SB 1438, as amended, Pavley. Controlled substances: opioid antagonists.
(1) Existing law authorizes a licensed health care provider who is permitted by law to prescribe an opioid antagonist and is acting with reasonable care to prescribe and subsequently dispense or distribute an opioid antagonist for the treatment of an opioid overdose to a person at risk of an opioid-related overdose or a family member, friend, or other person in a position to assist a person at risk of an opioid-related overdose. Under existing law, licensed health care providers are authorized to issue standing orders for the distribution of an opioid antagonist to a person at risk of an opioid-related overdose or to a family member, friend, or other person in a position to assist the person at risk. Existing law also authorizes licensed health care providers to issue standing orders for the administration of an opioid antagonist by a family member, friend, or other person in a position to assist a person experiencing or suspected of experiencing an opioid overdose.
Existing law provides that a licensed health care provider who acts with reasonable care and issues a prescription for, or an order for the administration of, an opioid antagonist to a person experiencing or suspected of experiencing an opioid overdose is not subject to professional review, liable in a civil action, or subject to criminal prosecution for issuing the prescription or order. Under existing law, a person who is not otherwise licensed to administer an opioid antagonist, but who meets other specified conditions, is not subject to professional review, liable in a civil action, or subject to criminal prosecution for administering an opioid antagonist.
This bill would clarify that peace officers are included among the persons authorized to receive and distribute opioid antagonists as described above.
(2) Existing law, the Emergency Medical Services System and the Prehospital Emergency Medical Care Personnel Act, establishes the Emergency Medical Services Authority (EMSA), which is responsible for the coordination and integration of all state agencies concerning emergency medical services. Under existing law, EMSA is required to establish training and standards, and promulgate regulations, for all prehospital emergency care personnel, as defined, regarding the characteristics and method of assessment and treatment of anaphylactic reactions and the use of epinephrine.
This bill would require EMSA to establish training and standards, and promulgate regulations, for all prehospital emergency care personnel, as defined, regarding the use and administration of naloxone hydrochloride and other opioid antagonists. begin deleteThe end deletebegin insertNotwithstanding
that requirement, the end insertbill would also authorize a local EMS agency to establish training and standards, and promulgate regulations, in lieu of those developed and promulgated by EMSA,begin insert for the purpose of considering local need,end insert for all prehospital emergency care personnel under the jurisdiction of that local EMS agency regarding the use and administration of naloxone hydrochloride and other opioid antagonists. The bill would specify that both of those types of trainings satisfy the requirements described above allowing for immunity from criminal and civil liability for administering an opioidbegin delete antagonist.end deletebegin insert
antagonist, and require certain best practices to apply to those trainings, standards, and regulations.end insert
(3) Existing law, the Uniform Controlled Substances Act, requires the Attorney General to encourage research on the misuse and abuse of controlled substances, and, in connection with that research, and in furtherance of the enforcement of the act, authorizes the Attorney General to undertake specific acts, including developing new or improved approaches, techniques, systems, equipment, and devices to strengthen the enforcement of the act.
This bill would additionally permit the Attorney General, in connection with that research, and in furtherance of the enforcement of the act, to authorize hospitals and trauma centers to share information with local law enforcement agencies and local emergency medical services agencies about controlled substances. The bill would limit the data that may be provided by hospitals and trauma centers to the number of overdoses and the substances suspected as the primary cause of the overdoses. The bill would require that the information shared be shared in a manner that ensures complete patient confidentiality.
Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.
The people of the State of California do enact as follows:
Section 1714.22 of the Civil Code is amended
2to read:
(a) For purposes of this section, the following
4definitions shall apply:
5(1) “Opioid antagonist” means naloxone hydrochloride that is
6approved by the federal Food and Drug Administration for the
7treatment of an opioid overdose.
8(2) “Opioid overdose prevention and treatment training
9program” means any program operated by a local health
10jurisdiction or that is registered by a local health jurisdiction to
11train individuals to prevent, recognize, and respond to an opiate
12overdose, and that provides, at a minimum, training in all of the
13following:
14(A) The causes of an opiate overdose.
15(B) Mouth to mouth resuscitation.
16(C) How to contact appropriate emergency medical services.
17(D) How to administer an opioid antagonist.
18(b) A licensed health care provider who is authorized by law to
19prescribe an opioid antagonist may, if acting with reasonable care,
20prescribe and subsequently dispense or distribute an opioid
21antagonist to a person at risk of an opioid-related overdose or to
22a family member, friend, peace officer, or other person in a position
23to assist a person at risk of an opioid-related overdose.
