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.