California-2023-AB1915-Amended

Amended IN Assembly April 01, 2024

CALIFORNIA LEGISLATURE— 2023–2024 REGULAR SESSION

Assembly Bill

No. 1915

Introduced by Assembly Member Arambula

January 24, 2024

An act to amend Section 49414.3 of, and to add Article 5.5 (commencing with Section 49478) to Chapter 9 of Part 27 of Division 4 of Title 2 of, the Education Code, relating to pupil health.

LEGISLATIVE COUNSEL'S DIGEST

AB 1915, as amended, Arambula. Pupil health: drug education: opioid overdose training program.

Existing law requires instruction to be given in the elementary and secondary schools by appropriately trained instructors on drug education and the effects of the use of tobacco, alcohol, narcotics, dangerous drugs, as defined, and other dangerous substances. Existing law authorizes a public or private elementary or secondary school to determine whether or not to make emergency naloxone hydrochloride or another opioid antagonist and trained personnel available at its school, and to designate one or more volunteers to receive related training to address an opioid overdose, as specified.

Commencing with the 2023–24 fiscal year, and for each fiscal year thereafter, existing law appropriates $3,500,000 from the General Fund to the State Department of Education for allocation to county offices of education for the purpose of purchasing and maintaining a sufficient stock of emergency opioid antagonists for school districts and charter schools within their jurisdiction to maintain a minimum of two units at each middle school, junior high school, high school, and adult school schoolsite, as provided.

This bill would require school districts, county offices of education, and charter schools that voluntarily determine to make naloxone hydrochloride or another opioid antagonist available on campus to ensure that the naloxone hydrochloride or another opioid antagonist is placed in an appropriate location that is widely known and easily accessible, during school hours and after school hours. The bill would require the naloxone hydrochloride or another opioid antagonist to be located on campus in at least one of several specified locations.

This bill would require the State Department of Public Health to develop an opioid overdose training program and program toolkit, as defined, to be made available to public high schools for public high school pupils to be trained on how to identify and respond to an opioid overdose, including by administering a federally approved opioid overdose reversal medication, as provided. The bill would require the department, by July 1, 2026, to notify public high schools of the availability of the program toolkit. The bill would require the department to provide the program toolkit upon request to those public high schools that opt to host the program on their ~~campuses and to consider making its representatives available to provide the training onsite at public schools upon request. The bill would require the department to~~ campuses, and to collaborate with local, state, and national organizations, as provided, to provide pupils with integrated, comprehensive, accurate, and unbiased educational materials on opioid and drug overdose prevention, opioid and drug safety, and stigma reduction. The bill would require the department to collect, on an annual basis, data on the number of pupils participating in the program and to share this information with the Legislature and the Senate and Assembly Budget Subcommittees on Education, Health, and Human Services, as provided.

Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO

The people of the State of California do enact as follows:

SECTION 1.

The Legislature finds and declares all of the following:

(a) The fentanyl crisis among California youth is an urgent public health emergency. Youth overdose rates continue to rise in California, corresponding with the increasing presence of the potent synthetic opioid, Fentanyl, and other related analogs. Fentanyl contributes to more than 80 percent of all drug-related overdose deaths among young people.

(b) The opioid antagonist medication, naloxone hydrochloride, is designed to rapidly reverse an opioid overdose. This medication is available in a safe, easy-to-use nasal spray and in an injectable form. These are used to reduce preventable overdose fatalities. It is imperative that all pupils, faculty, and staff are aware of the location of naloxone hydrochloride on school campuses and understand how to identify the signs of an overdose and respond using an opioid antagonist medication.

(c) Senate Bill 114 of the 2023–24 Regular Session (Chapter 48 of the Statutes of 2023) prioritized opioid overdose prevention strategies and response measures by appropriating money for allocation to county offices of education for the purpose of purchasing and maintaining emergency opioid antagonists for school districts and charter schools.

SEC. 2.

Section 49414.3 of the Education Code is amended to read:

49414.3.

(a) School districts, county offices of education, and charter schools may provide emergency naloxone hydrochloride or another opioid antagonist to school nurses or trained personnel who have volunteered pursuant to subdivision (d), and school nurses or trained personnel may use naloxone hydrochloride or another opioid antagonist to provide emergency medical aid to persons suffering, or reasonably believed to be suffering, from an opioid overdose.

(b) For purposes of this section, the following terms have the following meanings:

(1) “Authorizing physician and surgeon” may include, but is not limited to, a physician and surgeon employed by, or contracting with, a local educational agency, a medical director of the local health department, or a local emergency medical services director.

(2) “Auto-injector” means a disposable delivery device designed for the automatic injection of a premeasured dose of an opioid antagonist into the human body and approved by the United States Food and Drug Administration for layperson use.

(3) “Opioid antagonist” means naloxone hydrochloride or another drug approved by the United States Food and Drug Administration that, when administered, negates or neutralizes in whole or in part the pharmacological effects of an opioid in the body, and has been approved for the treatment of an opioid overdose.

(4) “Qualified supervisor of health” may include, but is not limited to, a school nurse.

