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 tobegin delete establishend deletebegin insert develop and adoptend insert 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 delete Notwithstanding
that requirement, the bill would also authorize a local EMS agency to establish training and standards, and promulgate regulations, in lieu of those developed and promulgated by EMSA, for the purpose of considering local need, 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.end deletebegin insert The bill would authorize EMSA to adopt existing training and standards for prehospital emergency care personnel regarding the statewide use and administration of naloxone hydrochloride or another opioid antagonist to satisfy the requirements of the bill’s provisions. The bill would also authorize, at the discretion of the medical director of the local EMS agency, pertinent training completed by prehospital emergency care personnel to be used to satisfy partend insertbegin insert
of the training requirements established by EMSA pursuant to the bill’s provisions.end insert 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, and require certain best practices to apply to those trainings, standards, and regulations.end deletebegin insert antagonist.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.
P4 1(B) Mouth to mouth resuscitation.
2(C) How to contact appropriate emergency medical services.
3(D) How to administer an opioid antagonist.
4(b) A licensed health care provider who is authorized by law to
5prescribe an opioid antagonist may, if acting with reasonable care,
6prescribe and subsequently dispense or distribute an opioid
7antagonist to a person at risk of an opioid-related overdose or to
8a family member, friend, peace officer, or other person in a position
9to assist a person at risk of an opioid-related overdose.
10(c) (1) A licensed health care provider who
is authorized by
11law to prescribe an opioid antagonist may issue standing orders
12for the distribution of an opioid antagonist to a person at risk of
13an opioid-related overdose or to a family member, friend, peace
14officer, or other person in a position to assist a person at risk of an
15opioid-related overdose.
16(2) A licensed health care provider who is authorized by law to
17prescribe an opioid antagonist may issue standing orders for the
18administration of an opioid antagonist to a person at risk of an
19opioid-related overdose by a family member, friend, peace officer,
20or other person in a position to assist a person experiencing or
21reasonably suspected of experiencing an opioid overdose.
22(d) (1) A person who is prescribed or possesses an opioid
23antagonist pursuant to a
standing order shall receive the training
24provided by an opioid overdose prevention and treatment training
25program.
26(2) A person who is prescribed an opioid antagonist directly
27from a licensed prescriber shall not be required to receive training
28from an opioid prevention and treatment training program.
29(e) A licensed health care provider who acts with reasonable
30care shall not be subject to professional review, be liable in a civil
31action, or be subject to criminal prosecution for issuing a
32prescription or order pursuant to subdivision (b) or (c).
33(f) Notwithstanding any other law, a person who possesses or
34distributes an opioid antagonist pursuant to a prescription or
35standing order shall not be subject to professional
review, be liable
36in a civil action, or be subject to criminal prosecution for this
37possession or distribution. Notwithstanding any other law, a person
38not otherwise licensed to administer an opioid antagonist, but
39trained as required under paragraph (1) of subdivision (d), who
40acts with reasonable care in administering an opioid antagonist,
P5 1in good faith and not for compensation, to a person who is
2experiencing or is suspected of experiencing an overdose shall not
3be subject to professional review, be liable in a civil action, or be
4subject to criminal prosecution for this administration.
Section 1797.197 of the Health and Safety Code is
6amended to read:
(a) The authority shall establish training and
8standards for all prehospital emergency care personnel, as defined
9in paragraph (2) of subdivision (a) of Section 1797.189, regarding
10the characteristics and method of assessment and treatment of
11anaphylactic reactions and the use of epinephrine. The authority
12shall promulgate regulations regarding these matters for use by all
13prehospital emergency care personnel.
14(b) (1) The authority shallbegin delete establishend deletebegin insert develop and, after approval
15by the
commission pursuant to Section 1799.50, adoptend insert training
16and standards for all prehospital emergency care personnel, as
17defined in paragraph (2) of subdivision (a) of Section 1797.189,
18regarding the use and administration of naloxone hydrochloride
19and other opioid antagonists. The authority shall promulgate
20regulations regarding these matters for use by all prehospital
21emergency care personnel. The authority maybegin delete designateend deletebegin insert adoptend insert
22 existing training and standards forbegin insert prehospital emergency care
23personnel regardingend insert thebegin insert statewideend insert use and
administration of
24naloxone hydrochloride or another opioid antagonist to satisfy the
25requirements of this section.
26(2) Notwithstanding paragraph (1), a local EMS agency may
27develop its own training and standards, and may promulgate
28regulations, in lieu of the training and standards and regulations
29developed by the authority pursuant to paragraph (1), for the
30
purpose of considering local need, regarding the use and
31administration of naloxone hydrochloride and other opioid
32antagonists by prehospital emergency care personnel under the
33jurisdiction of that local EMS agency.
34(3) The training, standards, and regulations described in
35paragraphs (1) and (2) shall be in line with best practices in the
36Substance Abuse and Mental Health Services Administration’s
37Opioid Overdose Prevention Toolkit.
38(2) Pertinent training completed by prehospital emergency care
39personnel, at the discretion of the medical director of the local
40EMS agency, may be used to satisfy part of the training
P6 1
requirements established pursuant to paragraph (1) regarding the
2use and administration of naloxone hydrochloride and other opioid
3antagonists by prehospital emergency care personnel.
4(4)
end delete
5begin insert(3)end insert The training described in paragraphs (1) and (2) shall satisfy
6the requirements of paragraph (1) of subdivision (d) of Section
71714.22 of the Civil Code.
Section 11601 of the Health and Safety Code is
9amended to read:
The Attorney General shall encourage research on
11misuse and abuse of controlled substances. In connection with the
12research, and in furtherance of the enforcement of this division,
13he or she may do all of the following:
14(a) Develop new or improved approaches, techniques, systems,
15equipment, and devices to strengthen the enforcement of this
16division.
17(b) Enter into contracts with public agencies, institutions of
18higher education, and private organizations or individuals for the
19purpose of conducting demonstrations or special projects that bear
20directly on misuse and abuse of controlled substances.
21(c) (1) Authorize hospitals and trauma centers to share
22information with local law enforcement agencies and local
23emergency medical services agencies about controlled substance
24overdose trends.
25(2) The information provided by hospitals and trauma centers
26pursuant to this subdivision shall include only the number of
27overdoses and the substances suspected as the primary cause of
28the overdoses. Any information shared pursuant to this subdivision
29shall be shared in a manner that ensures complete patient
30confidentiality.
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