Texas 2023 - 88th Regular

Texas House Bill HB4058 Compare Versions

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1	1	88R17177 CXP-D
2	2	By: Cortez, Campos, Guerra H.B. No. 4058
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the use of opioid antagonists on the campuses of public
8	8	and private schools and institutions of higher education and at or
9	9	in transit to or from off-campus school events.
10	10	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	11	SECTION 1. The heading to Subchapter E, Chapter 38,
12	12	Education Code, is amended to read as follows:
13	13	SUBCHAPTER E. MAINTENANCE, [AND] ADMINISTRATION, AND DISPOSAL OF
14	14	EPINEPHRINE AUTO-INJECTORS, OPIOID ANTAGONISTS, AND ASTHMA
15	15	MEDICINE
16	16	SECTION 2. Section 38.201, Education Code, is amended by
17	17	amending Subdivision (1) and adding Subdivision (3-a) to read as
18	18	follows:
19	19	(1) "Advisory committee" means the stock medication
20	20	advisory committee established under Section 38.202.
21	21	(3-a) "Opioid antagonist" and "opioid-related drug
22	22	overdose" have the meanings assigned by Section 483.101, Health and
23	23	Safety Code.
24	24	SECTION 3. The heading to Section 38.202, Education Code,
25	25	is amended to read as follows:
26	26	Sec. 38.202. STOCK MEDICATION ADVISORY COMMITTEE:
27	27	ESTABLISHMENT AND COMPOSITION.
28	28	SECTION 4. Sections 38.202(a) and (b), Education Code, are
29	29	amended to read as follows:
30	30	(a) The commissioner of state health services shall
31	31	establish a stock medication [an] advisory committee to examine and
32	32	review the administration of epinephrine auto-injectors to a person
33	33	experiencing an anaphylactic reaction, and opioid antagonists to a
34	34	person experiencing an apparent opioid-related drug overdose, on a
35	35	campus of a school district, an open-enrollment charter school, a
36	36	private school, or an institution of higher education or at an
37	37	off-campus school event or while in transit to or from a school
38	38	event.
39	39	(b) The advisory committee shall be composed of members
40	40	appointed by the commissioner of state health services. In making
41	41	appointments, the commissioner shall ensure that:
42	42	(1) a majority of the members are physicians with
43	43	expertise in treating anaphylaxis or opioid-related drug
44	44	overdoses, including physicians who specialize in the fields of
45	45	pediatrics, allergies, asthma, drug use disorders, and immunology;
46	46	(2) at least one member is a registered nurse employed
47	47	by a school district, open-enrollment charter school, or private
48	48	school as a school nurse;
49	49	(3) at least one member is an employee of a general
50	50	academic teaching institution; and
51	51	(4) at least one member is an employee of a public
52	52	junior college or a public technical institute.
53	53	SECTION 5. Section 38.207, Education Code, is amended to
54	54	read as follows:
55	55	Sec. 38.207. ADVISORY COMMITTEE: DUTIES. The advisory
56	56	committee shall advise the commissioner of state health services
57	57	on:
58	58	(1) the storage and maintenance of epinephrine
59	59	auto-injectors and opioid antagonists on school campuses and
60	60	campuses of institutions of higher education;
61	61	(2) the training of school personnel and school
62	62	volunteers, and of personnel and volunteers at institutions of
63	63	higher education, in the administration of an epinephrine
64	64	auto-injector and opioid antagonist; and
65	65	(3) a plan for:
66	66	(A) one or more school personnel members or
67	67	school volunteers trained in the administration of an epinephrine
68	68	auto-injector to be on each school campus; [and]
69	69	(B) one or more school personnel members or
70	70	school volunteers trained in the administration of an opioid
71	71	antagonist to be on each school campus;
72	72	(C) one or more personnel members or volunteers
73	73	of an institution of higher education trained in the administration
74	74	of an epinephrine auto-injector to be on each campus of an
75	75	institution of higher education; and
76	76	(D) one or more personnel members or volunteers
77	77	of an institution of higher education trained in the administration
78	78	of an opioid antagonist to be on each campus of an institution of
79	79	higher education.
