88R11675 GCB-D     By: Guerra H.B. No. 3735       A BILL TO BE ENTITLED   AN ACT   relating to the administration of opioid antagonists by a school   nurse at public school campuses.          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, [AND] ASTHMA MEDICINE, AND OPIOID   ANTAGONISTS          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.          SECTION 3.  The heading to Section 38.208, Education Code,   is amended to read as follows:          Sec. 38.208.  MAINTENANCE, [AND] ADMINISTRATION, AND   DISPOSAL OF EPINEPHRINE AUTO-INJECTORS, [AND] ASTHMA MEDICINE, AND   OPIOID ANTAGONISTS.          SECTION 4.  Section 38.208, Education Code, is amended by   adding Subsections (a-2) and (c-1) and amending Subsections (c) and   (e) to read as follows:          (a-2)  Each school district and open-enrollment charter   school shall adopt and implement a policy authorizing a school   nurse to maintain, administer, and dispose of an opioid antagonist   at each campus of the district or school.          (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:                (1)  the maintenance, administration, and disposal of   an epinephrine auto-injector at a school campus subject to a policy   adopted under Subsection (a);                (2)  [and] the maintenance and administration of asthma   medicine at a school campus subject to a policy adopted under   Subsection (a-1); and                (3)  the maintenance, administration, and disposal of   an opioid antagonist at a school campus in accordance with a policy   adopted under Subsection (a-2).          (c-1)  The rules adopted under Subsection (c) must   establish:                (1)  the number of epinephrine auto-injectors   available at each campus;                (2)  the amount of prescription asthma medicine   available at each campus;                (3)  the amount and type of opioid antagonists   available at each campus;                (4)  the process for a [each] school district,   open-enrollment charter school, and private school, as applicable,   to check the inventory of epinephrine auto-injectors, [and] asthma   medicine, and opioid antagonists at regular intervals for   expiration and replacement; and                (5) [(4)]  the amount of training required for school   personnel and school volunteers to administer an epinephrine   auto-injector.          (e)  The supply of epinephrine auto-injectors 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.  The supply of asthma   medicine and opioid antagonists at each campus must be stored in a   secure location and be easily accessible to the school nurse.          SECTION 5.  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 in accordance   with a policy adopted under Section 38.208(a), or a school nurse   administers an opioid antagonist under Section 38.208(a-2), 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, as applicable;                (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, as applicable;                (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 6.  The heading to Section 38.211, Education Code,   is amended to read as follows:          Sec. 38.211.  PRESCRIPTION OF EPINEPHRINE AUTO-INJECTORS,   [AND] ASTHMA MEDICINE, AND OPIOID ANTAGONISTS.          SECTION 7.  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:                (1)  epinephrine auto-injectors or asthma medicine in   the name of a school district, open-enrollment charter school, or   private school; or                (2)  opioid antagonists in the name of a school   district or open-enrollment charter school.          (b)  A physician or other person who prescribes epinephrine   auto-injectors, [or] asthma medicine, or 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, as applicable:                (1)  an epinephrine auto-injector to a person   reasonably believed to be experiencing anaphylaxis; [or]                (2)  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); or                (3)  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 epinephrine auto-injector, [or]   asthma medicine, or opioid antagonist 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, [or]   asthma medicine, or opioid antagonists to be obtained and   maintained under the order; and                (4)  the date of issue.          (f)  A pharmacist may dispense, without requiring the name or   any other identifying information relating to the user:                (1)  an epinephrine auto-injector or asthma medicine to   a school district, open-enrollment charter school, or private   school; or                (2)  an opioid antagonist to a school district or   open-enrollment charter school [without requiring the name or any   other identifying information relating to the user].          SECTION 8.  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,   [or] asthma medicine, or opioid antagonists;                (2)  supervising or delegating the administration of an   epinephrine auto-injector or asthma medicine;                (3)  possessing, maintaining, storing, or disposing of   an epinephrine auto-injector, [or] asthma medicine, or opioid   antagonist;                (4)  prescribing an epinephrine auto-injector, [or]   asthma medicine, or opioid antagonist;                (5)  dispensing:                      (A)  an epinephrine auto-injector or opioid   antagonist; or                      (B)  asthma medicine, provided that permission   has been granted as provided by Section 38.208(b-1);                (6)  administering, or assisting in administering:                      (A)  [,] an epinephrine auto-injector or opioid   antagonist; or                      (B)  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 9.  This Act applies beginning with the 2023-2024   school year.          SECTION 10.  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.