New Jersey-2018-A4265-Introduced

An Act concerning the possession, administration, and dispensing of opioid antidotes by first responders, and amending P.L.2013, c.46.

Be It Enacted by the Senate and General Assembly of the State of New Jersey:

1. Section 3 of P.L.2013, c.46 (C.24:6J-3) is amended to read as follows:

3. As used in this act:

"Commissioner" means the Commissioner of [Human Services] Health.

"Drug overdose" means an acute condition including, but not limited to, physical illness, coma, mania, hysteria, or death resulting from the consumption or use of a controlled dangerous substance or another substance with which a controlled dangerous substance was combined and that a layperson would reasonably believe to require medical assistance.

"Emergency medical response entity" means an organization, company, governmental entity, community-based program, or healthcare system that provides pre-hospital emergency medical services and assistance to opioid or heroin addicts or abusers in the event of an overdose. "Emergency medical response entity" includes, but is not limited to, a first aid, rescue and ambulance squad or other basic life support (BLS) ambulance provider; a mobile intensive care provider or other advanced life support (ALS) ambulance provider; an air medical service provider; or a fire-fighting company or organization, which squad, provider, company, or organization is qualified to send paid or volunteer emergency medical responders to the scene of an emergency.

"Emergency medical responder" means a person, other than a health care practitioner or law enforcement officer, who is employed on a paid or volunteer basis in the area of emergency response, including, but not limited to, an emergency medical technician, a mobile intensive care paramedic, or a fire fighter, acting in that person's professional capacity.

"First responder" means a law enforcement officer or emergency medical responder.

"First response agency" means a law enforcement agency or emergency medical response entity that is qualified to dispatch first responders to the scene of an emergency for the purpose of providing medical care or other assistance.

"Health care practitioner" means a prescriber, pharmacist, or other individual whose professional practice is regulated pursuant to Title 45 of the Revised Statutes, and who, in accordance with the practitioner's scope of professional practice, prescribes or dispenses an opioid antidote.

"Law enforcement agency" means a department, division, bureau, commission, board, or other authority of the State, or of any political subdivision thereof, which employs law enforcement officers.

"Law enforcement officer" means any person whose public duties include the power to act as an officer for the detection, apprehension, arrest, and conviction of offenders against the laws of this State. "Law enforcement officer" includes any active member of a county or municipal police force or organization established pursuant to N.J.S.40A:14-106 or N.J.S.40A:14-118, and any active member of the State Police, regardless of whether such member operates on a temporary or permanent basis, or in a full-time or part-time capacity.

"Medical assistance" means professional medical services that are provided to a person experiencing a drug overdose by a health care practitioner, acting within the practitioner's scope of professional practice, including professional medical services that are mobilized through telephone contact with the 911 telephone emergency service.

"Opioid antidote" means any drug, regardless of dosage amount or method of administration, which has been approved by the United States Food and Drug Administration (FDA) for the treatment of an opioid overdose. "Opioid antidote" includes, but is not limited to, naloxone hydrochloride, in any dosage amount, which is administered through nasal spray or any other FDA-approved means or methods.

"Overdose victim" means a person whom an antidote recipient believes, in good faith, is experiencing an overdose from the use of heroin or other opioid drugs.

"Patient" means a person who is at risk of an opioid overdose or a person who is not at risk of an opioid overdose who, in the person's individual capacity, obtains an opioid antidote from a health care practitioner, from a professional[,] or professional entity , or from a first responder or first response agency for the purpose of administering that antidote to another person in an emergency, in accordance with subsection [c.] d. of section 4 of P.L.2013, c.46 (C.24:6J-4). "Patient" includes a law enforcement officer, professional , or emergency medical responder who is acting in that [professional's] person's individual capacity, but does not include a law enforcement officer, professional , or emergency medical responder who is acting in a professional capacity.

"Prescriber" means a health care practitioner authorized by law to prescribe medications who, acting within the practitioner's scope of professional practice, prescribes an opioid antidote. "Prescriber" includes, but is not limited to, a physician, physician assistant, or advanced practice nurse.

"Professional" means a person, other than a health care practitioner or law enforcement officer, who is employed on a paid basis or is engaged on a volunteer basis in the areas of substance abuse treatment or therapy, criminal justice, or a related area, and who, acting in that person's professional or volunteer capacity, either: obtains an opioid antidote from a health care practitioner for the purposes of dispensing [or administering] that antidote to other parties in the course of business or volunteer activities ; or obtains an opioid antidote from a health care practitioner, from a first responder or first response entity, or from another professional or professional entity for the purposes of administering that antidote to an overdose victim in the course of business or volunteer activities. "Professional" includes, but is not limited to, a sterile syringe access program employee [, or a law enforcement official].

