88R17177 CXP-D
By: Cortez, Campos, Guerra H.B. No. 4058
A BILL TO BE ENTITLED
AN ACT
relating to the use of opioid antagonists on the campuses of public
and private schools and institutions of higher education and at or
in transit to or from off-campus school events.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. The heading to Subchapter E, Chapter 38,
Education Code, is amended to read as follows:
SUBCHAPTER E. MAINTENANCE, [AND] ADMINISTRATION, AND DISPOSAL OF
EPINEPHRINE AUTO-INJECTORS, OPIOID ANTAGONISTS, AND ASTHMA
MEDICINE
SECTION 2. Section 38.201, Education Code, is amended by
amending Subdivision (1) and adding Subdivision (3-a) to read as
follows:
(1) "Advisory committee" means the stock medication
advisory committee established under Section 38.202.
(3-a) "Opioid antagonist" and "opioid-related drug
overdose" have the meanings assigned by Section 483.101, Health and
Safety Code.
SECTION 3. The heading to Section 38.202, Education Code,
is amended to read as follows:
Sec. 38.202. STOCK MEDICATION ADVISORY COMMITTEE:
ESTABLISHMENT AND COMPOSITION.
SECTION 4. Sections 38.202(a) and (b), Education Code, are
amended to read as follows:
(a) The commissioner of state health services shall
establish a stock medication [an] advisory committee to examine and
review the administration of epinephrine auto-injectors to a person
experiencing an anaphylactic reaction, and opioid antagonists to a
person experiencing an apparent opioid-related drug overdose, on a
campus of a school district, an open-enrollment charter school, a
private school, or an institution of higher education or at an
off-campus school event or while in transit to or from a school
event.
(b) The advisory committee shall be composed of members
appointed by the commissioner of state health services. In making
appointments, the commissioner shall ensure that:
(1) a majority of the members are physicians with
expertise in treating anaphylaxis or opioid-related drug
overdoses, including physicians who specialize in the fields of
pediatrics, allergies, asthma, drug use disorders, and immunology;
(2) at least one member is a registered nurse employed
by a school district, open-enrollment charter school, or private
school as a school nurse;
(3) at least one member is an employee of a general
academic teaching institution; and
(4) at least one member is an employee of a public
junior college or a public technical institute.
SECTION 5. Section 38.207, Education Code, is amended to
read as follows:
Sec. 38.207. ADVISORY COMMITTEE: DUTIES. The advisory
committee shall advise the commissioner of state health services
on:
(1) the storage and maintenance of epinephrine
auto-injectors and opioid antagonists on school campuses and
campuses of institutions of higher education;
(2) the training of school personnel and school
volunteers, and of personnel and volunteers at institutions of
higher education, in the administration of an epinephrine
auto-injector and opioid antagonist; and
(3) a plan for:
(A) one or more school personnel members or
school volunteers trained in the administration of an epinephrine
auto-injector to be on each school campus; [and]
(B) one or more school personnel members or
school volunteers trained in the administration of an opioid
antagonist to be on each school campus;
(C) one or more personnel members or volunteers
of an institution of higher education trained in the administration
of an epinephrine auto-injector to be on each campus of an
institution of higher education; and
(D) one or more personnel members or volunteers
of an institution of higher education trained in the administration
of an opioid antagonist to be on each campus of an institution of
higher education.
SECTION 6. The heading to Section 38.208, Education Code,
is amended to read as follows:
Sec. 38.208. MAINTENANCE AND ADMINISTRATION OF EPINEPHRINE
AUTO-INJECTORS, OPIOID ANTAGONISTS, AND ASTHMA MEDICINE.
SECTION 7. Sections 38.208(a), (b), (c), and (e), Education
Code, are amended to read as follows:
(a) Each school district, open-enrollment charter school,
and private school may adopt and implement a policy regarding the
maintenance, administration, and disposal of epinephrine
auto-injectors or opioid antagonists at each campus in the district
or school.
