Bill Text: CA SB1438 | 2013-2014 | Regular Session | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Controlled substances: opioid antagonists.

Spectrum: Moderate Partisan Bill (Democrat 5-1)

Status: (Passed) 2014-09-19 - Chaptered by Secretary of State. Chapter 491, Statutes of 2014. [SB1438 Detail]

Download: California-2013-SB1438-Amended.html

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BILL NUMBER: SB 1438	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  AUGUST 4, 2014
	AMENDED IN ASSEMBLY  JUNE 11, 2014
	AMENDED IN SENATE  MAY 21, 2014
	AMENDED IN SENATE  MAY 6, 2014
	AMENDED IN SENATE  APRIL 10, 2014

INTRODUCED BY   Senator Pavley
   (Coauthor: Senator Anderson)

                        FEBRUARY 21, 2014

   An act to amend Section 1714.22 of the Civil Code, and to amend
Sections 1797.170, 1797.197, and 11601 of the Health and Safety Code,
relating to controlled substances.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 1438, as amended, Pavley. Controlled substances: opioid
antagonists.
   (1) Existing law authorizes a licensed health care provider who is
permitted by law to prescribe an opioid antagonist and is acting
with reasonable care to prescribe and subsequently dispense or
distribute an opioid antagonist for the treatment of an opioid
overdose to a person at risk of an opioid-related overdose or a
family member, friend, or other person in a position to assist a
person at risk of an opioid-related overdose. Under existing law,
licensed health care providers are authorized to issue standing
orders for the distribution of an opioid antagonist to a person at
risk of an opioid-related overdose or to a family member, friend, or
other person in a position to assist the person at risk. Existing law
also authorizes licensed health care providers to issue standing
orders for the administration of an opioid antagonist by a family
member, friend, or other person in a position to assist a person
experiencing or suspected of experiencing an opioid overdose.
   Existing law provides that a licensed health care provider who
acts with reasonable care and issues a prescription for, or an order
for the administration of, an opioid antagonist to a person
experiencing or suspected of experiencing an opioid overdose is not
subject to professional review, liable in a civil action, or subject
to criminal prosecution for issuing the prescription or order. Under
existing law, a person who is not otherwise licensed to administer an
opioid antagonist, but who meets other specified conditions, is not
subject to professional review, liable in a civil action, or subject
to criminal prosecution for administering an opioid antagonist.
   This bill would clarify that peace officers are included among the
persons authorized to receive and distribute opioid antagonists as
described above.
   (2) Existing law, the Emergency Medical Services System and the
Prehospital Emergency Medical Care Personnel Act, establishes the
Emergency Medical Services Authority (EMSA), which is responsible for
the coordination and integration of all state agencies concerning
emergency medical services. Under existing law, EMSA is required to
establish training and standards, and promulgate regulations, for all
prehospital emergency  medical  care personnel, as defined,
regarding the characteristics and method of assessment and treatment
of anaphylactic reactions and the use of epinephrine. Existing law
also requires EMSA to develop and adopt regulations for the training
and scope of practice for emergency medical  technicians-I
  technician-I  (EMT-I) certification, which
includes, among other things, a specified course of training on the
nature of sudden infant death syndrome.
   This bill would require EMSA to develop and adopt training and
standards, and promulgate regulations, for all prehospital emergency
 medical  care personnel, as defined, regarding the use and
administration of naloxone hydrochloride and other opioid
antagonists. The bill would authorize EMSA to adopt existing training
and standards for prehospital emergency  medical  care
personnel regarding the statewide use and administration of naloxone
hydrochloride or another opioid antagonist to satisfy the
requirements of the bill's provisions. The bill would also authorize,
at the discretion of the medical director of the local EMS agency,
pertinent training completed by prehospital emergency  medical
 care personnel to be used to satisfy part of the training
requirements established by EMSA pursuant to the bill's provisions.
The bill would specify that both of those types of trainings satisfy
the requirements described above allowing for immunity from criminal
and civil liability for administering an opioid antagonist.