"Professional entity" means an organization, company, governmental entity, community-based program, sterile syringe access program, or any other organized group that employs two or more professionals who engage, during the regular course of business or volunteer activities, in direct interactions with opioid or heroin addicts or abusers or other persons susceptible to opioid overdose, or with other persons who are in a position to provide direct medical assistance to opioid or heroin addicts or abusers in the event of an overdose.

"Recipient" means a patient, law enforcement officer, law enforcement agency, professional, professional entity, emergency medical responder, or emergency medical response entity who is prescribed or dispensed an opioid antidote in accordance with section 4 of P.L.2013, c.46 (C.24:6J-4).

(cf: P.L.2017, c.381, s.1)

2. Section 4 of P.L.2013, c.46 (C.24:6J-4) is amended to read as follows:

4. a. (1) A prescriber or other health care practitioner, as appropriate, may prescribe or dispense an opioid antidote:

(a) directly or through a standing order, to any [recipient] patient who is deemed by the health care practitioner to be capable of administering the opioid antidote to an overdose victim in an emergency;

(b) through a standing order, to any professional [or emergency medical responder who is not acting in a professional or volunteer capacity for a professional entity, or an emergency medical response entity, but] who is deemed by the health care practitioner to be capable of either administering opioid antidotes to overdose victims, [as part of the professional's regular course of business or volunteer activities;

(c) through a standing order, to any professional who is not acting in a professional or volunteer capacity for a professional entity, but who is deemed by the health care practitioner to be capable of] or dispensing opioid antidotes to recipients, for administration thereby to third-party overdose victims, as part of the professional's regular course of business or volunteer activities;

[(d)] (c) through a standing order, to any professional entity [or any emergency medical response entity, which] that is deemed by the health care practitioner to employ professionals [or emergency medical responders, as appropriate,] who are capable of either administering opioid antidotes to overdose victims [as part of the entity's regular course of business or volunteer activities;

(e) through a standing order, to any professional entity which is deemed by the health care practitioner to employ professionals who are capable of] or dispensing opioid antidotes to recipients [,] for administration thereby to third-party overdose victims, as part of the [entity's] regular course of business or volunteer activities; or

(d) to any law enforcement officer or law enforcement agency, and to any emergency medical responder or emergency medical response entity, in accordance with the Statewide standing order that is issued pursuant to paragraph (2) of this section.

(2) (a) [For the purposes of this subsection, whenever] A law enforcement officer or emergency medical responder shall be presumed to be capable both of administering an opioid antidote to an overdose victim in an emergency, and of dispensing an opioid antidote to another recipient for administration to a third party. Immediately upon the effective date of P.L. , c. (C. ) (pending before the Legislature as this bill), the Commissioner of Health, or, if the commissioner is not a duly licensed physician, the Deputy Commissioner for Public Health Services, shall issue a Statewide standing order authorizing each law enforcement officer employed by a law enforcement agency in the State and each emergency medical responder employed by an emergency medical response entity in the State to administer opioid antidotes to overdose victims in an emergency, and to dispense opioid antidotes to patients and other recipients who are deemed by the law enforcement officer, law enforcement agency, emergency medical responder, or emergency medical response agency to be capable of administering the antidote to a third-party overdose victim.

Nothing in this section, or in any other law or regulation, shall be deemed to require a law enforcement officer or emergency medical responder to possess an individual prescription or an officer-specific, responder-specific, or agency-specific standing order, in order to carry, administer, or dispense opioid antidotes in the State.

(b) Whenever the law expressly authorizes or requires a certain type of professional or professional entity to obtain a standing order for opioid antidotes pursuant to this [section] subsection, such professional, or the professionals employed or engaged by such professional entity, as the case may be, shall be presumed by the prescribing or dispensing health care practitioner to be capable of administering or dispensing the opioid antidote, consistent with the express statutory requirement.

Nothing in this section, or in any other law or regulation, shall be deemed to require a professional to obtain an individual prescription or a professional-specific standing order, in order to carry, administer, or dispense opioid antidotes; provided that the entity employing the professional is in possession of a standing order issued by a prescriber, pursuant to this subsection, which authorizes the professionals in the entity's employ to engage in such activities.