(b) If a policy is adopted under Subsection (a), the policy,
as applicable:
(1) must provide that school personnel and school
volunteers who are authorized and trained may administer an
epinephrine auto-injector to a person who is reasonably believed to
be experiencing anaphylaxis, or an opioid antagonist to a person
who is reasonably believed to be experiencing an opioid-related
drug overdose, on a school campus; and
(2) may provide that school personnel and school
volunteers who are authorized and trained may administer an
epinephrine auto-injector to a person who is reasonably believed to
be experiencing anaphylaxis, or an opioid antagonist to a person
who is reasonably believed to be experiencing an opioid-related
drug overdose, at an off-campus school event or while in transit to
or from a school event.
(c) The executive commissioner of the Health and Human
Services Commission, in consultation with the commissioner of
education, and with advice from the advisory committee as
appropriate, shall adopt rules regarding the maintenance,
administration, and disposal of an epinephrine auto-injector and
opioid antagonist at a school campus subject to a policy adopted
under Subsection (a) and the maintenance and administration of
asthma medicine at a school campus subject to a policy adopted under
Subsection (a-1). The rules must establish:
(1) the number of epinephrine auto-injectors and
opioid antagonists available at each campus;
(2) the amount of prescription asthma medicine
available at each campus;
(3) the process for each school district,
open-enrollment charter school, and private school to check the
inventory of epinephrine auto-injectors, opioid antagonists, and
asthma medicine at regular intervals for expiration and
replacement; and
(4) the amount of training required for school
personnel and school volunteers to administer an epinephrine
auto-injector or opioid antagonist.
(e) The supply of epinephrine auto-injectors and opioid
antagonists at each campus must be stored in a secure location and
be easily accessible to school personnel and school volunteers
authorized and trained to administer an epinephrine auto-injector
or opioid antagonist. The supply of asthma medicine at each campus
must be stored in a secure location and be easily accessible to the
school nurse.
SECTION 8. Section 38.209, Education Code, is amended to
read as follows:
Sec. 38.209. REPORT ON ADMINISTERING EPINEPHRINE
AUTO-INJECTOR OR OPIOID ANTAGONIST. (a) Not later than the 10th
business day after the date a school personnel member or school
volunteer administers an epinephrine auto-injector or opioid
antagonist in accordance with a policy adopted under Section
38.208(a), the school shall report the information required under
Subsection (b) 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
epinephrine auto-injector or 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 epinephrine auto-injector or opioid
antagonist;
(2) whether the person who received the administration
of the epinephrine auto-injector or opioid antagonist was a
student, a school personnel member or school volunteer, or a
visitor;
(3) the physical location where the epinephrine
auto-injector or opioid antagonist was administered;
(4) the number of doses of epinephrine auto-injector
or opioid antagonist administered;
(5) the title of the person who administered the
epinephrine auto-injector or opioid antagonist; and
(6) any other information required by the commissioner
of education.
SECTION 9. Sections 38.210(a) and (b), Education Code, are
amended to read as follows:
(a) Each school district, open-enrollment charter school,
and private school that adopts a policy under Section 38.208(a) is
responsible for training school personnel and school volunteers in
the administration of an epinephrine auto-injector or opioid
antagonist.
(b) Training required under this section must:
(1) include information on:
(A) recognizing the signs and symptoms of
anaphylaxis or an opioid-related drug overdose;
(B) administering an epinephrine auto-injector
or opioid antagonist;
(C) implementing emergency procedures, if
necessary, after administering an epinephrine auto-injector or
opioid antagonist; and
(D) properly disposing of used or expired
epinephrine auto-injectors or 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.
SECTION 10. The heading to Section 38.211, Education Code,
is amended to read as follows:
Sec. 38.211. PRESCRIPTION OF EPINEPHRINE AUTO-INJECTORS,
OPIOID ANTAGONISTS, AND ASTHMA MEDICINE.
SECTION 11. Sections 38.211(a), (b), (c), (e), and (f),
Education Code, are amended to read as follows:
(a) A physician or person who has been delegated
prescriptive authority under Chapter 157, Occupations Code, may
prescribe epinephrine auto-injectors, opioid antagonists, or
asthma medicine in the name of a school district, open-enrollment
charter school, or private school.