P4 1(c) (1) A licensed health care provider who is
authorized by
2law to prescribe an opioid antagonist may issue standing orders
3for the distribution of an opioid antagonist to a person at risk of
4an opioid-related overdose or to a family member, friend, peace
5officer, or other person in a position to assist a person at risk of an
6opioid-related overdose.
7(2) A licensed health care provider who is authorized by law to
8prescribe an opioid antagonist may issue standing orders for the
9administration of an opioid antagonist to a person at risk of an
10opioid-related overdose by a family member, friend, peace officer,
11or other person in a position to assist a person experiencing or
12reasonably suspected of experiencing an opioid overdose.
13(d) (1) A person who is prescribed or possesses an opioid
14antagonist pursuant
to a standing order shall receive the training
15provided by an opioid overdose prevention and treatment training
16program.
17(2) A person who is prescribed an opioid antagonist directly
18from a licensed prescriber shall not be required to receive training
19from an opioid prevention and treatment training program.
20(e) A licensed health care provider who acts with reasonable
21care shall not be subject to professional review, be liable in a civil
22action, or be subject to criminal prosecution for issuing a
23prescription or order pursuant to subdivision (b) or (c).
24(f) Notwithstanding any other law, a person who possesses or
25distributes an opioid antagonist pursuant to a prescription or
26standing order shall not be subject to
professional review, be liable
27in a civil action, or be subject to criminal prosecution for this
28possession or distribution. Notwithstanding any other law, a person
29not otherwise licensed to administer an opioid antagonist, but
30trained as required under paragraph (1) of subdivision (d), who
31acts with reasonable care in administering an opioid antagonist,
32in good faith and not for compensation, to a person who is
33experiencing or is suspected of experiencing an overdose shall not
34be subject to professional review, be liable in a civil action, or be
35subject to criminal prosecution for this administration.
Section 1797.197 of the Health and Safety Code is
37amended to read:
(a) The authority shall establish training and
39standards for all prehospital emergency care personnel, as defined
40in paragraph (2) of subdivision (a) of Section 1797.189, regarding
P5 1the characteristics and method of assessment and treatment of
2anaphylactic reactions and the use of epinephrine. The authority
3shall promulgate regulations regarding these matters for use by all
4prehospital emergency care personnel.
5(b) (1) The authority shall establish training and standards for
6all prehospital emergency care personnel, as defined in paragraph
7(2) of subdivision (a) of Section 1797.189, regarding the use and
8administration of
naloxone hydrochloride and other opioid
9antagonists. The authority shall promulgate regulations regarding
10these matters for use by all prehospital emergency care personnel.
11The authority may designate existing training and standards for
12the use and administration of naloxone hydrochloride or another
13opioid antagonist to satisfy the requirements of this section.
14(2) begin deleteA end deletebegin insertNotwithstanding paragraph (1), a end insertlocal EMS agency may
15develop its own training and standards, and may promulgate
16regulations, in lieu of the training and standards and regulations
17developed by the authority pursuant to paragraph (1),begin insert for the
18
purpose of considering local need,end insert regarding the use and
19administration of naloxone hydrochloride and other opioid
20antagonists by prehospital emergency care personnel under the
21jurisdiction of that local EMS agency.
22(3) The training, standards, and regulations described in
23paragraphs (1) and (2) shall be in line with best practices in the
24Substance Abuse and Mental Health Services Administration’s
25Opioid Overdose Prevention Toolkit.
26(3)
end delete
27begin insert(4)end insert The training described in paragraphs (1) and (2) shall satisfy
28the requirements of paragraph (1) of subdivision (d) of Section
291714.22 of the Civil Code.
Section 11601 of the Health and Safety Code is
31amended to read:
The Attorney General shall encourage research on
33misuse and abuse of controlled substances. In connection with the
34research, and in furtherance of the enforcement of this division,
35he or she may do all of the following:
36(a) Develop new or improved approaches, techniques, systems,
37equipment, and devices to strengthen the enforcement of this
38division.
39(b) Enter into contracts with public agencies, institutions of
40higher education, and private organizations or individuals for the
P6 1purpose of conducting demonstrations or special projects that bear
2directly on misuse and abuse of controlled substances.
3(c) (1) Authorize hospitals and trauma centers to share
4information with local law enforcement agencies and local
5emergency medical services agencies about controlled substance
6overdose trends.
7(2) The information provided by hospitals and trauma centers
8pursuant to this subdivision shall include only the number of
9overdoses and the substances suspected as the primary cause of
10the overdoses. Any information shared pursuant to this subdivision
11shall be shared in a manner that ensures complete patient
12confidentiality.
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