    The bill would also require EMSA to develop and adopt regulations
to include the administration of naloxone hydrochloride in the
training and scope of practice of EMT-I certification, on or before
July 1,  2015.   2016.  The bill would
require these regulations to be substantially similar to certain
regulations that authorize an EMT-I to receive training for naloxone
hydrochloride administration without having to complete the entire
emergency medical  technicians-II  
technician-II  (EMT-II) certification course.
   (3) Existing law, the Uniform Controlled Substances Act, requires
the Attorney General to encourage research on the misuse and abuse of
controlled substances, and, in connection with that research, and in
furtherance of the enforcement of the act, authorizes the Attorney
General to undertake specific acts, including developing new or
improved approaches, techniques, systems, equipment, and devices to
strengthen the enforcement of the act.
   This bill would additionally permit the Attorney General, in
connection with that research, and in furtherance of the enforcement
of the act, to authorize hospitals and trauma centers to share
information with local law enforcement agencies and local emergency
medical services agencies about controlled substances. The bill would
limit the data that may be provided by hospitals and trauma centers
to the number of overdoses and the substances suspected as the
primary cause of the overdoses. The bill would require that the
information shared be shared in a manner that ensures complete
patient confidentiality.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 1714.22 of the Civil Code is amended to read:
   1714.22.  (a) For purposes of this section, the following
definitions shall apply:
   (1) "Opioid antagonist" means naloxone hydrochloride that is
approved by the federal Food and Drug Administration for the
treatment of an opioid overdose.
   (2) "Opioid overdose prevention and treatment training program"
means any program operated by a local health jurisdiction or that is
registered by a local health jurisdiction to train individuals to
prevent, recognize, and respond to an opiate overdose, and that
provides, at a minimum, training in all of the following:
   (A) The causes of an opiate overdose.
   (B) Mouth to mouth resuscitation.
   (C) How to contact appropriate emergency medical services.
   (D) How to administer an opioid antagonist.
   (b) A licensed health care provider who is authorized by law to
prescribe an opioid antagonist may, if acting with reasonable care,
prescribe and subsequently dispense or distribute an opioid
antagonist to a person at risk of an opioid-related overdose or to a
family member, friend, peace officer, or other person in a position
to assist a person at risk of an opioid-related overdose.
   (c) (1) A licensed health care provider who is authorized by law
to prescribe an opioid antagonist may issue standing orders for the
distribution of an opioid antagonist to a person at risk of an
opioid-related overdose or to a family member, friend, peace officer,
or other person in a position to assist a person at risk of an
opioid-related overdose.
   (2) A licensed health care provider who is authorized by law to
prescribe an opioid antagonist may issue standing orders for the
administration of an opioid antagonist to a person at risk of an
opioid-related overdose by a family member, friend, peace officer, or
other person in a position to assist a person experiencing or
reasonably suspected of experiencing an opioid overdose.
   (d) (1) A person who is prescribed or possesses an opioid
antagonist pursuant to a standing order shall receive the training
provided by an opioid overdose prevention and treatment training
program.
   (2) A person who is prescribed an opioid antagonist directly from
a licensed prescriber shall not be required to receive training from
an opioid prevention and treatment training program.
   (e) A licensed health care provider who acts with reasonable care
shall not be subject to professional review, be liable in a civil
action, or be subject to criminal prosecution for issuing a
prescription or order pursuant to subdivision (b) or (c).
   (f) Notwithstanding any other law, a person who possesses or
distributes an opioid antagonist pursuant to a prescription or
standing order shall not be subject to professional review, be liable
in a civil action, or be subject to criminal prosecution for this
possession or distribution. Notwithstanding any other law, a person
not otherwise licensed to administer an opioid antagonist, but
trained as required under paragraph (1) of subdivision (d), who acts
with reasonable care in administering an opioid antagonist, in good
