BILL NUMBER: AB 1748 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY APRIL 14, 2016
AMENDED IN ASSEMBLY MARCH 18, 2016
INTRODUCED BY Assembly Member Mayes
FEBRUARY 2, 2016
An act to add Section 4119.8 to the Business and Professions Code,
and to add Section 49414.3 to the Education Code, relating to
pupils.
LEGISLATIVE COUNSEL'S DIGEST
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 persons
suffering suffering, 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 opioid
antagonist, 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.
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 4119.8 is added to the Business and Professions
Code, to read:
4119.8. (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.
SEC. 2. Section 49414.3 is added to the Education Code, to read:
49414.3. (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" antagonist
" 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) (1) 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.
(2) An employee who volunteers pursuant to this section may
rescind his or her offer to administer emergency naloxone
hydrochloride or another opioid antagonist at any time, including
after receipt of training.
(3) A volunteer shall be allowed to administer naloxone
hydrochloride or another opioid antagonist in the available form the
volunteer is most comfortable with.
(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).
(3) The right of an employee to rescind his or her offer to
volunteer pursuant to this section.
(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.