88R20867 CXP-F
 
  By: Talarico, Oliverson, Leo-Wilson, Howard, H.B. No. 2411
      Zwiener, et al.
 
  Substitute the following for H.B. No. 2411:
 
  By:  Buckley C.S.H.B. No. 2411
 
 
 
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.