faith and not for compensation, to a person who is experiencing or is
suspected of experiencing an overdose shall not be subject to
professional review, be liable in a civil action, or be subject to
criminal prosecution for this administration.
  SEC. 2.  Section 1797.170 of the Health and Safety Code is amended
to read:
   1797.170.  (a) The authority shall develop and, after approval by
the commission pursuant to Section 1799.50, adopt regulations for the
training and scope of practice for EMT-I certification.
   (b) Any individual certified as an EMT-I pursuant to this division
shall be recognized as an EMT-I on a statewide basis, and
recertification shall be based on statewide standards.
   (c) Effective July 1, 1990, any individual certified as an EMT-I
pursuant to this act shall complete a course of training on the
nature of sudden infant death syndrome which is developed by the
California SIDS program in the State Department of Public Health in
consultation with experts in the field of sudden infant death
syndrome.
   (d) On or before July 1,  2015,   2016, 
the authority shall develop and, after approval by the commission
pursuant to Section 1799.50, adopt regulations to include the
administration of naloxone hydrochloride in the training and scope of
practice of EMT-I certification. These regulations shall be
substantially similar to existing regulations set forth in Chapter 3
(commencing with Section 100101) of Division 9 of Title 22 of the
California Code of Regulations that authorize an EMT-I to receive
EMT-II training in the administration of naloxone hydrochloride
without having to complete the entire EMT-II certification course.
  SEC. 3.  Section 1797.197 of the Health and Safety Code is amended
to read:
   1797.197.  (a) The authority shall establish training and
standards for all prehospital emergency  medical  care
personnel, as defined in paragraph (2) of subdivision (a) of Section
1797.189, regarding the characteristics and method of assessment and
treatment of anaphylactic reactions and the use of epinephrine. The
authority shall promulgate regulations regarding these matters for
use by all prehospital emergency  medical  care personnel.
   (b) (1) The authority shall develop and, after approval by the
commission pursuant to Section 1799.50, adopt training and standards
for all prehospital emergency  medical  care personnel, as
defined in paragraph (2) of subdivision (a) of Section 1797.189,
regarding the use and administration of naloxone hydrochloride and
other opioid antagonists. The authority shall promulgate regulations
regarding these matters for use by all prehospital emergency 
medical  care personnel. The authority may adopt existing
training and standards for prehospital emergency  medical 
care personnel regarding the statewide use and administration of
naloxone hydrochloride or another opioid antagonist to satisfy the
requirements of this section.
   (2) Pertinent training completed by prehospital emergency 
medical  care personnel, at the discretion of the medical
director of the local EMS agency, may be used to satisfy part of the
training requirements established pursuant to paragraph (1) regarding
the use and administration of naloxone hydrochloride and other
opioid antagonists by prehospital emergency  medical  care
personnel.
   (3) The training described in paragraphs (1) and (2) shall satisfy
the requirements of paragraph (1) of subdivision (d) of Section
1714.22 of the Civil Code.
  SEC. 4.  Section 11601 of the Health and Safety Code is amended to
read:
   11601.  The Attorney General shall encourage research on misuse
and abuse of controlled substances. In connection with the research,
and in furtherance of the enforcement of this division, he or she may
do all of the following:
   (a) Develop new or improved approaches, techniques, systems,
equipment, and devices to strengthen the enforcement of this
division.
   (b) Enter into contracts with public agencies, institutions of
higher education, and private organizations or individuals for the
purpose of conducting demonstrations or special projects that bear
directly on misuse and abuse of controlled substances.
   (c) (1) Authorize hospitals and trauma centers to share
information with local law enforcement agencies and local emergency
medical services agencies about controlled substance overdose trends.

   (2) The information provided by hospitals and trauma centers
pursuant to this subdivision shall include only the number of
overdoses and the substances suspected as the primary cause of the
overdoses. Any information shared pursuant to this subdivision shall
be shared in a manner that ensures complete patient confidentiality.