80	80	SECTION 6. The heading to Section 38.208, Education Code,
81	81	is amended to read as follows:
82	82	Sec. 38.208. MAINTENANCE AND ADMINISTRATION OF EPINEPHRINE
83	83	AUTO-INJECTORS, OPIOID ANTAGONISTS, AND ASTHMA MEDICINE.
84	84	SECTION 7. Sections 38.208(a), (b), (c), and (e), Education
85	85	Code, are amended to read as follows:
86	86	(a) Each school district, open-enrollment charter school,
87	87	and private school may adopt and implement a policy regarding the
88	88	maintenance, administration, and disposal of epinephrine
89	89	auto-injectors or opioid antagonists at each campus in the district
90	90	or school.
91	91	(b) If a policy is adopted under Subsection (a), the policy,
92	92	as applicable:
93	93	(1) must provide that school personnel and school
94	94	volunteers who are authorized and trained may administer an
95	95	epinephrine auto-injector to a person who is reasonably believed to
96	96	be experiencing anaphylaxis, or an opioid antagonist to a person
97	97	who is reasonably believed to be experiencing an opioid-related
98	98	drug overdose, on a school campus; and
99	99	(2) may provide that school personnel and school
100	100	volunteers who are authorized and trained may administer an
101	101	epinephrine auto-injector to a person who is reasonably believed to
102	102	be experiencing anaphylaxis, or an opioid antagonist to a person
103	103	who is reasonably believed to be experiencing an opioid-related
104	104	drug overdose, at an off-campus school event or while in transit to
105	105	or from a school event.
106	106	(c) The executive commissioner of the Health and Human
107	107	Services Commission, in consultation with the commissioner of
108	108	education, and with advice from the advisory committee as
109	109	appropriate, shall adopt rules regarding the maintenance,
110	110	administration, and disposal of an epinephrine auto-injector and
111	111	opioid antagonist at a school campus subject to a policy adopted
112	112	under Subsection (a) and the maintenance and administration of
113	113	asthma medicine at a school campus subject to a policy adopted under
114	114	Subsection (a-1). The rules must establish:
115	115	(1) the number of epinephrine auto-injectors and
116	116	opioid antagonists available at each campus;
117	117	(2) the amount of prescription asthma medicine
118	118	available at each campus;
119	119	(3) the process for each school district,
120	120	open-enrollment charter school, and private school to check the
121	121	inventory of epinephrine auto-injectors, opioid antagonists, and
122	122	asthma medicine at regular intervals for expiration and
123	123	replacement; and
124	124	(4) the amount of training required for school
125	125	personnel and school volunteers to administer an epinephrine
126	126	auto-injector or opioid antagonist.
127	127	(e) The supply of epinephrine auto-injectors and opioid
128	128	antagonists at each campus must be stored in a secure location and
129	129	be easily accessible to school personnel and school volunteers
130	130	authorized and trained to administer an epinephrine auto-injector
131	131	or opioid antagonist. The supply of asthma medicine at each campus
132	132	must be stored in a secure location and be easily accessible to the
133	133	school nurse.
134	134	SECTION 8. Section 38.209, Education Code, is amended to
135	135	read as follows:
136	136	Sec. 38.209. REPORT ON ADMINISTERING EPINEPHRINE
137	137	AUTO-INJECTOR OR OPIOID ANTAGONIST. (a) Not later than the 10th
138	138	business day after the date a school personnel member or school
139	139	volunteer administers an epinephrine auto-injector or opioid
140	140	antagonist in accordance with a policy adopted under Section
141	141	38.208(a), the school shall report the information required under
142	142	Subsection (b) to:
143	143	(1) the school district, the charter holder if the
144	144	school is an open-enrollment charter school, or the governing body
145	145	of the school if the school is a private school;
146	146	(2) the physician or other person who prescribed the
147	147	epinephrine auto-injector or opioid antagonist; and
148	148	(3) the commissioner of state health services.