(b) A physician or other person who prescribes epinephrine
auto-injectors, opioid antagonists, or asthma medicine under
Subsection (a) shall provide the school district, open-enrollment
charter school, or private school with a standing order for the
administration of, as applicable:
(1) an epinephrine auto-injector to a person
reasonably believed to be experiencing anaphylaxis; [or]
(2) an opioid antagonist to a person reasonably
believed to be experiencing an opioid-related drug overdose; or
(3) asthma medicine to a person reasonably believed to
be experiencing a symptom of asthma and who has provided written
notification and permission as required by Section 38.208(b-1).
(c) The standing order under Subsection (b) is not required
to be patient-specific, and the epinephrine auto-injector, opioid
antagonist, or asthma medicine may be administered to a person
without a previously established physician-patient relationship.
(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 epinephrine auto-injectors,
opioid antagonists, or asthma medicine to be obtained and
maintained under the order; and
(4) the date of issue.
(f) A pharmacist may dispense an epinephrine auto-injector,
opioid antagonist, or asthma medicine to a school district,
open-enrollment charter school, or private school without
requiring the name or any other identifying information relating to
the user.
SECTION 12. Section 38.215(a), Education Code, is amended
to read as follows:
(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 epinephrine auto-injectors,
opioid antagonists, or asthma medicine;
(2) supervising or delegating the administration of an
epinephrine auto-injector, an opioid antagonist, or asthma
medicine;
(3) possessing, maintaining, storing, or disposing of
an epinephrine auto-injector, an opioid antagonist, or asthma
medicine;
(4) prescribing an epinephrine auto-injector, an
opioid antagonist, or asthma medicine;
(5) dispensing:
(A) an epinephrine auto-injector; [or]
(B) an opioid antagonist; or
(C) asthma medicine, provided that permission
has been granted as provided by Section 38.208(b-1);
(6) administering, or assisting in administering, an
epinephrine auto-injector, an opioid antagonist, or asthma
medicine, provided that permission has been granted as provided by
Section 38.208(b-1);
(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.
SECTION 13. Chapter 51, Education Code, is amended by
adding Subchapter Y-2 to read as follows:
SUBCHAPTER Y-2. PROVIDING OPIOID ANTAGONISTS
Sec. 51.891. DEFINITIONS. In this subchapter:
(1) "Campus" means an educational unit under the
management and control of an institution of higher education or
private or independent institution of higher education and may
include, in addition to the main campus, off-campus and secondary
locations, such as branch campuses, teaching locations, and
regional centers.
(2) "Employee" means an employee of an institution of
higher education or private or independent institution of higher
education.
(3) "Institution of higher education" and "private or
independent institution of higher education" have the meanings
assigned by Section 61.003.
(4) "Opioid antagonist" and "opioid-related drug
overdose" have the meanings assigned by Section 483.101, Health and
Safety Code.
(5) "Physician" means a person who holds a license to
practice medicine in this state.
Sec. 51.892. POLICY REGARDING OPIOID ANTAGONISTS. (a)
Each institution of higher education or private or independent
institution of higher education may adopt and implement a policy
providing for:
(1) the availability of opioid antagonists at
locations throughout the institution's campus, including
provisions for the acquisition, maintenance, storage,
administration, and disposal of those devices; and
(2) the training of employees and student volunteers
in the proper use of those devices.
(b) A policy adopted under Subsection (a) must provide that
employees and student 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 on the
institution's campus.
(c) The Texas Higher Education Coordinating Board with
advice from the commissioner of state health services shall adopt
rules regarding the maintenance, storage, administration, and
disposal of an opioid antagonist to be used on the campus of an
institution that adopts a policy under Subsection (a). The rules
must establish:
(1) a process for each institution to check the
inventory of opioid antagonists at regular intervals for expiration
and replacement; and
(2) an amount of training required for employees and
student volunteers to administer an opioid antagonist.
(d) Each institution that adopts a policy under Subsection
(a) must include the policy in the institution's student handbook
or similar publication and publish the policy on the institution's
Internet website.
(e) The supply of opioid antagonists at a campus must be
stored in secure locations and be easily accessible to employees
and student volunteers authorized and trained to administer an
opioid antagonist.