[(b) For the purposes of this subsection, whenever the law expressly requires a certain type of emergency medical responder or emergency medical response entity to obtain a standing order for opioid antidotes pursuant to this section, such emergency medical responder, or the emergency medical responders employed or engaged by such emergency medical response entity, as the case may be, shall be presumed by the prescribing or dispensing health care practitioner to be capable of administering the opioid antidote, consistent with the express statutory requirement.]

(3) (a) [Whenever a prescriber or other health care practitioner prescribes or dispenses an opioid antidote to a professional or professional entity pursuant to a] A standing order for opioid antidotes, which is issued [under] by a prescriber to a professional or professional entity pursuant to paragraph (1) of this subsection, [the standing order] shall specify whether the professional or professional entity is authorized [thereby] by the standing order to directly administer [the] opioid [antidote] antidotes to overdose victims; to dispense [the] opioid [antidote] antidotes to patients and other recipients, for their administration to third parties; or to both administer and dispense the opioid [antidote] antidotes. If a standing order does not include a specification in this regard, it shall be deemed to authorize the professional or professional entity only to administer [the] opioid [antidote] antidotes with immunity, as provided by subsection c. of this section, and it shall not be deemed to authorize the professional or professional entity to engage in the further dispensing of the [antidote] antidotes to other recipients, unless such authority has been granted by law, as provided by subparagraph (b) of this paragraph.

(b) Notwithstanding the provisions of this paragraph to the contrary, if the law expressly authorizes or requires a certain type of professional[,] or professional entity [, emergency medical responder, or emergency medical response entity] to administer or dispense opioid antidotes pursuant to a standing order issued hereunder, the standing order issued pursuant to this section shall be deemed to grant the authority specified by the law, even if such authority is not expressly indicated on the face of the standing order.

(4) Any prescriber or other health care practitioner who prescribes or dispenses an opioid antidote, in good faith, and in accordance with the provisions of this subsection, shall not, as a result of the practitioner's acts or omissions, be subject to any criminal or civil liability, or any professional disciplinary action under Title 45 of the Revised Statutes, for prescribing or dispensing an opioid antidote in accordance with P.L.2013, c.46 (C.24:6J-1 et [seq] al.).

b. (1) Any first responder or first response agency that is covered by the Statewide standing order issued pursuant to paragraph (2) of subsection a. of this section, and that has received overdose prevention information pursuant to section 5 of P.L.2013, c.46 (C.24:6J-5), may administer an opioid antidote to an overdose victim, or may dispense an opioid antidote to any recipient who is deemed by the first responder or first response agency to be capable of administering the opioid antidote to an overdose victim in an emergency.

(2) Any first responder or first response agency, which administers or dispenses an opioid antidote, in good faith, in accordance with the provisions of paragraph (1) of this subsection, and pursuant to the Statewide standing order issued under paragraph (2) of subsection a. of this section, shall not, as a result of any acts or omissions, be subject to any criminal or civil liability, or any professional disciplinary action, for administering or dispensing the opioid antidote in accordance with P.L.2013, c.46 (C.24:6J-1 et al.).

c. (1) Any professional or professional entity that has obtained a standing order for the administration of opioid antidotes, pursuant to subsection a. of this section, and overdose prevention information pursuant to section 5 of P.L.2013, c.46 (C.24:6J-5), may administer an opioid antidote to an overdose victim. Any professional or professional entity that has obtained a standing order for the dispensing of opioid antidotes, pursuant to subsection a. of this section, and overdose prevention information pursuant to section 5 of P.L.2013, c.46 (C.24:6J-5), may dispense an opioid antidote to any recipient who is deemed by the professional or professional entity to be capable of administering the opioid antidote to an overdose victim in an emergency. Any professional or professional entity that has obtained a standing order for both the administration and dispensing of opioid antidotes, pursuant to subsection a. of this section, and overdose prevention information pursuant to section 5 of P.L.2013, c.46 (C.24:6J-5), may both administer and dispense opioid antidotes.

(2) Any professional or professional entity that administers or dispenses an opioid antidote , in good faith, in accordance with paragraph (1) of this subsection, [in good faith,] and pursuant to a standing order issued under subsection a. of this section, shall not, as a result of any acts or omissions, be subject to any criminal or civil liability, or any professional disciplinary action, for administering or dispensing [an] the opioid antidote in accordance with P.L.2013, c.46 (C.24:6J-1 et [seq] al.).

[c. (1) Any emergency medical responder or emergency medical response entity that has obtained a standing order, pursuant to subsection a. of this section, for the administration of opioid antidotes, may administer an opioid antidote to overdose victims.