149	149	(b) The report required under this section must include the
150	150	following information:
151	151	(1) the age of the person who received the
152	152	administration of the epinephrine auto-injector or opioid
153	153	antagonist;
154	154	(2) whether the person who received the administration
155	155	of the epinephrine auto-injector or opioid antagonist was a
156	156	student, a school personnel member or school volunteer, or a
157	157	visitor;
158	158	(3) the physical location where the epinephrine
159	159	auto-injector or opioid antagonist was administered;
160	160	(4) the number of doses of epinephrine auto-injector
161	161	or opioid antagonist administered;
162	162	(5) the title of the person who administered the
163	163	epinephrine auto-injector or opioid antagonist; and
164	164	(6) any other information required by the commissioner
165	165	of education.
166	166	SECTION 9. Sections 38.210(a) and (b), Education Code, are
167	167	amended to read as follows:
168	168	(a) Each school district, open-enrollment charter school,
169	169	and private school that adopts a policy under Section 38.208(a) is
170	170	responsible for training school personnel and school volunteers in
171	171	the administration of an epinephrine auto-injector or opioid
172	172	antagonist.
173	173	(b) Training required under this section must:
174	174	(1) include information on:
175	175	(A) recognizing the signs and symptoms of
176	176	anaphylaxis or an opioid-related drug overdose;
177	177	(B) administering an epinephrine auto-injector
178	178	or opioid antagonist;
179	179	(C) implementing emergency procedures, if
180	180	necessary, after administering an epinephrine auto-injector or
181	181	opioid antagonist; and
182	182	(D) properly disposing of used or expired
183	183	epinephrine auto-injectors or opioid antagonists;
184	184	(2) be provided in a formal training session or
185	185	through online education; and
186	186	(3) be provided in accordance with the policy adopted
187	187	under Section 21.4515.
188	188	SECTION 10. The heading to Section 38.211, Education Code,
189	189	is amended to read as follows:
190	190	Sec. 38.211. PRESCRIPTION OF EPINEPHRINE AUTO-INJECTORS,
191	191	OPIOID ANTAGONISTS, AND ASTHMA MEDICINE.
192	192	SECTION 11. Sections 38.211(a), (b), (c), (e), and (f),
193	193	Education Code, are amended to read as follows:
194	194	(a) A physician or person who has been delegated
195	195	prescriptive authority under Chapter 157, Occupations Code, may
196	196	prescribe epinephrine auto-injectors, opioid antagonists, or
197	197	asthma medicine in the name of a school district, open-enrollment
198	198	charter school, or private school.
199	199	(b) A physician or other person who prescribes epinephrine
200	200	auto-injectors, opioid antagonists, or asthma medicine under
201	201	Subsection (a) shall provide the school district, open-enrollment
202	202	charter school, or private school with a standing order for the
203	203	administration of, as applicable:
204	204	(1) an epinephrine auto-injector to a person
205	205	reasonably believed to be experiencing anaphylaxis; [or]
206	206	(2) an opioid antagonist to a person reasonably
207	207	believed to be experiencing an opioid-related drug overdose; or
208	208	(3) asthma medicine to a person reasonably believed to
209	209	be experiencing a symptom of asthma and who has provided written
210	210	notification and permission as required by Section 38.208(b-1).
211	211	(c) The standing order under Subsection (b) is not required
212	212	to be patient-specific, and the epinephrine auto-injector, opioid
213	213	antagonist, or asthma medicine may be administered to a person
214	214	without a previously established physician-patient relationship.
215	215	(e) An order issued under this section must contain:
216	216	(1) the name and signature of the prescribing
217	217	physician or other person;
218	218	(2) the name of the school district, open-enrollment
219	219	charter school, or private school to which the order is issued;
220	220	(3) the quantity of epinephrine auto-injectors,
221	221	opioid antagonists, or asthma medicine to be obtained and
222	222	maintained under the order; and
223	223	(4) the date of issue.
