Amended in Assembly March 18, 2016

California Legislature—2015–16 Regular Session

Assembly Bill No. 1748

Introduced by Assembly Member Mayes

February 2, 2016

An act to begin delete amend Section 48913 of end delete begin insert add Section 4119.8 to the Business and Professions Code, and to add Section 49414.3 to end insert the Education Code, relating to pupils.

LEGISLATIVE COUNSEL’S DIGEST

AB 1748, as amended, Mayes. Pupils: begin delete suspensions: completion of missed work. end delete begin insert pupil health: opioid antagonist. end insert

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(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.

end insert begin insert

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.

end insert begin insert

(2) Under existing law, the governing board of any 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.

end insert begin insert

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 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 require those individuals to initiate emergency medical services or other appropriate medical followup in accordance with written training materials. 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 acts with reasonable care in administering naloxone hydrochloride or another opioid antagonist, in good faith, to a person who is experiencing or is suspected of 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.

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Existing law authorizes the teacher of any class from which a pupil is suspended to require the suspended pupil to complete any assignments and tests missed during the suspension.

end delete begin delete

This bill would make a nonsubstantive change to this provision.

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Vote: majority. Appropriation: no. Fiscal committee:  begin delete no end delete begin insert yes end insert . State-mandated local program: no.

The people of the State of California do enact as follows:

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begin insert SECTION 1. end insert   

end insert

begin insert Section 4119.8 is added to the end insert begin insert Business and
Professions Code end insert begin insert , to read: end insert

begin insert

begin insert 4119.8. end insert   

(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.

end insert

begin insert

begin insert SEC. 2. end insert   

end insert

begin insert Section 49414.3 is added to the end insert begin insert Education Code end insert begin insert , to
read: end insert

begin insert

begin insert 49414.3. end insert   

(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. Any school district, county office of education,
or charter school choosing to exercise the authority provided under
this subdivision shall not receive state funds specifically for
purposes of this subdivision.

(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) “Opioid antangonist” 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.

(3) “Qualified supervisor of health” may include, but is not
limited to, a school nurse.

(4) “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 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
private 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) 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. Any school choosing to exercise
the authority provided under this subdivision shall not receive
state funds specifically for purposes of this subdivision.

(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 State Department
of Public Health, 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) Emergency followup procedures, including calling the
emergency 911 telephone number and contacting, if possible, the
pupil’s parent and physician.

(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).

(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).

(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) 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 their expiration date.

(i) A volunteer shall initiate emergency medical services or
other appropriate medical followup in accordance with the training
materials retained pursuant to paragraph (4) of subdivision (e).

(j) 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.

(k) Notwithstanding any other law, a person trained as required
under subdivision (d), who acts with reasonable care in
administering naloxone hydrochloride or another opioid
antagonist, in good faith, to a person who is experiencing or is
suspected of experiencing an opioid overdose shall not be subject
to professional review, be liable in a civil action, or be subject to
criminal prosecution for this administration.

(l) 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.

end insert

begin delete

SECTION 1.  

Section 48913 of the Education Code is amended
to read:

48913.  

The teacher of a class from which a pupil is suspended
may require the suspended pupil to complete any assignments and
tests missed during the suspension.

end delete