88R20867 CXP-F
By: Talarico, Oliverson, Leo-Wilson, Howard, H.B. No. 2411
Zwiener, et al.
A BILL TO BE ENTITLED
AN ACT
relating to the maintenance, administration, and disposal of opioid
antagonists on public and private school campuses and to the
permissible uses of money appropriated to a state agency from the
opioid abatement account.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Chapter 38, Education Code, is amended by adding
Subchapter E-1 to read as follows:
SUBCHAPTER E-1. MAINTENANCE, ADMINISTRATION, AND DISPOSAL OF
OPIOID ANTAGONISTS
Sec. 38.221. DEFINITIONS. In this subchapter:
(1) "Opioid antagonist" and "opioid-related drug
overdose" have the meanings assigned by Section 483.101, Health and
Safety Code.
(2) "Physician" means a person who holds a license to
practice medicine in this state.
Sec. 38.222. MAINTENANCE, ADMINISTRATION, AND DISPOSAL OF
OPIOID ANTAGONISTS. (a) Each school district shall adopt and
implement a policy regarding the maintenance, administration, and
disposal of opioid antagonists at each campus in the district that
serves students in grades 6 through 12 and may adopt and implement
such a policy at each campus in the district, including campuses
serving students in a grade level below grade 6.
(b) An open-enrollment charter school or private school may
adopt and implement a policy regarding the maintenance,
administration, and disposal of opioid antagonists. If a school
adopts a policy under this subsection, the school may apply the
policy:
(1) only at campuses of the school serving students in
grades 6 through 12; or
(2) at each campus of the school, including campuses
serving students in a grade level below grade 6.
(c) A policy adopted under this section must:
(1) provide that school personnel and school
volunteers who are authorized and trained may administer an opioid
antagonist to a person who is reasonably believed to be
experiencing an opioid-related drug overdose;
(2) require that each school campus subject to a
policy adopted under this section have one or more school personnel
members or school volunteers authorized and trained to administer
an opioid antagonist present during regular school hours;
(3) establish the number of opioid antagonists that
must be available at each campus at any given time; and
(4) require that the supply of opioid antagonists at
each school campus subject to a policy adopted under this section
must be stored in a secure location and be easily accessible to
school personnel and school volunteers authorized and trained to
administer an opioid antagonist.
(d) The executive commissioner of the Health and Human
Services Commission, in consultation with the commissioner of
education, shall adopt rules regarding the maintenance,
administration, and disposal of opioid antagonists at a school
campus subject to a policy adopted under this section. The rules
must establish:
(1) the process for checking the inventory of opioid
antagonists at regular intervals for expiration and replacement;
and
(2) the amount of training required for school
personnel and school volunteers to administer an opioid antagonist.
Sec. 38.223. REPORT ON ADMINISTERING OPIOID ANTAGONIST.
(a) Not later than the 10th business day after the date a school
personnel member or school volunteer administers an opioid
antagonist in accordance with a policy adopted under Section
38.222(a) or (b), the school shall report the information required
under Subsection (b) of this section to:
(1) the school district, the charter holder if the
school is an open-enrollment charter school, or the governing body
of the school if the school is a private school;
(2) the physician or other person who prescribed the
opioid antagonist; and
(3) the commissioner of state health services.
(b) The report required under this section must include the
following information:
(1) the age of the person who received the
administration of the opioid antagonist;
(2) whether the person who received the administration
of the opioid antagonist was a student, a school personnel member or
school volunteer, or a visitor;
(3) the physical location where the opioid antagonist
was administered;
(4) the number of doses of opioid antagonist
administered;
(5) the title of the person who administered the
opioid antagonist; and
(6) any other information required by the commissioner
of education.
Sec. 38.224. TRAINING. (a) Each school district,
open-enrollment charter school, and private school that adopts a
policy under Section 38.222(a) or (b) is responsible for training
school personnel and school volunteers in the administration of an
opioid antagonist.
(b) Training required under this section must:
(1) include information on:
(A) recognizing the signs and symptoms of an
opioid-related drug overdose;
(B) administering an opioid antagonist;
(C) implementing emergency procedures, if
necessary, after administering an opioid antagonist; and
(D) properly disposing of used or expired opioid
antagonists;
(2) be provided in a formal training session or
through online education; and
(3) be provided in accordance with the policy adopted
under Section 21.4515.
(c) Each school district, open-enrollment charter school,
or private school that adopts a policy under Section 38.222(a) or
(b) must maintain records on the training required under this
section.
Sec. 38.225. PRESCRIPTION OF OPIOID ANTAGONISTS. (a) A
physician or person who has been delegated prescriptive authority
under Chapter 157, Occupations Code, may prescribe opioid
antagonists in the name of a school district, open-enrollment
charter school, or private school.
(b) A physician or other person who prescribes opioid
antagonists under Subsection (a) shall provide the school district,
open-enrollment charter school, or private school with a standing
order for the administration of an opioid antagonist to a person
reasonably believed to be experiencing an opioid-related drug
overdose.
(c) The standing order under Subsection (b) is not required
to be patient-specific, and the opioid antagonist may be
administered to a person without a previously established
physician-patient relationship.
(d) Notwithstanding any other provisions of law,
supervision or delegation by a physician is considered adequate if
the physician:
(1) periodically reviews the order; and
(2) is available through direct telecommunication as
needed for consultation, assistance, and direction.
