Amended in Senate April 10, 2014

Senate BillNo. 1438


Introduced by Senator Pavley

February 21, 2014


An act to amendbegin insert Section 1714.22 of the Civil Code, and to amendend insertbegin delete Section 11601end deletebegin insert Sections 1797.197 and 11601end insert of the Health and Safety Code, relating to controlled substances.

LEGISLATIVE COUNSEL’S DIGEST

SB 1438, as amended, Pavley. Controlled substances:begin delete research.end deletebegin insert opioid antagonists.end insert

begin insert

(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.

end insert
begin insert

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.

end insert
begin insert

This bill would clarify that peace officers are included among the persons authorized to receive and distribute opioid antagonists as described above.

end insert
begin insert

(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 care personnel, as defined, regarding the characteristics and method of assessment and treatment of anaphylactic reactions and the use of epinephrine.

end insert
begin insert

This bill would require EMSA to establish training and standards, and promulgate regulations, for all prehospital emergency care personnel, as defined, regarding the use and administration of naloxone hydrochloride and other opioid antagonists. The bill would also authorize a local EMS agency to establish training and standards, and promulgate regulations, in lieu of those developed and promulgated by EMSA, for all prehospital emergency care personnel under the jurisdiction of that local EMS agency regarding the use and administration of naloxone hydrochloride and other opioid antagonists. 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.

end insert
begin delete

Existing

end delete

begin insert(3)end insertbegin insertend insertbegin insertExistingend insert 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 agenciesbegin insert and local emergency medical services agenciesend insert 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:

P3    1begin insert

begin insertSECTION 1.end insert  

end insert

begin insertSection 1714.22 of the end insertbegin insertCivil Codeend insertbegin insert is amended to
2read:end insert

3

1714.22.  

(a) For purposes of this section, the following
4definitions shall apply:

5(1) “Opioid antagonist” means naloxone hydrochloride that is
6approved by the federal Food and Drug Administration for the
7treatment of an opioid overdose.

8(2) “Opioid overdose prevention and treatment training
9program” means any program operated by a local health
10jurisdiction or that is registered by a local health jurisdiction to
11train individuals to prevent, recognize, and respond to an opiate
12overdose, and that provides, at a minimum, training in all of the
13following:

14(A) The causes of an opiate overdose.

15(B) Mouth to mouth resuscitation.

16(C) How to contact appropriate emergency medical services.

17(D) How to administer an opioid antagonist.

18(b) A licensed health care provider who is authorized by law to
19prescribe an opioid antagonist may, if acting with reasonable care,
20prescribe and subsequently dispense or distribute an opioid
21antagonist to a person at risk of an opioid-related overdose or to
22a family member, friend,begin insert peace officer,end insert or other person in a position
23to assist a person at risk of an opioid-related overdose.

24(c) (1) A licensed health care provider who is authorized by
25law to prescribe an opioid antagonist may issue standing orders
26for the distribution of an opioid antagonist to a person at risk of
27an opioid-related overdose or to a family member, friend,begin insert peace
P4    1officer,end insert
or other person in a position to assist a person at risk of an
2opioid-related overdose.

3(2) A licensed health care provider who is authorized by law to
4prescribe an opioid antagonist may issue standing orders for the
5administration of an opioid antagonist to a person at risk of an
6opioid-related overdose by a family member, friend,begin insert peace officer,end insert
7 or other person in a position to assist a person experiencing or
8reasonably suspected of experiencing an opioid overdose.

9(d) (1) A person who is prescribed or possesses an opioid
10antagonist pursuant to a standing order shall receive the training
11provided by an opioid overdose prevention and treatment training
12program.

13(2) A person who is prescribed an opioid antagonist directly
14from a licensed prescriber shall not be required to receive training
15from an opioid prevention and treatment training program.

16(e) A licensed health care provider who acts with reasonable
17care shall not be subject to professional review, be liable in a civil
18action, or be subject to criminal prosecution for issuing a
19prescription or order pursuant to subdivision (b) or (c).

20(f) Notwithstanding any other law, a person who possesses or
21distributes an opioid antagonist pursuant to a prescription or
22standing order shall not be subject to professional review, be liable
23in a civil action, or be subject to criminal prosecution for this
24possession or distribution. Notwithstanding any other law, a person
25not otherwise licensed to administer an opioid antagonist, but
26trained as required under paragraph (1) of subdivision (d), who
27acts with reasonable care in administering an opioid antagonist,
28in good faith and not for compensation, to a person who is
29experiencing or is suspected of experiencing an overdose shall not
30be subject to professional review, be liable in a civil action, or be
31subject to criminal prosecution for this administration.

32begin insert

begin insertSEC. 2.end insert  

end insert

begin insertSection 1797.197 of the end insertbegin insertHealth and Safety Codeend insertbegin insert is
33amended to read:end insert

34

1797.197.  

begin insert(a)end insertbegin insertend insert The authority shall establish training and
35standards for all prehospital emergency care personnel, as defined
36begin delete pursuant toend deletebegin insert inend insert paragraph (2) of subdivision (a) of Section 1797.189,
37regarding the characteristics and method of assessment and
38treatment of anaphylactic reactions and the usebegin insert ofend insert epinephrine.
39The authority shall promulgate regulations regarding these matters
40for use by all prehospital emergency care personnel.

begin insert

P5    1(b) (1) The authority shall establish training and standards for
2all prehospital emergency care personnel, as defined in paragraph
3(2) of subdivision (a) of Section 1797.189, regarding the use and
4administration of naloxone hydrochloride and other opioid
5antagonists. The authority shall promulgate regulations regarding
6these matters for use by all prehospital emergency care personnel.
7The authority may designate existing training and standards for
8the use and administration of naloxone hydrochloride or another
9opioid antagonist to satisfy the requirements of this section.

end insert
begin insert

10(2) A local EMS agency may develop its own training and
11standards, and may promulgate regulations, in lieu of the training
12and standards and regulations developed by the authority pursuant
13to paragraph (1), regarding the use and administration of naloxone
14hydrochloride and other opioid antagonists by prehospital
15emergency care personnel under the jurisdiction of that local EMS
16agency.

end insert
begin insert

17(3) The training described in paragraphs (1) and (2) shall satisfy
18the requirements of paragraph (1) of subdivision (d) of Section
191714.22 of the Civil Code.

end insert
20

begin deleteSECTION 1.end delete
21begin insertSEC. 3.end insert  

Section 11601 of the Health and Safety Code is
22amended to read:

23

11601.  

The Attorney General shall encourage research on
24misuse and abuse of controlled substances. In connection with the
25research, and in furtherance of the enforcement of this division,
26he or she may do all of the following:

27(a) Develop new or improved approaches, techniques, systems,
28equipment, and devices to strengthen the enforcement of this
29division.

30(b) Enter into contracts with public agencies, institutions of
31higher education, and private organizations or individuals for the
32purpose of conducting demonstrations or special projects that bear
33directly on misuse and abuse of controlled substances.

34(c) (1) Authorize hospitals and trauma centers to share
35information with local law enforcement agenciesbegin insert and local
36emergency medical services agenciesend insert
about controlled substance
37overdose trends.

38(2) The information provided by hospitals and trauma centers
39pursuant to this subdivision shall include only the number of
40overdoses and the substances suspected as the primary cause of
P6    1the overdoses. Any information shared pursuant to this subdivision
2shall be shared in a manner that ensures complete patient
3confidentiality.



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