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 a 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.
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 volunteers’ 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 provide that volunteers maybegin delete onlyend delete administer naloxone hydrochloride or another opioid antagonistbegin insert onlyend insert by nasalbegin delete spray.end deletebegin insert
spray or by auto-injector, as specified.end insert 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 administers naloxone hydrochloride or another opioid antagonist, in good faith and not for compensation, to a person who 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 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.
P4 1(2) A physician and surgeon provides a written order that
2specifies the quantity of naloxone hydrochloride or another opioid
3antagonist to be furnished.
4(b) Records regarding the acquisition and disposition of
5naloxone hydrochloride or another opioid antagonist furnished
6pursuant to subdivision (a) shall be maintained by the school
7district, county office of education, or charter school for a period
8of three years from the date the records were created. The school
9district, county office of education, or charter school shall be
10responsible for monitoring the supply of naloxone hydrochloride
11or another opioid antagonist and ensuring the destruction of expired
12naloxone hydrochloride or another opioid antagonist.
Section 49414.3 is added to the Education Code, to
14read:
(a) School districts, county offices of education, and
16charter schools may provide emergency naloxone hydrochloride
17or another opioid antagonist to school nurses or trained personnel
18who have volunteered pursuant to subdivision (d), and school
19nurses or trained personnel may use naloxone hydrochloride or
20another opioid antagonist to provide emergency medical aid to
21persons suffering, or reasonably believed to be suffering, from an
22opioid overdose.
23(b) For purposes of this section, the following terms have the
24following meanings:
25(1) “Authorizing physician and surgeon” may include, but is
26not
limited to, a physician and surgeon employed by, or contracting
27with, a local educational agency, a medical director of the local
28health department, or a local emergency medical services director.
29
(2) “Auto-injector” means a disposable delivery device designed
30for the automatic injection of a premeasured dose of an opioid
31antagonist into the human body and approved by the federal Food
32and Drug Administration for layperson use.
33(2)
end delete
34begin insert(3)end insert “Opioid antagonist” means naloxone
hydrochloride or
35another drug approved by the federal Food and Drug
36Administration that, when administered, negates or neutralizes in
37whole or in part the pharmacological effects of an opioid in the
38body, and has been approved for the treatment of an opioid
39overdose.
40(3)
end delete
P5 1begin insert(4)end insert “Qualified supervisor of health” may include, but is not
2limited to, a school nurse.
3(4)
end delete
4begin insert(5)end insert “Volunteer” or “trained personnel” means an employee who
5has volunteered to administer naloxone hydrochloride or another
6opioid antagonist to a person if the person is suffering, or
7reasonably believed to be suffering, from an opioid overdose, has
8been designated by a school, and has received training pursuant
9to subdivision (d).
10(c) Each public and private elementary and secondary school
11in the state may voluntarily determine whether or not to make
12emergency naloxone hydrochloride or another opioid antagonist
13and trained personnel available at its school. In making this
14determination, a school shall evaluate the emergency medical
15response time to the school and determine whether initiating
16emergency medical services is an acceptable alternative to naloxone
17hydrochloride or another opioid antagonist and trained personnel.
18
A private elementary or secondary school choosing to exercise the
19authority provided under this subdivision shall not receive state
20funds specifically for purposes of this subdivision.
21(d) (1) Each public and private elementary and secondary school
22in the state may designate one or more volunteers to receive initial
23and annual refresher training, based on the standards developed
24pursuant to subdivision (e), regarding the storage and emergency
25use of naloxone hydrochloride or another opioid antagonist from
26the school nurse or other qualified person designated by an
27authorizing physician and surgeon. A benefit shall not be granted
28to or withheld from any individual based on his or her offer to
29volunteer and there shall be no retaliation against any individual
30for rescinding his or her offer to volunteer, including after receiving
31training.
Any school district, county office of education, or charter
32school choosing to exercise the authority provided under this
33subdivision shall provide the training for the volunteers at no cost
34to the volunteer and during the volunteer’s regular working hours.
35(2) An employee who volunteers pursuant to this section may
36rescind his or her offer to administer emergency naloxone
37hydrochloride or another opioid antagonist at any time, including
38after receipt of training.
39(e) (1) The Superintendent shall establish minimum standards
40of training for the administration of naloxone hydrochloride or
P6 1another opioid antagonist that satisfies the requirements of
2paragraph (2). Every five years, or sooner as deemed necessary
3by the Superintendent, the Superintendent shall review
minimum
4standards of training for the administration of naloxone
5hydrochloride or other opioid antagonists that satisfy the
6requirements of paragraph (2). For purposes of this subdivision,
7the Superintendent shall consult with organizations and providers
8with expertise in administering naloxone hydrochloride or another
9opioid antagonist and administering medication in a school
10environment, including, but not limited to, the State Department
11of Public Health, the Emergency Medical Services Authority, the
12California School Nurses Organization, the California Medical
13Association, the American Academy of Pediatrics, and others.
14(2) Training established pursuant to this subdivision shall include
15all of the following:
16(A) Techniques for recognizing symptoms of an opioid
17overdose.
18(B) Standards and procedures for the storage, restocking, and
19emergency use of naloxone hydrochloride or another opioid
20antagonist.