224	224	(f) A pharmacist may dispense an epinephrine auto-injector,
225	225	opioid antagonist, or asthma medicine to a school district,
226	226	open-enrollment charter school, or private school without
227	227	requiring the name or any other identifying information relating to
228	228	the user.
229	229	SECTION 12. Section 38.215(a), Education Code, is amended
230	230	to read as follows:
231	231	(a) A person who in good faith takes, or fails to take, any
232	232	action under this subchapter is immune from civil or criminal
233	233	liability or disciplinary action resulting from that action or
234	234	failure to act, including:
235	235	(1) issuing an order for epinephrine auto-injectors,
236	236	opioid antagonists, or asthma medicine;
237	237	(2) supervising or delegating the administration of an
238	238	epinephrine auto-injector, an opioid antagonist, or asthma
239	239	medicine;
240	240	(3) possessing, maintaining, storing, or disposing of
241	241	an epinephrine auto-injector, an opioid antagonist, or asthma
242	242	medicine;
243	243	(4) prescribing an epinephrine auto-injector, an
244	244	opioid antagonist, or asthma medicine;
245	245	(5) dispensing:
246	246	(A) an epinephrine auto-injector; [or]
247	247	(B) an opioid antagonist; or
248	248	(C) asthma medicine, provided that permission
249	249	has been granted as provided by Section 38.208(b-1);
250	250	(6) administering, or assisting in administering, an
251	251	epinephrine auto-injector, an opioid antagonist, or asthma
252	252	medicine, provided that permission has been granted as provided by
253	253	Section 38.208(b-1);
254	254	(7) providing, or assisting in providing, training,
255	255	consultation, or advice in the development, adoption, or
256	256	implementation of policies, guidelines, rules, or plans; or
257	257	(8) undertaking any other act permitted or required
258	258	under this subchapter.
259	259	SECTION 13. Chapter 51, Education Code, is amended by
260	260	adding Subchapter Y-2 to read as follows:
261	261	SUBCHAPTER Y-2. PROVIDING OPIOID ANTAGONISTS
262	262	Sec. 51.891. DEFINITIONS. In this subchapter:
263	263	(1) "Campus" means an educational unit under the
264	264	management and control of an institution of higher education or
265	265	private or independent institution of higher education and may
266	266	include, in addition to the main campus, off-campus and secondary
267	267	locations, such as branch campuses, teaching locations, and
268	268	regional centers.
269	269	(2) "Employee" means an employee of an institution of
270	270	higher education or private or independent institution of higher
271	271	education.
272	272	(3) "Institution of higher education" and "private or
273	273	independent institution of higher education" have the meanings
274	274	assigned by Section 61.003.
275	275	(4) "Opioid antagonist" and "opioid-related drug
276	276	overdose" have the meanings assigned by Section 483.101, Health and
277	277	Safety Code.
278	278	(5) "Physician" means a person who holds a license to
279	279	practice medicine in this state.
280	280	Sec. 51.892. POLICY REGARDING OPIOID ANTAGONISTS. (a)
281	281	Each institution of higher education or private or independent
282	282	institution of higher education may adopt and implement a policy
283	283	providing for:
284	284	(1) the availability of opioid antagonists at
285	285	locations throughout the institution's campus, including
286	286	provisions for the acquisition, maintenance, storage,
287	287	administration, and disposal of those devices; and
288	288	(2) the training of employees and student volunteers
289	289	in the proper use of those devices.
290	290	(b) A policy adopted under Subsection (a) must provide that
291	291	employees and student volunteers who are authorized and trained may
292	292	administer an opioid antagonist to a person who is reasonably
293	293	believed to be experiencing an opioid-related drug overdose on the
294	294	institution's campus.
