BILL ANALYSIS Ó
AB 1748
Page 1
Date of Hearing: May 18, 2016
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Lorena Gonzalez, Chair
AB
1748 (Mayes) - As Amended May 11, 2016
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| |Judiciary | |9 - 1 |
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Urgency: No State Mandated Local Program: NoReimbursable: No
SUMMARY:
This bill authorizes local education agencies (LEAs), to provide
emergency naloxone hydrochloride (NH), or another opioid
antagonist, to school nurses or trained personnel who have
volunteered, as specified, so they may provide emergency medical
aid to persons suffering, or reasonably believed to be
suffering, from an opioid overdose. Volunteers may only issue
the medication through nasal spray. Specifically, this bill:
AB 1748
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1)Authorizes a pharmacy to furnish an opioid antagonist to an
LEA if it is provided exclusively for use at the LEA
requesting the medication, per written physician order, as
specified. Requires records of the acquisition and disposition
of the medication to be maintained by the LEA for at least
three years.
2)Authorizes public and private schools to voluntarily determine
whether or not to make an opioid antagonist available at its
school. States private schools cannot receive state funds for
this purpose.
3)Authorizes each public or private school to designate one or
more volunteers to receive initial and annual refresher
training on storage and use of the medication, based on
standards developed by the Superintendent of Public
Instruction (SPI), from the school nurse or other qualified
person designated by an authorizing physician and surgeon.
Requires the LEA to provide training at no cost to the
volunteer and during the volunteer's regular working hours.
4)Requires the SPI to establish minimum standards of training
for the administration of an opioid antagonist, as specified,
and review these standards of training every five years.
5)Requires the SPI to include a clearinghouse on the department
website for best practices in training nonmedical personnel to
administer an opioid antagonist to pupils.
6)Requires LEAs, choosing to utilize an opioid antagonist for
emergency aid, to distribute an informational notice at least
once per school year to all staff stating procedures for
volunteers and training.
AB 1748
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7)Requires a qualified supervisor of health or administrator at
the LEA, to obtain a prescription from an authorizing
physician and surgeon for each school choosing to provide an
opioid antagonist. This person is also responsible for
stocking and restocking the medication.
8)Specifies an authorizing physician and surgeon is not subject
to professional review, is not liable in a civil action, or
subject to criminal prosecution for the issuance of a
prescription or order, unless it constitutes gross negligence
or willful or malicious conduct.
9)Requires LEAs to ensure that each employee who volunteers to
provide the medication will be provided defense and
indemnification by the LEA for any and all civil liability, as
specified. Further specifies the person trained to administer
an opioid antagonist cannot be subject to professional review,
be liable in a civil action, or be subject to criminal
prosecution for his or her acts or omissions in administering
the medication.
10)Authorizes a state agency, the California Department of
Education (CDE) or a public school to accept gifts, grants,
and donations from any source for the support of the public
school carrying out the authorized activities in this bill,
including, but not limited to, the acceptance of an opioid
antagonist from a manufacturer or wholesaler.
FISCAL EFFECT:
General Fund administrative costs to the CDE of approximately
$60,000 in the first year of implementation to develop minimum
AB 1748
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standards of training for the administration of an opioid
antagonist and to provide a clearinghouse for best practices in
training. Ongoing costs of approximately $12,000 GF for the CDE
to review and update standards as necessary.
COMMENTS:
1)Purpose. The number of deaths resulting from opioid overdoses
has been steadily increasing over the past decade. According
to the author, there is no clear statutory authority for
schools to accept, stock, or administer opioid overdose
antidotes. This medication, which could potentially save
lives, should be available to schools that choose to stock it.
2)Background. Opioid antagonists are medications that rapidly
reverse the effects of a person suspected to be overdosing on
opioids such as heroin, methadone, or oxycodone. The most
common type of opioid antagonist is known as naloxone
hydrochloride (or its brand name "Narcan"). An opioid
antagonist is administered to counteract a depression of the
nervous system and to return breathing to normal. This
medication blocks receptors in the brain to prevent the action
of opioids and is potentially life-saving for someone
experiencing an overdose but causes no noticeable clinical
effect if a person is not experiencing an overdose.
In November 2015, the federal Food and Drug Administration
(FDA) approved an easy-to-use variant, administered by nasal
spray. In January 2016, Adapt Pharma announced an offer of a
free Narcan carton (2 doses) for every high school in the U.S.
and a grant to the National Association of School Nurses
(NASN) to develop school directed educational materials about
opioid overdose risks and prevention.
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3)Opposition. The California Teachers Association (CTA) is
opposed to this bill. According to CTA, the organization has a
long standing policy that the health and safety of children
are best met through the services of a credentialed nurse.
Analysis Prepared by:Misty Feusahrens / APPR. / (916) 319-2081