| |
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A BILL TO BE ENTITLED
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AN ACT
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relating to the use of opioid antagonists on the campuses of public |
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and private schools and institutions of higher education and at or |
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in transit to or from off-campus school events. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. The heading to Subchapter E, Chapter 38, |
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Education Code, is amended to read as follows: |
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SUBCHAPTER E. MAINTENANCE, [AND] ADMINISTRATION, AND DISPOSAL OF |
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EPINEPHRINE AUTO-INJECTORS, OPIOID ANTAGONISTS, AND ASTHMA |
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|
MEDICINE |
|
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SECTION 2. Section 38.201, Education Code, is amended by |
|
|
adding Subdivision (3-a) to read as follows: |
|
|
(3-a) "Opioid antagonist" and "opioid-related drug |
|
|
overdose" have the meanings assigned by Section 483.101, Health and |
|
|
Safety Code. |
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|
SECTION 3. Sections 38.202(a) and (b), Education Code, are |
|
|
amended to read as follows: |
|
|
(a) The commissioner of state health services shall |
|
|
establish 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. |
|
|
(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 |
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|
(4) at least one member is an employee of a public |
|
|
junior college or a public technical institute. |
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|
SECTION 4. 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: |
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|
(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 5. 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 6. Sections 38.208(a), (b), (c), (d), 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. |
|
|
(d) Each school district, open-enrollment charter school, |
|
|
and private school that adopts a policy under Subsection (a) must |
|
|
require that each campus have one or more school personnel members |
|
|
or school volunteers authorized and trained to administer an |
|
|
epinephrine auto-injector or an opioid antagonist, as applicable, |
|
|
present during all hours the campus is open. |
|
|
(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 7. 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 8. 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 9. 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 10. 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 11. 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 12. 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. REQUIRED POLICY REGARDING OPIOID ANTAGONISTS. |
|
|
(a) Each institution of higher education or private or independent |
|
|
institution of higher education shall 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) The 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 commissioner of 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 subject to a policy adopted |
|
|
under Subsection (a). The rules must establish: |
|
|
(1) the process for each institution to check the |
|
|
inventory of opioid antagonists at regular intervals for expiration |
|
|
and replacement; and |
|
|
(2) the amount of training required for employees and |
|
|
student volunteers to administer an opioid antagonist. |
|
|
(d) Each institution shall include the policy on opioid |
|
|
antagonists 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 |
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|
under this subchapter. |
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(d) An institution of higher education or private or |
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|
independent institution of higher education is immune from suit |
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|
resulting from an act, or failure to act, of any person under this |
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|
subchapter, including an act or failure to act under related |
|
|
policies and procedures. |
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|
(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 13. This Act applies beginning with the 2023-2024 |
|
|
school year or academic year, as applicable. |
|
|
SECTION 14. 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. |