(e) An order issued under this section must contain:
(1) the name and signature of the prescribing
physician or other person;
(2) the name of the school district, open-enrollment
charter school, or private school to which the order is issued;
(3) the quantity of opioid antagonists to be obtained
and maintained under the order; and
(4) the date of issue.
(f) A pharmacist may dispense an opioid antagonist to a
school district, open-enrollment charter school, or private school
without requiring the name or any other identifying information
relating to the user.
Sec. 38.226. GIFTS, GRANTS, AND DONATIONS. A school
district, open-enrollment charter school, or private school may
accept gifts, grants, donations, and federal and local funds to
implement this subchapter.
Sec. 38.227. IMMUNITY FROM LIABILITY. (a) A person who in
good faith takes, or fails to take, any action under this subchapter
is immune from civil or criminal liability or disciplinary action
resulting from that action or failure to act, including:
(1) issuing an order for opioid antagonists;
(2) supervising or delegating the administration of an
opioid antagonist;
(3) possessing, maintaining, storing, or disposing of
an opioid antagonist;
(4) prescribing an opioid antagonist;
(5) dispensing an opioid antagonist;
(6) administering, or assisting in administering, an
opioid antagonist;
(7) providing, or assisting in providing, training,
consultation, or advice in the development, adoption, or
implementation of policies, guidelines, rules, or plans; or
(8) undertaking any other act permitted or required
under this subchapter.
(b) The immunities and protections provided by this
subchapter are in addition to other immunities or limitations of
liability provided by law.
(c) Notwithstanding any other law, this subchapter does not
create a civil, criminal, or administrative cause of action or
liability or create a standard of care, obligation, or duty that
provides a basis for a cause of action for an act or omission under
this subchapter.
(d) A cause of action does not arise from an act or omission
described by this section.
(e) A school district, open-enrollment charter school, or
private school and school personnel and school volunteers are
immune from suit resulting from an act, or failure to act, under
this subchapter, including an act or failure to act under related
policies and procedures.
(f) An act or failure to act by school personnel or a school
volunteer under this subchapter, including an act or failure to act
under related policies and procedures, is the exercise of judgment
or discretion on the part of the school personnel or school
volunteer and is not considered to be a ministerial act for purposes
of liability of the school district, open-enrollment charter
school, or private school.
Sec. 38.228. RULES. Except as otherwise provided by this
subchapter, the commissioner of education and the executive
commissioner of the Health and Human Services Commission shall
jointly adopt rules necessary to implement this subchapter.
SECTION 2. Section 403.505(d), Government Code, is amended
to read as follows:
(d) A state agency may use money appropriated from the
account only to:
(1) prevent opioid use disorder through
evidence-based education and prevention, such as school-based
prevention, early intervention, or health care services or programs
intended to reduce the risk of opioid use by school-age children;
(2) support efforts to prevent or reduce deaths from
opioid overdoses or other opioid-related harms, including through
increasing the availability or distribution of naloxone or other
opioid antagonists for use by:
(A) health care providers;
(B) [,] first responders;
(C) [,] persons experiencing an opioid overdose;
(D) [,] families;
(E) [,] schools, including under a policy adopted
under Subchapter E-1, Chapter 38, Education Code, regarding the
maintenance, administration, and disposal of opioid antagonists;
(F) community-based service providers;
(G) [,] social workers;[,] or
(H) other members of the public;
(3) create and provide training on the treatment of
opioid addiction, including the treatment of opioid dependence with
each medication approved for that purpose by the United States Food
and Drug Administration, medical detoxification, relapse
prevention, patient assessment, individual treatment planning,
counseling, recovery supports, diversion control, and other best
practices;
(4) provide opioid use disorder treatment for youths
and adults, with an emphasis on programs that provide a continuum of
care that includes screening and assessment for opioid use disorder
and co-occurring behavioral health disorders, early intervention,
contingency management, cognitive behavioral therapy, case
management, relapse management, counseling services, and
medication-assisted treatments;
(5) provide patients suffering from opioid dependence
with access to all medications approved by the United States Food
and Drug Administration for the treatment of opioid dependence and
relapse prevention following opioid detoxification, including
opioid agonists, partial agonists, and antagonists;
(6) support efforts to reduce the abuse or misuse of
addictive prescription medications, including tools used to give
health care providers information needed to protect the public from
the harm caused by improper use of those medications;
(7) support treatment alternatives that provide both
psychosocial support and medication-assisted treatments in areas
with geographical or transportation-related challenges, including
providing access to mobile health services and telemedicine,
particularly in rural areas;
(8) address:
(A) the needs of persons involved with criminal
justice; and
(B) rural county unattended deaths; or
(9) further any other purpose related to opioid
abatement authorized by appropriation.
SECTION 3. Not later than November 1, 2023:
(1) the executive commissioner of the Health and Human
Services Commission shall, in consultation with the commissioner of
education, adopt rules required under Section 38.222, Education
Code, as added by this Act; and
(2) the commissioner of education and the executive
commissioner of the Health and Human Services Commission shall
jointly adopt rules necessary to implement Subchapter E-1, Chapter
38, Education Code, as added by this Act.
SECTION 4. Notwithstanding the effective date of this Act,
a school district is not required to comply with Section 38.222,
Education Code, as added by this Act, before January 1, 2024.
SECTION 5. This Act takes effect immediately if it receives
a vote of two-thirds of all the members elected to each house, as
provided by Section 39, Article III, Texas Constitution. If this
Act does not receive the vote necessary for immediate effect, this
Act takes effect September 1, 2023.