AB 1748, as amended, 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 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 personsbegin delete sufferingend deletebegin insert suffering,end insert 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 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 opioidbegin delete antagonist,end deletebegin insert antagonistend insert 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.
Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.
The people of the State of California do enact as follows:
Section 4119.8 is added to the Business and
2Professions Code, to read:
(a) Notwithstanding any other law, a pharmacy may
4furnish naloxone hydrochloride or another opioid antagonist to a
5school district, county office of education, or charter school
6pursuant to Section 49414.3 of the Education Code if all of the
7following are met:
8(1) The naloxone hydrochloride or another opioid antagonist is
9furnished exclusively for use at a school district schoolsite, county
10office of education schoolsite, or charter school.
11(2) A physician and surgeon provides a written order that
12specifies the quantity of naloxone hydrochloride or another opioid
13antagonist to be furnished.
14(b) Records regarding the acquisition and disposition of
15naloxone hydrochloride or another opioid antagonist furnished
16pursuant to subdivision (a) shall be maintained by the school
17district, county office of education, or charter school for a period
18of three years from the date the records were created. The school
19district, county office of education, or charter school shall be
20responsible for monitoring the supply of naloxone hydrochloride
21or another opioid antagonist and ensuring the destruction of expired
22naloxone hydrochloride or another opioid antagonist.
Section 49414.3 is added to the Education Code, to
2read:
(a) School districts, county offices of education, and
4charter schools may provide emergency naloxone hydrochloride
5or another opioid antagonist to school nurses or trained personnel
6who have volunteered pursuant to subdivision (d), and school
7nurses or trained personnel may use naloxone hydrochloride or
8another opioid antagonist to provide emergency medical aid to
9persons suffering, or reasonably believed to be suffering, from an
10opioid overdose. Any school district, county office of education,
11or charter school choosing to exercise the authority provided under
12this subdivision shall not receive state funds specifically for
13purposes of this subdivision.
14(b) For
purposes of this section, the following terms have the
15following meanings:
16(1) “Authorizing physician and surgeon” may include, but is
17not limited to, a physician and surgeon employed by, or contracting
18with, a local educational agency, a medical director of the local
19health department, or a local emergency medical services director.
20(2) “Opioidbegin delete antangonist”end deletebegin insert antagonistend insertbegin insert”end insert means naloxone
21hydrochloride or another drug approved by the federal Food and
22Drug Administration that, when administered, negates or
23neutralizes in whole
or in part the pharmacological effects of an
24opioid in the body, and has been approved for the treatment of an
25opioid overdose.
26(3) “Qualified supervisor of health” may include, but is not
27limited to, a school nurse.
28(4) “Volunteer” or “trained personnel” means an employee who
29has volunteered to administer naloxone hydrochloride or another
30opioid antagonist to a person if the person is suffering, or
31reasonably believed to be suffering, from an opioid overdose, has
32been designated by a school, and has received training pursuant
33to subdivision (d).
34(c) Each private elementary and secondary school in the state
35may voluntarily determine whether or not to make emergency
36naloxone hydrochloride or another opioid
antagonist and trained
37personnel available at its school. In making this determination, a
38private school shall evaluate the emergency medical response time
39to the school and determine whether initiating emergency medical
40services is an acceptable alternative to naloxone hydrochloride or
P5 1another opioid antagonist and trained personnel. A private
2elementary or secondary school choosing to exercise the authority
3provided under this subdivision shall not receive state funds
4specifically for purposes of this subdivision.
5(d) begin insert(1)end insertbegin insert end insert Each public and private elementary and secondary
6school in the state may designate one or more volunteers to
receive
7initial and annual refresher training, based on the standards
8developed pursuant to subdivision (e), regarding the storage and
9emergency use of naloxone hydrochloride or another opioid
10antagonist from the school nurse or other qualified person
11designated by an authorizing physician and surgeon. Any school
12choosing to exercise the authority provided under this subdivision
13shall not receive state funds specifically for purposes of this
14subdivision.
15
(2) An employee who volunteers pursuant to this section may
16rescind his or her offer to administer emergency naloxone
17hydrochloride or another opioid antagonist at any time, including
18after receipt of training.
19
(3) A volunteer shall be allowed to administer naloxone
20hydrochloride or another opioid antagonist in the available form
21the volunteer is most comfortable with.
22(e) (1) The Superintendent shall establish minimum standards
23of training for the administration of naloxone hydrochloride or
24another opioid antagonist that satisfies the requirements of
25paragraph (2). Every five years, or sooner as deemed necessary
26by the Superintendent, the Superintendent shall review minimum
27standards of training for the administration of naloxone
28hydrochloride or other opioid antagonists that satisfy the
29requirements of paragraph (2). For purposes of this subdivision,
30the Superintendent shall consult with organizations and providers
31with expertise in administering naloxone
hydrochloride or another
32opioid antagonist and administering medication in a school
33environment, including, but not limited to, the State Department
34of Public Health, the Emergency Medical Services Authority, the
35California School Nurses Organization, the California Medical
36Association, the American Academy of Pediatrics, and others.
