Bill Text: CA AB1748 | 2015-2016 | Regular Session | Chaptered
Bill Title: Pupils: pupil health: opioid antagonist.
Sponsorship: Partisan Bill (Independent 1)
Status: (Passed) 2016-09-24 - Chaptered by Secretary of State - Chapter 557, Statutes of 2016. [AB1748 Detail]
Download: California-2015-AB1748-Chaptered.html
BILL NUMBER: AB 1748 CHAPTERED
BILL TEXT
CHAPTER 557
FILED WITH SECRETARY OF STATE SEPTEMBER 24, 2016
APPROVED BY GOVERNOR SEPTEMBER 24, 2016
PASSED THE SENATE AUGUST 19, 2016
PASSED THE ASSEMBLY AUGUST 24, 2016
AMENDED IN SENATE AUGUST 1, 2016
AMENDED IN SENATE JUNE 20, 2016
AMENDED IN ASSEMBLY MAY 11, 2016
AMENDED IN ASSEMBLY APRIL 25, 2016
AMENDED IN ASSEMBLY APRIL 14, 2016
AMENDED IN ASSEMBLY MARCH 18, 2016
INTRODUCED BY Assembly Member Mayes
FEBRUARY 2, 2016
An act to add Section 4119.8 to the Business and Professions Code,
and to add Section 49414.3 to the Education Code, relating to
pupils.
LEGISLATIVE COUNSEL'S DIGEST
AB 1748, Mayes. Pupils: pupil health: opioid antagonist.
(1) Existing law authorizes a pharmacy to furnish epinephrine
auto-injectors to a school district, county office of education, or
charter school if certain conditions are met. Existing law requires
the school district, county office of education, or charter school to
maintain records regarding the acquisition and disposition of
epinephrine auto-injectors furnished by the pharmacy for a period of
3 years from the date the records were created.
This bill would authorize a pharmacy to furnish naloxone
hydrochloride or another opioid antagonist to a school district,
county office of education, or charter school if certain conditions
are met. The bill would require the school district, county office of
education, or charter school to maintain records regarding the
acquisition and disposition of naloxone hydrochloride or another
opioid antagonist furnished by the pharmacy for a period of 3 years
from the date the records were created.
(2) Under existing law, the governing board of a school district
is required to give diligent care to the health and physical
development of pupils and may employ properly certified persons for
that work. Existing law requires school districts, county offices of
education, and charter schools to provide emergency epinephrine
auto-injectors to school nurses or trained volunteer personnel and
authorizes school nurses and trained personnel to use epinephrine
auto-injectors to provide emergency medical aid to persons suffering,
or reasonably believed to be suffering, from an anaphylactic
reaction, as provided.
This bill would authorize a school district, county office of
education, or charter school to provide emergency naloxone
hydrochloride or another opioid antagonist to school nurses and
trained personnel who have volunteered, as specified, and authorizes
school nurses and trained personnel to use naloxone hydrochloride or
another opioid antagonist to provide emergency medical aid to persons
suffering, or reasonably believed to be suffering, from an opioid
overdose. The bill would expressly authorize each public and private
elementary and secondary school in the state to voluntarily determine
whether or not to make emergency naloxone hydrochloride or another
opioid antagonist and trained personnel available at its school and
to designate one or more school personnel to receive prescribed
training regarding naloxone hydrochloride or another opioid
antagonist from individuals in specified positions.
The bill would require the Superintendent of Public Instruction to
establish minimum standards of training for the administration of
naloxone hydrochloride or another opioid antagonist, to review these
standards every 5 years or sooner as specified, and to consult with
organizations and providers with expertise in administering naloxone
hydrochloride or another opioid antagonist and administering
medication in a school environment in developing and reviewing those
standards. The bill would require the State Department of Education
to include on its Internet Web site a clearinghouse for best
practices in training nonmedical personnel to administer naloxone
hydrochloride or another opioid antagonist to pupils.
The bill would require a school district, county office of
education, or charter school choosing to exercise the authority to
provide emergency naloxone hydrochloride or another opioid antagonist
to provide the training for the volunteers at no cost to the
volunteers and during the volunteers' regular working hours. The bill
would require a qualified supervisor of health or administrator at a
school district, county office of education, or charter school
electing to utilize naloxone hydrochloride or another opioid
antagonist for emergency medical aid to obtain the prescription for
naloxone hydrochloride or another opioid antagonist from an
authorizing physician and surgeon, as defined, and would authorize
the prescription to be filled by local or mail order pharmacies or
naloxone hydrochloride or another opioid antagonist manufacturers.
The bill would authorize school nurses or, if the school does not
have a school nurse, a person who has received training regarding
naloxone hydrochloride or another opioid antagonist to immediately
administer naloxone hydrochloride or another opioid antagonist under
certain circumstances. The bill would provide that volunteers may
administer naloxone hydrochloride or another opioid antagonist only
by nasal spray or by auto-injector, as specified.