(5) “Volunteer” or “trained personnel” means an employee who has volunteered to administer naloxone hydrochloride or another opioid antagonist to a person if the person is suffering, or is reasonably believed to be suffering, from an opioid overdose, has been designated by a school, and has received training pursuant to subdivision (d).

(c) Each public and private elementary and secondary school in the state may voluntarily determine whether or not to make emergency naloxone hydrochloride or another opioid antagonist and trained personnel available at its school. In making this determination, a school shall evaluate the emergency medical response time to the school and determine whether initiating emergency medical services is an acceptable alternative to naloxone hydrochloride or another opioid antagonist and trained personnel. A private elementary or secondary school choosing to exercise the authority provided under this subdivision shall not receive state funds specifically for purposes of this subdivision.

(d) (1) Each public and private elementary and secondary school in the state may designate one or more volunteers to receive initial and annual refresher training, based on the standards developed pursuant to subdivision (e), regarding the storage and emergency use of naloxone hydrochloride or another opioid antagonist from the school nurse or other qualified person designated by an authorizing physician and surgeon. A benefit shall not be granted to or withheld from any individual based on their offer to volunteer, and there shall be no retaliation against any individual for rescinding their offer to volunteer, including after receiving training. Any school district, county office of education, or charter school choosing to exercise the authority provided under this subdivision shall provide the training for the volunteers at no cost to the volunteer and during the volunteer’s regular working hours or schoolday.

(2) An employee who volunteers pursuant to this section may rescind their offer to administer emergency naloxone hydrochloride or another opioid antagonist at any time, including after receipt of training.

(e) (1) The Superintendent shall establish minimum standards of training for the administration of naloxone hydrochloride or another opioid antagonist that satisfies the requirements of paragraph (2). Every five years, or sooner as deemed necessary by the Superintendent, the Superintendent shall review minimum standards of training for the administration of naloxone hydrochloride or other opioid antagonists that satisfy the requirements of paragraph (2). For purposes of this subdivision, the Superintendent shall consult with organizations and providers with expertise in administering naloxone hydrochloride or another opioid antagonist and administering medication in a school environment, including, but not limited to, the California Society of Addiction Medicine, the Emergency Medical Services Authority, the California School Nurses Organization, the California Medical Association, the American Academy of Pediatrics, and others.

(2) Training established pursuant to this subdivision shall include all of the following:

(A) Techniques for recognizing symptoms of an opioid overdose.

(B) Standards and procedures for the storage, restocking, and emergency use of naloxone hydrochloride or another opioid antagonist.

(C) Basic emergency followup procedures, including, but not limited to, a requirement for the school or charter school administrator or, if the administrator is not available, another school staff member to call the emergency 911 telephone number and to contact the pupil’s parent or guardian.

(D) Recommendations on the necessity of instruction and certification in cardiopulmonary resuscitation.

(E) Written materials covering the information required under this subdivision.

(3) Training established pursuant to this subdivision shall be consistent with the most recent guidelines for medication administration issued by the department.

(4) A school shall retain for reference the written materials prepared under subparagraph (E) of paragraph (2).

(5) The department shall include on its internet website a clearinghouse for best practices in training nonmedical personnel to administer naloxone hydrochloride or another opioid antagonist to individuals.

(f) Any school district, county office of education, or charter school electing to use naloxone hydrochloride or another opioid antagonist for emergency aid shall distribute a notice at least once per school year to all staff that contains the following information:

(1) A description of the volunteer request stating that the request is for volunteers to be trained to administer naloxone hydrochloride or another opioid antagonist to a person if the person is suffering, or reasonably believed to be suffering, from an opioid overdose.

(2) A description of the training that the volunteer will receive pursuant to subdivision (d).

(3) The right of an employee to rescind their offer to volunteer pursuant to this section.

(4) A statement that no benefit will be granted to or withheld from any individual based on their offer to volunteer and that there will be no retaliation against any individual for rescinding their offer to volunteer, including after receiving training.

(g) (1) A qualified supervisor of health at a school district, county office of education, or charter school electing to use naloxone hydrochloride or another opioid antagonist for emergency aid shall obtain from an authorizing physician and surgeon a prescription for each school for naloxone hydrochloride or another opioid antagonist. A qualified supervisor of health at a school district, county office of education, or charter school shall be responsible for stocking the naloxone hydrochloride or another opioid antagonist and restocking it if it is used.

(2) If a school district, county office of education, or charter school does not have a qualified supervisor of health, an administrator at the school district, county office of education, or charter school shall carry out the duties specified in paragraph (1).

(3) A prescription obtained pursuant to this subdivision may be filled by local or mail order pharmacies or opioid antagonist manufacturers.

(4) An authorizing physician and surgeon shall not be subject to professional review, be liable in a civil action, or be subject to criminal prosecution for the issuance of a prescription or order pursuant to this section, unless the physician and surgeon’s issuance of the prescription or order constitutes gross negligence or willful or malicious conduct.

(h) (1) A school nurse or, if the school does not have a school nurse or the school nurse is not onsite or available, a volunteer may administer naloxone hydrochloride or another opioid antagonist to a person exhibiting potentially life-threatening symptoms of an opioid overdose at school or a school activity when a physician is not immediately available. If the naloxone hydrochloride or another opioid antagonist is used it shall be restocked as soon as reasonably possible, but no later than two weeks after it is used. Naloxone hydrochloride or another opioid antagonist shall be restocked before its expiration date.