37(2) Training established pursuant to this subdivision shall include
38all of the following:
39(A) Techniques for recognizing symptoms of an opioid
40overdose.
P6 1(B) Standards and procedures for the storage, restocking, and
2emergency use of naloxone hydrochloride or another opioid
3antagonist.
4(C) Emergency followup procedures,
including calling the
5emergency 911 telephone number and contacting, if possible, the
6pupil’s parent and physician.
7(D) Recommendations on the necessity of instruction and
8certification in cardiopulmonary resuscitation.
9(E) Written materials covering the information required under
10this subdivision.
11(3) Training established pursuant to this subdivision shall be
12consistent with the most recent guidelines for medication
13administration issued by the department.
14(4) A school shall retain for reference the written materials
15prepared under subparagraph (E) of paragraph (2).
16(f) Any school district, county
office of education, or charter
17school electing to utilize naloxone hydrochloride or another opioid
18antagonist for emergency aid shall distribute a notice at least once
19per school year to all staff that contains the following information:
20(1) A description of the volunteer request stating that the request
21is for volunteers to be trained to administer naloxone hydrochloride
22or another opioid antagonist to a person if the person is suffering,
23or reasonably believed to be suffering, from an opioid overdose.
24(2) A description of the training that the volunteer will receive
25pursuant to subdivision (d).
26
(3) The right of an employee to rescind his or her offer to
27
volunteer pursuant to this section.
28(g) (1) A qualified supervisor of health at a school district,
29county office of education, or charter school electing to utilize
30naloxone hydrochloride or another opioid antagonist for emergency
31aid shall obtain from an authorizing physician and surgeon a
32prescription for each school for naloxone hydrochloride or another
33opioid antagonist. A qualified supervisor of health at a school
34district, county office of education, or charter school shall be
35responsible for stocking the naloxone hydrochloride or another
36opioid antagonist and restocking it if it is used.
37(2) If a school district, county office of education, or charter
38school does not have a qualified supervisor of health, an
39administrator at the
school district, county office of education, or
40charter school shall carry out the duties specified in paragraph (1).
P7 1(3) A prescription pursuant to this subdivision may be filled by
2local or mail order pharmacies or naloxone hydrochloride or
3another opioid antagonist manufacturers.
4(4) An authorizing physician and surgeon shall not be subject
5to professional review, be liable in a civil action, or be subject to
6criminal prosecution for the issuance of a prescription or order
7pursuant to this section, unless the physician and surgeon’s issuance
8of the prescription or order constitutes gross negligence or willful
9or malicious conduct.
10(h) A school nurse or, if the school does not have a school nurse
11or the school
nurse is not onsite or available, a volunteer may
12administer naloxone hydrochloride or another opioid antagonist
13to a person exhibiting potentially life-threatening symptoms of an
14opioid overdose at school or a school activity when a physician is
15not immediately available. If the naloxone hydrochloride or another
16opioid antagonist is used it shall be restocked as soon as reasonably
17possible, but no later than two weeks after it is used.
Naloxone
18hydrochloride or another opioid antagonist shall be restocked
19before their expiration date.
20(i) A volunteer shall initiate emergency medical services or
21other appropriate medical followup in accordance with the training
22materials retained pursuant to paragraph (4) of subdivision (e).
23(j) A school district, county office of education, or charter school
24electing to utilize naloxone hydrochloride or another opioid
25antagonist for emergency aid shall ensure that each employee who
26volunteers under this section will be provided defense and
27indemnification by the school district, county office of education,
28or charter school for any and all civil liability, in accordance with,
29but not limited to, that provided in Division 3.6 (commencing with
30Section 810) of Title 1
of the Government Code. This information
31shall be reduced to writing, provided to the volunteer, and retained
32in the volunteer’s personnel file.
33(k) Notwithstanding any other law, a person trained as required
34under subdivision (d), who acts with reasonable care in
35administering naloxone hydrochloride or another opioid antagonist,
36in good faith, to a person who is experiencing or is suspected of
37experiencing an opioid overdose shall not be subject to professional
38review, be liable in a civil action, or be subject to criminal
39prosecution for this administration.
P8 1(l) A state agency, the department, or a public school may accept
2gifts, grants, and donations from any source for the support of the
3public school carrying out the provisions of this section, including,
4but not
limited to, the acceptance of naloxone hydrochloride or
5another opioid antagonist from a manufacturer or wholesaler.
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