(2) Any emergency medical responder or emergency medical response entity that administers an opioid antidote, in good faith, in accordance with paragraph (1) of this subsection, and pursuant to a standing order issued under subsection a. of this section, shall not, as a result of any acts or omissions, be subject to any criminal or civil liability, or any disciplinary action, for administering the opioid antidote in accordance with P.L.2013, c.46 (C.24:6J-1 et seq.).]

d. (1) Any [person who is the recipient of an opioid antidote, which has been prescribed or dispensed] patient who has obtained an opioid antidote for administration purposes pursuant to subsection a. [or] b., or c. of this section, and [who has received] overdose prevention information pursuant to section 5 of P.L.2013, c.46 (C.24:6J-5), may administer the opioid antidote to [another person] an overdose victim in an emergency, without fee [, if the antidote recipient believes, in good faith, that the other person is experiencing an opioid overdose].

(2) Any person who administers an opioid antidote [pursuant to] , in good faith, and in accordance with paragraph (1) of this subsection shall not, as a result of the person's acts or omissions, be subject to any criminal or civil liability for administering the opioid antidote in accordance with P.L.2013, c.46 (C.24:6J-1 et [seq] al.).

e. In addition to the immunity that is provided by this section for authorized persons who are engaged in the prescribing, dispensing, or administering of an opioid antidote, the immunity provided by section 7 or section 8 of P.L.2013, c.46 (C.2C:35-30 or C.2C:35-31) shall apply to a person who acts in accordance with this section, provided that the requirements of those sections, as applicable, have been met.

f. Notwithstanding the provisions of any law, rule, regulation, ordinance, or institutional or organizational directive to the contrary, any person or entity authorized to administer an opioid antidote, pursuant to this section, may administer to an overdose victim, with full immunity:

(1) a single dose of any type of opioid antidote that has been approved by the United States Food and Drug Administration for use in the treatment of opioid overdoses; and

(2) up to three doses of an opioid antidote that is administered through intranasal application, or through an intramuscular auto-injector, as may be necessary to revive the overdose victim. Prior consultation with, or approval by, a third-party physician or other medical personnel shall not be required before an authorized person or entity may administer up to three doses of an opioid antidote, as provided in this paragraph, to the same overdose victim.

g. No later than 45 days after the effective date of P.L.2017, c.381, the Commissioner of Health shall provide written notice to all emergency medical response entities affected by subsection f. of this section, notifying them of the provisions of subsection f. of this section.

(cf: P.L.2017, c.381, s.2)

3. Section 5 of P.L.2013, c.46 (C.24:6J-5) is amended to read as follows:

5. a. (1) A prescriber or other health care practitioner who prescribes or dispenses an opioid antidote, in accordance with paragraph (1) of subsection a. of section 4 of P.L.2013, c.46 (C.24:6J-4), shall ensure that overdose prevention information is provided to the antidote recipient. The State health official who issues a Statewide standing order applicable to first responders, in accordance with paragraph (2) of subsection a. of section 4 of P.L.2013, c.46 (C.24:6J-4), shall ensure that overdose prevention information is provided to every law enforcement agency and emergency medical response entity in the State that is covered by the standing order. The [requisite] overdose prevention information that is distributed pursuant this subsection shall include, but [is] need not be limited to: information on opioid overdose prevention and recognition; instructions on how to perform rescue breathing and resuscitation; information on opioid antidote dosage and instructions on opioid antidote administration; information describing the importance of calling 911 emergency telephone service for assistance with an opioid overdose; and instructions for appropriate care of an overdose victim after administration of the opioid antidote.

(2) A professional or professional entity that dispenses an opioid antidote pursuant to a standing order, in accordance with subsection [b.] c. of section 4 of P.L.2013, c.46 (C.24:6J-4), shall ensure that each patient or other recipient who is dispensed an opioid antidote also receives a copy of the overdose prevention information that has been provided to the professional or professional entity pursuant to paragraph (1) of this subsection.