(2) Volunteers may administer naloxone hydrochloride or another opioid antagonist only by nasal spray or by auto-injector.

(3) A volunteer shall be allowed to administer naloxone hydrochloride or another opioid antagonist in a form listed in paragraph (2) that the volunteer is most comfortable with.

(i) A school district, county office of education, or charter school electing to use naloxone hydrochloride or another opioid antagonist for emergency aid shall ensure that each employee who volunteers under this section will be provided defense and indemnification by the school district, county office of education, or charter school for any and all civil liability, in accordance with, but not limited to, that provided in Division 3.6 (commencing with Section 810) of Title 1 of the Government Code. This information shall be reduced to writing, provided to the volunteer, and retained in the volunteer’s personnel file.

(j) (1) Notwithstanding any other law, a person trained as required under subdivision (d), who administers naloxone hydrochloride or another opioid antagonist, in good faith and not for compensation, to a person who appears to be experiencing an opioid overdose shall not be subject to professional review, be liable in a civil action, or be subject to criminal prosecution for their acts or omissions in administering the naloxone hydrochloride or another opioid antagonist.

(2) The protection specified in paragraph (1) shall not apply in a case of gross negligence or willful and wanton misconduct of the person who renders emergency care treatment by the use of naloxone hydrochloride or another opioid antagonist.

(3) Any public employee who volunteers to administer naloxone hydrochloride or another opioid antagonist pursuant to subdivision (d) is not providing emergency medical care “for compensation,” notwithstanding the fact that they are a paid public employee.

(k) A state agency, the department, or a public school may accept gifts, grants, and donations from any source for the support of the public school carrying out the provisions of this section, including, but not limited to, the acceptance of naloxone hydrochloride or another opioid antagonist from a manufacturer or wholesaler.

(l) Any school district, county office of education, or charter school that voluntarily determines to make naloxone hydrochloride or another opioid antagonist available on campus shall ensure that the naloxone hydrochloride or another opioid antagonist is placed in an appropriate location, as determined by the governing board or body, that is widely known and easily accessible, during school hours and after school hours. The naloxone hydrochloride or another opioid antagonist shall be located in at least one of the following locations on campus:

(1) School nurse’s office.

(2) Athletic trainer’s office.

(3) Front office.

(4) Performing arts auditorium.

(5) Library.

(6) Cafeteria.

(7) Athletic gym.

SEC. 3.

Article 5.5 (commencing with Section 49478) is added to Chapter 9 of Part 27 of Division 4 of Title 2 of the Education Code, to read:

Article 5.5. Opioid Overdose Prevention Training Program

49478.

(a) For purposes of this article, the following definitions apply:

(1) “Program” means the opioid overdose prevention training program established pursuant to subdivision (b).

(2) “Program toolkit” means the opioid overdose prevention training program materials necessary for a public high school to self-administer the program.

(3) “Public high school” means a public school serving pupils in grades 9 to 12, inclusive.

(b) (1) The State Department of Public Health shall develop an opioid overdose training program and program toolkit to be made available to public high schools for public high school pupils to be trained on how to identify and respond to an opioid overdose, including by administering a federally approved opioid overdose reversal medication.

(2) The program may include, but is not limited to, all of the following:

(A) Informational videos, graphics, and in-person training on what to do and how to respond during a drug or opioid overdose. The State Department of Public Health may use any existing content or other relevant materials already developed, or develop new materials.

(B) Information on how to recognize signs of a drug or opioid overdose.

(3) The program toolkit shall encourage and support opioid overdose training instruction in person at public high schools from appropriately trained instructors from local, state, and national organizations, which may include community health centers, community health experts, nonprofit organizations with related expertise, and school staff. Instructors who are not employed by the school shall undergo state-approved background checks.

(4) The program toolkit shall provide resource materials related to drug and opioid use or prevention, for appropriate use with pupils of all races, genders, sexual orientations, and ethnic and cultural backgrounds, pupils with disabilities, and English learners.

(5) The State Department of Public Health shall, by July 1, 2026, notify public high schools of the availability of the program toolkit.

(6) The State Department of Public Health shall provide the program toolkit upon request to those public high schools that opt to host the program on their campuses.

~~(7)The State Department of Public Health shall consider making its representatives available to provide the training onsite at public high schools upon request.~~

(c) The State Department of Public Health shall collaborate with local, state, and national organizations, which may include community health centers, community health experts, and nonprofit organizations with related expertise, to provide pupils with integrated, comprehensive, accurate, and unbiased educational materials on opioid and drug overdose prevention, opioid and drug safety, and stigma reduction.

(d)In order to determine the efficacy of program training resources and program drug and opioid prevention informational efforts, the State Department of Public Health shall, on an annual basis, collect data on the number of pupils participating in the program and share this information with the Legislature, in compliance with Section 9795 of the Government Code, and with the Senate and Assembly Budget Subcommittees on Education, Health, and Human Services.