The bill would prohibit an authorizing physician and surgeon from
being subject to professional review, being liable in a civil action,
or being subject to criminal prosecution for any act in the issuing
of a prescription or order, pursuant to these provisions, unless the
act constitutes gross negligence or willful or malicious conduct. The
bill would prohibit a person trained under these provisions who
administers naloxone hydrochloride or another opioid antagonist, in
good faith and not for compensation, to a person who appears to be
experiencing an opioid overdose from being subject to professional
review, being liable in a civil action, or being subject to criminal
prosecution for this administration.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 4119.8 is added to the Business and Professions
Code, to read:
4119.8. (a) Notwithstanding any other law, a pharmacy may furnish
naloxone hydrochloride or another opioid antagonist to a school
district, county office of education, or charter school pursuant to
Section 49414.3 of the Education Code if all of the following are
met:
(1) The naloxone hydrochloride or another opioid antagonist is
furnished exclusively for use at a school district schoolsite, county
office of education schoolsite, or charter school.
(2) A physician and surgeon provides a written order that
specifies the quantity of naloxone hydrochloride or another opioid
antagonist to be furnished.
(b) Records regarding the acquisition and disposition of naloxone
hydrochloride or another opioid antagonist furnished pursuant to
subdivision (a) shall be maintained by the school district, county
office of education, or charter school for a period of three years
from the date the records were created. The school district, county
office of education, or charter school shall be responsible for
monitoring the supply of naloxone hydrochloride or another opioid
antagonist and ensuring the destruction of expired naloxone
hydrochloride or another opioid antagonist.
SEC. 2. Section 49414.3 is added to the Education Code, to read:
49414.3. (a) School districts, county offices of education, and
charter schools may provide emergency naloxone hydrochloride or
another opioid antagonist to school nurses or trained personnel who
have volunteered pursuant to subdivision (d), and school nurses or
trained personnel may use naloxone hydrochloride or another opioid
antagonist to provide emergency medical aid to persons suffering, or
reasonably believed to be suffering, from an opioid overdose.
(b) For purposes of this section, the following terms have the
following meanings:
(1) "Authorizing physician and surgeon" may include, but is not
limited to, a physician and surgeon employed by, or contracting with,
a local educational agency, a medical director of the local health
department, or a local emergency medical services director.
(2) "Auto-injector" means a disposable delivery device designed
for the automatic injection of a premeasured dose of an opioid
antagonist into the human body and approved by the federal Food and
Drug Administration for layperson use.
(3) "Opioid antagonist" means naloxone hydrochloride or another
drug approved by the federal Food and Drug Administration that, when
administered, negates or neutralizes in whole or in part the
pharmacological effects of an opioid in the body, and has been
approved for the treatment of an opioid overdose.
(4) "Qualified supervisor of health" may include, but is not
limited to, a school nurse.
(5) "Volunteer" or "trained personnel" means an employee who has
volunteered to administer naloxone hydrochloride or another opioid
antagonist to a person if the person is suffering, or reasonably
believed to be suffering, from an opioid overdose, has been
designated by a school, and has received training pursuant to
subdivision (d).
(c) Each public and private elementary and secondary school in the
state may voluntarily determine whether or not to make emergency
naloxone hydrochloride or another opioid antagonist and trained
personnel available at its school. In making this determination, a
school shall evaluate the emergency medical response time to the
school and determine whether initiating emergency medical services is
an acceptable alternative to naloxone hydrochloride or another
opioid antagonist and trained personnel. A private elementary or
secondary school choosing to exercise the authority provided under
this subdivision shall not receive state funds specifically for
purposes of this subdivision.
(d) (1) Each public and private elementary and secondary school in
the state may designate one or more volunteers to receive initial
and annual refresher training, based on the standards developed
pursuant to subdivision (e), regarding the storage and emergency use
of naloxone hydrochloride or another opioid antagonist from the
school nurse or other qualified person designated by an authorizing
physician and surgeon. A benefit shall not be granted to or withheld
from any individual based on his or her offer to volunteer, and there
shall be no retaliation against any individual for rescinding his or
her offer to volunteer, including after receiving training. Any
school district, county office of education, or charter school
choosing to exercise the authority provided under this subdivision
shall provide the training for the volunteers at no cost to the
volunteer and during the volunteer's regular working hours.
(2) An employee who volunteers pursuant to this section may
rescind his or her offer to administer emergency naloxone
hydrochloride or another opioid antagonist at any time, including
after receipt of training.
(e) (1) The Superintendent shall establish minimum standards of
training for the administration of naloxone hydrochloride or another
opioid antagonist that satisfies the requirements of paragraph (2).
Every five years, or sooner as deemed necessary by the
Superintendent, the Superintendent shall review minimum standards of
training for the administration of naloxone hydrochloride or other
opioid antagonists that satisfy the requirements of paragraph (2).
For purposes of this subdivision, the Superintendent shall consult
with organizations and providers with expertise in administering
naloxone hydrochloride or another opioid antagonist and administering
medication in a school environment, including, but not limited to,
the California Society of Addiction Medicine, the Emergency Medical
Services Authority, the California School Nurses Organization, the
California Medical Association, the American Academy of Pediatrics,
and others.
(2) Training established pursuant to this subdivision shall
include all of the following:
(A) Techniques for recognizing symptoms of an opioid overdose.
