BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  SB 1438
                                                                  Page  1

          SENATE THIRD READING
          SB 1438 (Pavley)
          As Amended August 22, 2014
          Majority vote

           SENATE VOTE  :  31-0
            
           HEALTH              17-0        JUDICIARY           9-0         
           
           ----------------------------------------------------------------- 
          |Ayes:|Pan, Maienschein,         |Ayes:|Wieckowski, Wagner,       |
          |     |Ammiano, Bonilla, Bonta,  |     |Alejo, Chau, Dickinson,   |
          |     |Chesbro, Gomez, Gonzalez, |     |Garcia, Maienschein,      |
          |     |Roger Hernández,          |     |Muratsuchi, Stone         |
          |     |Lowenthal, Mansoor,       |     |                          |
          |     |Nazarian, Nestande,       |     |                          |
          |     |Patterson, Ridley-Thomas, |     |                          |
          |     |Rodriguez, Wieckowski     |     |                          |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           APPROPRIATIONS      17-0                                        
           
           -------------------------------------- 
          |Ayes:|Gatto, Bigelow,           |     |
          |     |Bocanegra, Bradford, Ian  |     |
          |     |Calderon, Campos,         |     |
          |     |Donnelly, Eggman, Gomez,  |     |
          |     |Holden, Jones, Linder,    |     |
          |     |Pan, Quirk,               |     |
          |     |Ridley-Thomas, Wagner,    |     |
          |     |Weber                     |     |
          |     |                          |     |
           -------------------------------------- 
           SUMMARY  :  Adds peace officers to those allowed to administer an  
          opioid antagonist to a person at risk of an opioid-related  
          overdose.  Requires the Emergency Medical Services Authority  
          (EMSA) to develop and adopt training and standards for all  
          prehospital emergency care personnel regarding the use and  
          administration of naloxone hydrochloride (naloxone) and other  
          opioid antagonists and to include the administration of naloxone  
          in the training and scope of practice, consistent with current  
          law, for emergency medical technician I (EMT-I) certification.   
          Requires the Attorney General to authorize hospitals and trauma  
          centers to share data on controlled substance overdose trends  
          with local law enforcement agencies and local emergency medical  








                                                                  SB 1438
                                                                  Page  2

          services agencies, as specified. 

           FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee:

          1)One-time staff costs, not likely to exceed $100,000 for EMSA  
            to issue regulations.

          2)Local and private costs will be incurred as well.  Local and  
            private EMS [Emergency Medical Services] agencies who have not  
            adopted naloxone administration on a voluntary basis will  
            incur costs for policy development and revising training  
            curriculum.  EMT-Is will incur a cost of $50-80 each for the  
            additional training.  These costs are not state-reimbursable.
           
          COMMENTS  :  According to the author, California and the nation  
          are in the midst of a drug abuse crisis.  Drug overdoses are the  
          leading cause of accidental death in the United States (U.S.),  
          killing about 38,000 people each year.  Prescription opioid and  
          heroin abuse have precipitated a public health epidemic marked  
          by a spike in fatal overdoses.  While naloxone, an opiate  
          antidote that reverses opiate overdoses, has been used by  
          paramedics and advanced emergency medical technicians (EMTs) to  
          save lives for the last few decades, current law is unclear  
          about the ability of other first emergency responders, such as  
          law enforcement, to use this medication.  According to the  
          sponsor, the California Professional Firefighters (CPF), under  
          current law, a doctor can prescribe naloxone to a patient, their  
          family member, or a friend to assist a person who is at risk of  
          an opioid overdose and those individuals may also take part in a  
          training program for the administration of opioid antagonists.   
          CPF states that this bill would add prehospital care personnel  
          to the list of people who can receive a prescription and  
          training for an opioid antagonist for the purposes of assisting  
          a person at risk of an overdose.

          While paramedics and EMTs are often the first to respond to a  
          medical emergency, some localities report that peace officers  
          are increasingly the first to encounter an overdose victim.  A  
          recent internal survey within the San Diego Sheriff's Department  
          found that sheriff's deputies responded to over 200  
          overdose-related emergency calls in the first nine months of  
          2013.  In over 50% of those cases, the sheriff's deputy was the  
          first emergency responder on the scene.  Last month, in  
          recognition of the nationwide surge in opiate overdoses, U.S.  








                                                                  SB 1438
                                                                  Page  3

          Attorney General Eric Holder echoed the plea made by the  
          director of the White House Office of National Drug Control  
          Policy to train and equip law enforcement officers with  
          naloxone.

          According to the U.S. Food and Drug Administration, naloxone,  
          which is not a controlled substance, rapidly reverses the  
          effects of opioid overdose and is the standard treatment for  
          overdose, which is characterized by decreased breathing or heart  
          rate or loss of consciousness.  When administered quickly and  
          effectively, naloxone immediately restores breathing to a victim  
          in the throes of an opioid overdose.  According to the Drug  
          Policy Alliance's (DPA) Internet Web site, naloxone has been  
          safely and effectively used for more than 40 years in ambulances  
          and emergency rooms across the country.  Naloxone has no  
          potential for abuse and side effects are rare.  The Drug Policy  
          Alliance also cites ongoing research showing that expanding  
          access to naloxone does not promote increased drug use or  
          risk-taking behavior that results in unintended overdoses.

          Law enforcement agencies in other states have been successfully  
          carrying and administering naloxone.  The police officers in  
          Quincy, a suburb of Boston, Massachusetts, have been carrying a  
          nasal form of naloxone since October 2010.  Quincy officers have  
          administered the drug 221 times and reversed 211 overdoses.  In  
          New York, Staten Island police officers have been trained to  
          administer the spray as part of a pilot program to fight the  
          high rate of painkiller abuse.

          DPA writes that this bill is an urgently needed measure to allow  
          first responders to administer opiate overdose reversal  
          medication to a person at risk of a fatal overdose.  The San  
          Diego Sheriff's Department writes in support of providing  
          naloxone to and the training of deputies and officers in the  
          administration of the opioid antagonist in order to help efforts  
          in San Diego County to stem the tide of overdose-related deaths  
          in their community.  The San Diego Sheriff's Department recently  
          conducted an internal survey and found that their deputies  
          responded to over 200 overdose-related emergency calls in the  
          first nine months of 2013, and in over half of those cases the  
          deputy was the first emergency responder on the scene.

          This bill has no known opposition.










                                                                  SB 1438
                                                                  Page  4

           Analysis Prepared by  :    Patty Rodgers / HEALTH / (916) 319-2097  
                                                       FN: 0005330