BILL NUMBER: AB 1748 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY APRIL 25, 2016
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, 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.
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 the State Department of
Education to include on its Internet Web site a clearinghouse for
best practices in training nonmedical personnel to administer
naloxone hydrochloride or another opioid antagonist to pupils. The
bill would require a school district, county office of education, or
charter school choosing to exercise the authority to provide
emergency naloxone hydrochloride or another opioid antagonist to
provide the training for the volunteers at no cost to the
volunteers and during the volunteer s ' regular
working hours. 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 provide
that volunteers may only administer naloxone hydrochloride
or another opioid antagonist by nasal spray. 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 provisions who
administers naloxone hydrochloride or another opioid
antagonist, in good faith, faith and not for
compensation, to a person who is experiencing or is
suspected of appears to be 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 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. A benefit shall not be granted to or
withheld from any individual based on his or her offer to volunteer
and there shall be no retaliation against any individual for
rescinding his or her offer to volunteer, including after receiving
training. 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. provide
the training for the volunteers at no cost to the volunteer and
during the volunteer's regular working hours.
(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 Basic emergency
followup procedures, including calling
including, but not limited to, a requirement for the school or
charter school administrator or, if the administrator is not
available, another school staff member to call the emergency
911 telephone number and contacting, if possible,
to contact the pupil's parent and physician.
or guardian. The requirement for the school or charter
school administrator or other school staff member to call the
emergency 911 telephone number shall not require a pupil to be
transported to an emergency room.
(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).
(5) The department shall include on its Internet Web site a
clearinghouse for best practices in training nonmedical personnel to
administer naloxone hydrochloride or another opioid antagonist to
pupils.
(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.
(4) A statement that no benefit will be granted to or withheld
from any individual based on his or her offer to volunteer and that
there will be no retaliation against any individual for rescinding
his or her offer to volunteer, including after receiving training.
(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) (1) 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
its expiration date.
(2) Volunteers may only administer naloxone hydrochloride or
another opioid antagonist by nasal spray.
(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)
(i) 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)
(j) (1) Notwithstanding any other
law, a person trained as required under subdivision (d), who
acts with reasonable care in administering
administers naloxone hydrochloride or another opioid
antagonist, in good faith, faith
and not for compensation, to a person who is
experiencing or is suspected of appears to be
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. his or
her acts or omissions in administering the naloxone hydrochloride or
another opioid antagonist.
(2) The protection specified in paragraph (1) shall not apply in a
case of gross negligence or willful and wanton misconduct of the
person who renders emergency care treatment by the use of naloxone
hydrochloride or another opioid antagonist.
(3) Any public employee who volunteers to administer naloxone
hydrochloride or another opioid antagonist pursuant to subdivision
(d) is not providing emergency medical care "for compensation,"
notwithstanding the fact that he or she is a paid public employee.
(l)
(k) 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.