295	295	(c) The Texas Higher Education Coordinating Board with
296	296	advice from the commissioner of state health services shall adopt
297	297	rules regarding the maintenance, storage, administration, and
298	298	disposal of an opioid antagonist to be used on the campus of an
299	299	institution that adopts a policy under Subsection (a). The rules
300	300	must establish:
301	301	(1) a process for each institution to check the
302	302	inventory of opioid antagonists at regular intervals for expiration
303	303	and replacement; and
304	304	(2) an amount of training required for employees and
305	305	student volunteers to administer an opioid antagonist.
306	306	(d) Each institution that adopts a policy under Subsection
307	307	(a) must include the policy in the institution's student handbook
308	308	or similar publication and publish the policy on the institution's
309	309	Internet website.
310	310	(e) The supply of opioid antagonists at a campus must be
311	311	stored in secure locations and be easily accessible to employees
312	312	and student volunteers authorized and trained to administer an
313	313	opioid antagonist.
314	314	Sec. 51.893. REPORT ON ADMINISTERING OPIOID ANTAGONIST.
315	315	(a) Not later than the 10th business day after the date an employee
316	316	or student volunteer administers an opioid antagonist in accordance
317	317	with a policy adopted under Section 51.892, the institution of
318	318	higher education or private or independent institution of higher
319	319	education shall report the information required under Subsection
320	320	(b) to the physician who prescribed the opioid antagonist.
321	321	(b) The report required under this section must include the
322	322	following information:
323	323	(1) the age of the person who received the
324	324	administration of the opioid antagonist;
325	325	(2) whether the person who received the administration
326	326	of the opioid antagonist was a student, employee, or visitor;
327	327	(3) the physical location where the opioid antagonist
328	328	was administered;
329	329	(4) the number of doses of opioid antagonist
330	330	administered;
331	331	(5) the title of the person who administered the
332	332	opioid antagonist; and
333	333	(6) any other information required by the commissioner
334	334	of higher education.
335	335	Sec. 51.894. TRAINING. (a) Each institution of higher
336	336	education or private or independent institution of higher education
337	337	is responsible for training employees and student volunteers in the
338	338	administration of an opioid antagonist.
339	339	(b) Training required under this section must:
340	340	(1) include information on:
341	341	(A) recognizing the signs and symptoms of an
342	342	opioid-related drug overdose;
343	343	(B) administering an opioid antagonist;
344	344	(C) implementing emergency procedures, if
345	345	necessary, after administering an opioid antagonist;
346	346	(D) the required alerting of emergency medical
347	347	services during or immediately after the administration of the
348	348	opioid antagonist; and
349	349	(E) properly disposing of used or expired opioid
350	350	antagonists;
351	351	(2) be provided along with any other mandatory
352	352	training the institution imposes, in a formal training session or
353	353	through online education, and be completed annually; and
354	354	(3) provide an opportunity to address frequently asked
355	355	questions.
356	356	(c) Each institution shall maintain records on the training
357	357	required under this section.
358	358	Sec. 51.895. PRESCRIPTION OF OPIOID ANTAGONISTS. (a) A
359	359	physician may prescribe opioid antagonists in the name of an
360	360	institution of higher education or private or independent
361	361	institution of higher education. The physician shall provide the
362	362	institution with a standing order for the administration of an
363	363	opioid antagonist to a person reasonably believed to be
364	364	experiencing an opioid-related drug overdose.
365	365	(b) The standing order under Subsection (a) is not required
366	366	to be patient-specific, and the opioid antagonist may be
367	367	administered to a person without an established physician-patient
368	368	relationship.
369	369	(c) Notwithstanding any other provisions of law,
370	370	supervision or delegation by a physician is considered adequate if
371	371	the physician:
372	372	(1) periodically reviews the order; and
373	373	(2) is available through direct telecommunication as
374	374	needed for consultation, assistance, and direction.
