By: Menéndez, et al.  S.B. No. 629
         (In the Senate - Filed January 26, 2023; February 17, 2023,
  read first time and referred to Committee on Education;
  May 1, 2023, reported adversely, with favorable Committee
  Substitute by the following vote:  Yeas 12, Nays 0; May 1, 2023,
  sent to printer.)
Click here to see the committee vote
 
  COMMITTEE SUBSTITUTE FOR S.B. No. 629 By:  West
 
 
A BILL TO BE ENTITLED
 
AN ACT
 
  relating to the use of opioid antagonists on public and private
  school campuses and at or in transit to or from off-campus school
  events 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.  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 medicine
  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 MEDICINE 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 medicine [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
               (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), (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 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,
  an 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 38.212, Education Code, is amended to
  read as follows:
         Sec. 38.212.  NOTICE TO PARENTS. (a)  Each [If a] school
  district, open-enrollment charter school, or private school
  [implements a policy under this subchapter, the district or school]
  shall provide written notice to a parent or guardian of each student
  enrolled in the district or school regarding any policies the
  district or school implements under this subchapter.
         (b)  Notice required under this section must be provided
  before a policy is implemented by the district or school and before
  the start of each school year.
         SECTION 13.  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 14.  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, 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 15.  This Act applies beginning with the 2023-2024
  school year.
         SECTION 16.  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.
 
  * * * * *