21(C) Basic emergency followup procedures, including, but not
22limited to, a requirement for the school or charter school
23administrator or, if the administrator is not available, another school
24staff member to call the emergency 911 telephone number and to
25contact the pupil’s parent or guardian. The requirement for the
26school or charter school administrator or other school staff member
27to call the emergency 911 telephone number shall not require a
28pupil to be transported to an emergency room.
29(D) Recommendations on the necessity of instruction and
30certification in cardiopulmonary
resuscitation.
31(E) Written materials covering the information required under
32this subdivision.
33(3) Training established pursuant to this subdivision shall be
34consistent with the most recent guidelines for medication
35administration issued by the department.
36(4) A school shall retain for reference the written materials
37prepared under subparagraph (E) of paragraph (2).
38(5) The department shall include on its Internet Web site a
39clearinghouse for best practices in training nonmedical personnel
P7 1to administer naloxone hydrochloride or another opioid antagonist
2to pupils.
3(f) Any school district,
county office of education, or charter
4school electing to utilize naloxone hydrochloride or another opioid
5antagonist for emergency aid shall distribute a notice at least once
6per school year to all staff that contains the following information:
7(1) A description of the volunteer request stating that the request
8is for volunteers to be trained to administer naloxone hydrochloride
9or another opioid antagonist to a person if the person is suffering,
10or reasonably believed to be suffering, from an opioid overdose.
11(2) A description of the training that the volunteer will receive
12pursuant to subdivision (d).
13(3) The right of an employee to rescind his or her offer to
14
volunteer pursuant to this section.
15(4) A statement that no benefit will be granted to or withheld
16from any individual based on his or her offer to volunteer and that
17there will be no retaliation against any individual for rescinding
18his or her offer to volunteer, including after receiving training.
19(g) (1) A qualified supervisor of health at a school district,
20county office of education, or charter school electing to utilize
21naloxone hydrochloride or another opioid antagonist for emergency
22aid shall obtain from an authorizing physician and surgeon a
23prescription for each school for naloxone hydrochloride or another
24opioid antagonist. A qualified supervisor of health at a school
25district, county office of education, or charter school shall be
26responsible
for stocking the naloxone hydrochloride or another
27opioid antagonist and restocking it if it is used.
28(2) If a school district, county office of education, or charter
29school does not have a qualified supervisor of health, an
30administrator at the school district, county office of education, or
31charter school shall carry out the duties specified in paragraph (1).
32(3) A prescription pursuant to this subdivision may be filled by
33local or mail order pharmacies or naloxone hydrochloride or
34another opioid antagonist manufacturers.
35(4) An authorizing physician and surgeon shall not be subject
36to professional review, be liable in a civil action, or be subject to
37criminal prosecution for the issuance of a prescription or order
38pursuant
to this section, unless the physician and surgeon’s issuance
39of the prescription or order constitutes gross negligence or willful
40or malicious conduct.
P8 1(h) (1) A school nurse or, if the school does not have a school
2nurse or the school nurse is not onsite or available, a volunteer
3may administer naloxone hydrochloride or another opioid
4antagonist to a person exhibiting potentially life-threatening
5symptoms of an opioid overdose at school or a school activity
6when a physician is not immediately available. If the naloxone
7hydrochloride or another opioid antagonist is used it shall be
8restocked as soon as reasonably possible, but no later than two
9weeks after it is used. Naloxone hydrochloride or another opioid
10antagonist shall be restocked before its expiration date.
11(2) Volunteers maybegin delete onlyend delete administer naloxone hydrochloride or
12another opioid antagonistbegin insert onlyend insert by nasalbegin delete spray.end deletebegin insert spray or by
13auto-injector.end insert
14
(3) A volunteer shall be allowed to administer naloxone
15hydrochloride or another opioid antagonist in a form listed in
16paragraph (2) that the volunteer is most comfortable with.
17(i) A school district, county office of education, or charter
school
18electing to utilize naloxone hydrochloride or another opioid
19antagonist for emergency aid shall ensure that each employee who
20volunteers under this section will be provided defense and
21indemnification by the school district, county office of education,
22or charter school for any and all civil liability, in accordance with,
23but not limited to, that provided in Division 3.6 (commencing with
24Section 810) of Title 1 of the Government Code. This information
25shall be reduced to writing, provided to the volunteer, and retained
26in the volunteer’s personnel file.
27(j) (1) Notwithstanding any other law, a person trained as
28required under subdivision (d), who administers naloxone
29hydrochloride or another opioid antagonist, in good faith and not
30for compensation, to a person who appears to be experiencing an
31opioid overdose
shall not be subject to professional review, be
32liable in a civil action, or be subject to criminal prosecution for
33his or her acts or omissions in administering the naloxone
34hydrochloride or another opioid antagonist.
35(2) The protection specified in paragraph (1) shall not apply in
36a case of gross negligence or willful and wanton misconduct of
37the person who renders emergency care treatment by the use of
38naloxone hydrochloride or another opioid antagonist.
39(3) Any public employee who volunteers to administer naloxone
40hydrochloride or another opioid antagonist pursuant to subdivision
P9 1(d) is not providing emergency medical care “for compensation,”
2notwithstanding the fact that he or she is a paid public employee.
3(k) A
state agency, the department, or a public school may
4accept gifts, grants, and donations from any source for the support
5of the public school carrying out the provisions of this section,
6including, but not limited to, the acceptance of naloxone
7hydrochloride or another opioid antagonist from a manufacturer
8or wholesaler.
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