375	375	(d) An order issued under this section must contain:
376	376	(1) the name and signature of the prescribing
377	377	physician;
378	378	(2) the name of the institution of higher education or
379	379	private or independent institution of higher education to which the
380	380	order is issued;
381	381	(3) the quantity of opioid antagonists to be obtained
382	382	and maintained under the order; and
383	383	(4) the date of issue.
384	384	(e) A pharmacist may dispense an opioid antagonist to an
385	385	institution for purposes of this subchapter without requiring the
386	386	name or any other identifying information relating to the user.
387	387	Sec. 51.896. GIFTS, GRANTS, AND DONATIONS. An institution
388	388	of higher education or private or independent institution of higher
389	389	education may accept gifts, grants, donations, and federal funds to
390	390	implement this subchapter.
391	391	Sec. 51.897. RULES. The commissioner of higher education
392	392	shall adopt rules necessary to implement this subchapter.
393	393	Sec. 51.898. IMMUNITIES. (a) A person who in good faith
394	394	takes, or fails to take, any action under this subchapter is immune
395	395	from civil or criminal liability or disciplinary action resulting
396	396	from that act or failure to act, including:
397	397	(1) issuing an order for opioid antagonists;
398	398	(2) supervising or delegating the administration of an
399	399	opioid antagonist;
400	400	(3) possessing an opioid antagonist;
401	401	(4) maintaining an opioid antagonist;
402	402	(5) storing an opioid antagonist;
403	403	(6) disposing of an opioid antagonist;
404	404	(7) prescribing an opioid antagonist;
405	405	(8) dispensing an opioid antagonist;
406	406	(9) administering, or assisting in administering, an
407	407	opioid antagonist;
408	408	(10) providing, or assisting in providing, training,
409	409	consultation, or advice in the development, adoption, or
410	410	implementation of policies, guidelines, rules, or plans regarding
411	411	the availability and use of an opioid antagonist; or
412	412	(11) undertaking any other act permitted or required
413	413	under this subchapter.
414	414	(b) The immunity provided by Subsection (a) is in addition
415	415	to other immunity or limitations of liability provided by law.
416	416	(c) Notwithstanding any other law, this subchapter does not
417	417	create a civil, criminal, or administrative cause of action or
418	418	liability or create a standard of care, obligation, or duty that
419	419	provides the basis for a cause of action for an act or omission
420	420	under this subchapter.
421	421	(d) An institution of higher education or private or
422	422	independent institution of higher education is immune from suit
423	423	resulting from an act, or failure to act, of any person under this
424	424	subchapter, including an act or failure to act under related
425	425	policies and procedures.
426	426	(e) A cause of action does not arise from an act or omission
427	427	described by this section.
428	428	(f) A person acting in good faith who reports or requests
429	429	emergency medical assistance for a person who is reasonably
430	430	believed to be experiencing an opioid-related drug overdose on
431	431	campus:
432	432	(1) is immune from civil liability, and from criminal
433	433	liability for offenses under Section 481.115(b), 481.1151(b)(1),
434	434	481.116(b), 481.1161(b)(1) or (2), 481.117(b), 481.118(b),
435	435	481.119(b), 481.121(b)(1) or (2), 481.125(a), 483.041(a), or
436	436	485.031(a), Health and Safety Code, that might otherwise be
437	437	incurred or imposed as a result of those actions; and
438	438	(2) may not be subjected to any disciplinary action by
439	439	the institution of higher education or private or independent
440	440	institution of higher education at which the person is enrolled or
441	441	employed for any violation by the person of the institution's code
442	442	of conduct reasonably related to the incident unless suspension or
443	443	expulsion from the institution is a possible punishment.
444	444	SECTION 14. This Act applies beginning with the 2023-2024
445	445	school year or academic year, as applicable.
446	446	SECTION 15. This Act takes effect immediately if it
447	447	receives a vote of two-thirds of all the members elected to each
448	448	house, as provided by Section 39, Article III, Texas Constitution.
449	449	If this Act does not receive the vote necessary for immediate
450	450	effect, this Act takes effect September 1, 2023.