Sec. 51.893. REPORT ON ADMINISTERING OPIOID ANTAGONIST.
(a) Not later than the 10th business day after the date an employee
or student volunteer administers an opioid antagonist in accordance
with a policy adopted under Section 51.892, the institution of
higher education or private or independent institution of higher
education shall report the information required under Subsection
(b) to the physician who prescribed the opioid antagonist.
(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, employee, or 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 higher education.
Sec. 51.894. TRAINING. (a) Each institution of higher
education or private or independent institution of higher education
is responsible for training employees and student 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;
(D) the required alerting of emergency medical
services during or immediately after the administration of the
opioid antagonist; and
(E) properly disposing of used or expired opioid
antagonists;
(2) be provided along with any other mandatory
training the institution imposes, in a formal training session or
through online education, and be completed annually; and
(3) provide an opportunity to address frequently asked
questions.
(c) Each institution shall maintain records on the training
required under this section.
Sec. 51.895. PRESCRIPTION OF OPIOID ANTAGONISTS. (a) A
physician may prescribe opioid antagonists in the name of an
institution of higher education or private or independent
institution of higher education. The physician shall provide the
institution with a standing order for the administration of an
opioid antagonist to a person reasonably believed to be
experiencing an opioid-related drug overdose.
(b) The standing order under Subsection (a) is not required
to be patient-specific, and the opioid antagonist may be
administered to a person without an established physician-patient
relationship.
(c) 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.
(d) An order issued under this section must contain:
(1) the name and signature of the prescribing
physician;
(2) the name of the institution of higher education or
private or independent institution of higher education 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.
(e) A pharmacist may dispense an opioid antagonist to an
institution for purposes of this subchapter without requiring the
name or any other identifying information relating to the user.
Sec. 51.896. GIFTS, GRANTS, AND DONATIONS. An institution
of higher education or private or independent institution of higher
education may accept gifts, grants, donations, and federal funds to
implement this subchapter.
Sec. 51.897. RULES. The commissioner of higher education
shall adopt rules necessary to implement this subchapter.
Sec. 51.898. IMMUNITIES. (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 act or failure to act, including:
(1) issuing an order for opioid antagonists;
(2) supervising or delegating the administration of an
opioid antagonist;
(3) possessing an opioid antagonist;
(4) maintaining an opioid antagonist;
(5) storing an opioid antagonist;
(6) disposing of an opioid antagonist;
(7) prescribing an opioid antagonist;
(8) dispensing an opioid antagonist;
(9) administering, or assisting in administering, an
opioid antagonist;
(10) providing, or assisting in providing, training,
consultation, or advice in the development, adoption, or
implementation of policies, guidelines, rules, or plans regarding
the availability and use of an opioid antagonist; or
(11) undertaking any other act permitted or required
under this subchapter.
(b) The immunity provided by Subsection (a) is in addition
to other immunity 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 the basis for a cause of action for an act or omission
under this subchapter.
(d) An institution of higher education or private or
independent institution of higher education is immune from suit
resulting from an act, or failure to act, of any person under this
subchapter, including an act or failure to act under related
policies and procedures.
(e) A cause of action does not arise from an act or omission
described by this section.
(f) A person acting in good faith who reports or requests
emergency medical assistance for a person who is reasonably
believed to be experiencing an opioid-related drug overdose on
campus:
(1) is immune from civil liability, and from criminal
liability for offenses under Section 481.115(b), 481.1151(b)(1),
481.116(b), 481.1161(b)(1) or (2), 481.117(b), 481.118(b),
481.119(b), 481.121(b)(1) or (2), 481.125(a), 483.041(a), or
485.031(a), Health and Safety Code, that might otherwise be
incurred or imposed as a result of those actions; and
(2) may not be subjected to any disciplinary action by
the institution of higher education or private or independent
institution of higher education at which the person is enrolled or
employed for any violation by the person of the institution's code
of conduct reasonably related to the incident unless suspension or
expulsion from the institution is a possible punishment.
SECTION 14. This Act applies beginning with the 2023-2024
school year or academic year, as applicable.
SECTION 15. 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.