.


Retention of the injection card by the facility at all times when a controlled substance is being administered.


Adequate initial evaluation of patients, including, but not limited to, a determination as to whether each patient is a proper subject for the injection card system.


Ongoing medical evaluation of the patient’s response to the injection card system.


That all injection cards shall become a permanent part of the patient’s medical record within 15 days from the date the last authorized dose is administered.


Nothing in this section shall be construed to prohibit the use, or impose new requirements on the use, of an injection card system for noncontrolled substances.
Last Updated

Aug. 19, 2023

§ 4065’s source at ca​.gov