(B) Standards and procedures for the storage, restocking, and
emergency use of naloxone hydrochloride or another opioid antagonist.
(C) Basic emergency followup procedures, including, but not
limited to, a requirement for the school or charter school
administrator or, if the administrator is not available, another
school staff member to call the emergency 911 telephone number and to
contact the pupil's parent or guardian.
(D) Recommendations on the necessity of instruction and
certification in cardiopulmonary resuscitation.
(E) Written materials covering the information required under this
subdivision.
(3) Training established pursuant to this subdivision shall be
consistent with the most recent guidelines for medication
administration issued by the department.
(4) A school shall retain for reference the written materials
prepared under subparagraph (E) of paragraph (2).
(5) The department shall include on its Internet Web site a
clearinghouse for best practices in training nonmedical personnel to
administer naloxone hydrochloride or another opioid antagonist to
pupils.
(f) Any school district, county office of education, or charter
school electing to utilize naloxone hydrochloride or another opioid
antagonist for emergency aid shall distribute a notice at least once
per school year to all staff that contains the following information:
(1) A description of the volunteer request stating that the
request is for volunteers to be trained to administer naloxone
hydrochloride or another opioid antagonist to a person if the person
is suffering, or reasonably believed to be suffering, from an opioid
overdose.
(2) A description of the training that the volunteer will receive
pursuant to subdivision (d).
(3) The right of an employee to rescind his or her offer to
volunteer pursuant to this section.
(4) A statement that no benefit will be granted to or withheld
from any individual based on his or her offer to volunteer and that
there will be no retaliation against any individual for rescinding
his or her offer to volunteer, including after receiving training.
(g) (1) A qualified supervisor of health at a school district,
county office of education, or charter school electing to utilize
naloxone hydrochloride or another opioid antagonist for emergency aid
shall obtain from an authorizing physician and surgeon a
prescription for each school for naloxone hydrochloride or another
opioid antagonist. A qualified supervisor of health at a school
district, county office of education, or charter school shall be
responsible for stocking the naloxone hydrochloride or another opioid
antagonist and restocking it if it is used.
(2) If a school district, county office of education, or charter
school does not have a qualified supervisor of health, an
administrator at the school district, county office of education, or
charter school shall carry out the duties specified in paragraph (1).
(3) A prescription pursuant to this subdivision may be filled by
local or mail order pharmacies or naloxone hydrochloride or another
opioid antagonist manufacturers.
(4) An authorizing physician and surgeon shall not be subject to
professional review, be liable in a civil action, or be subject to
criminal prosecution for the issuance of a prescription or order
pursuant to this section, unless the physician and surgeon's issuance
of the prescription or order constitutes gross negligence or willful
or malicious conduct.
(h) (1) A school nurse or, if the school does not have a school
nurse or the school nurse is not onsite or available, a volunteer may
administer naloxone hydrochloride or another opioid antagonist to a
person exhibiting potentially life-threatening symptoms of an opioid
overdose at school or a school activity when a physician is not
immediately available. If the naloxone hydrochloride or another
opioid antagonist is used it shall be restocked as soon as reasonably
possible, but no later than two weeks after it is used. Naloxone
hydrochloride or another opioid antagonist shall be restocked before
its expiration date.
(2) Volunteers may administer naloxone hydrochloride or another
opioid antagonist only by nasal spray or by auto-injector.
(3) A volunteer shall be allowed to administer naloxone
hydrochloride or another opioid antagonist in a form listed in
paragraph (2) that the volunteer is most comfortable with.
(i) A school district, county office of education, or charter
school electing to utilize naloxone hydrochloride or another opioid
antagonist for emergency aid shall ensure that each employee who
volunteers under this section will be provided defense and
indemnification by the school district, county office of education,
or charter school for any and all civil liability, in accordance
with, but not limited to, that provided in Division 3.6 (commencing
with Section 810) of Title 1 of the Government Code. This information
shall be reduced to writing, provided to the volunteer, and retained
in the volunteer's personnel file.
(j) (1) Notwithstanding any other law, a person trained as
required under subdivision (d), who administers naloxone
hydrochloride or another opioid antagonist, in good faith and not for
compensation, to a person who appears to be experiencing an opioid
overdose shall not be subject to professional review, be liable in a
civil action, or be subject to criminal prosecution for his or her
acts or omissions in administering the naloxone hydrochloride or
another opioid antagonist.
(2) The protection specified in paragraph (1) shall not apply in a
case of gross negligence or willful and wanton misconduct of the
person who renders emergency care treatment by the use of naloxone
hydrochloride or another opioid antagonist.
(3) Any public employee who volunteers to administer naloxone
hydrochloride or another opioid antagonist pursuant to subdivision
(d) is not providing emergency medical care "for compensation,"
notwithstanding the fact that he or she is a paid public employee.
(k) A state agency, the department, or a public school may accept
gifts, grants, and donations from any source for the support of the
public school carrying out the provisions of this section, including,
but not limited to, the acceptance of naloxone hydrochloride or
another opioid antagonist from a manufacturer or wholesaler.