(3) A law enforcement officer, law enforcement agency, emergency medical responder, or emergency medical response entity that dispenses an opioid antidote pursuant to a Statewide standing order, in accordance with subsection b. of section 4 of P.L.2013, c.46 (C.24:6J-4), shall ensure that each patient or other recipient who is dispensed an opioid antidote also receives a copy of the overdose prevention information that has been provided to the law enforcement agency or emergency medical response entity, as the case may be, pursuant to paragraph (1) of this subsection.

b. (1) In [order to fulfill] fulfilling the information distribution requirements of subsection a. of this section, overdose prevention information may be provided directly by the prescribing or dispensing health care practitioner or State health official, or by the dispensing professional or professional entity, law enforcement officer or agency, or emergency medical responder or response entity, or may be provided indirectly by a community-based organization, or other organization that addresses medical or social issues related to [drug addiction] substance use disorders, and with which the health care practitioner or State health official, the professional[,] or professional entity, the law enforcement officer or agency, or the emergency medical responder or response entity, as appropriate, maintains a written agreement. Any such written agreement shall incorporate, at a minimum: procedures for the timely dissemination of overdose prevention information; information as to how employees or volunteers providing the information will be trained; and standards for recordkeeping under paragraph (2) of this subsection.

(2) The dissemination of overdose prevention information in accordance with this section, and the contact information for the persons receiving such information, to the extent known, shall be documented by the prescribing or dispensing health care practitioner or State health official, or by the dispensing professional[,] or professional entity, law enforcement officer or agency, or emergency medical responder or response entity, as appropriate, in: (a) the patient's medical record, if applicable; [or] (b) another appropriate record or log, if the patient's medical record is unavailable or inaccessible, or if the antidote recipient is [a professional or professional entity] acting in [their] a professional capacity; or (c) any other similar recordkeeping location, as specified in a written agreement that has been executed pursuant to paragraph (1) of this subsection.

c. In order to facilitate the dissemination of overdose prevention information in accordance with this section, the Commissioner of [Human Services] Health, in consultation with Statewide organizations representing physicians, advanced practice nurses, or physician assistants, and organizations operating community-based programs, sterile syringe access programs, or other programs which address medical or social issues related to [drug addiction] substance use disorders, may develop training materials in video, electronic, or other appropriate formats, and disseminate these materials to: health care practitioners; first responders and first response agencies; professionals and professional entities that are authorized by standing order to dispense opioid antidotes; and organizations that are authorized to disseminate overdose prevention information under a written agreement executed pursuant to paragraph (1) of subsection b. of this section.

(cf: P.L.2015, c.10, s.3)

4. Section 1 of P.L.2017, c.285 (C.24:6J-5.1) is amended to read as follows:

1. a. [If] Whenever an opioid antidote is administered by a health care professional or a first responder to a person experiencing a drug overdose, information concerning substance [abuse] use disorder treatment programs and resources, including information on the availability of opioid antidotes, shall be provided to the person as follows:

(1) If the person is admitted to a health care facility or receives treatment in the emergency department of a health care facility, a staff member designated by the health care facility, who may be a social worker, addiction counselor, or other appropriate professional, shall provide the information to the person at any time after the treatment for the drug overdose is complete, but prior to the person's discharge from the facility. The designated staff member shall document the provision of the information in the person's medical record, and may, in collaboration with an appropriate health care professional, additionally develop an individualized substance [abuse] use disorder treatment plan for the person.

(2) If the opioid antidote is administered by a first responder and the person experiencing the overdose is not subsequently transported to a health care facility, the first responder shall provide the information to the person at the time the treatment for the drug overdose is complete.

b. As used in this section:

"First responder" means a law enforcement officer [, paid or volunteer firefighter, paid or volunteer member of a duly incorporated first aid, emergency, ambulance, or rescue squad association, or any other individual who, in the course of that individual's employment, is dispatched to the scene of an emergency situation for the purpose of providing medical care or other assistance] or emergency medical responder, as those terms are defined by section 1 of P.L.2013, c.46 (C.24:6J-3).

"Health care facility" means a health care facility licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).

c. The Commissioner of [Human Services] Health shall develop informational materials concerning substance [abuse] use disorder treatment programs, and resources and information on the availability of opioid antidotes, for dissemination to health care professionals and first responders to facilitate the provision of
information to patients pursuant to this section.

(cf: P.L.2017, c.285, s.1)

5. Section 6 of P.L.2013, c.46 (C.24:6J-6) is amended to read as follows:

6. a. The Commissioner of [Human Services] Health may award grants, based upon any monies appropriated by the Legislature, to create or support local opioid overdose prevention, recognition, and response projects. County and municipal health departments, correctional institutions, hospitals, and universities, as well as organizations operating community-based programs, substance abuse programs, syringe access programs, or other programs which address medical or social issues related to drug addiction may apply to the Department of [Human Services] Health for a grant under this section, on forms and in the manner prescribed by the commissioner.

b. In awarding any grant, the commissioner shall consider the necessity for overdose prevention projects in various health care facility and non-health care facility settings, and the applicant's ability to develop interventions that will be effective and viable in the local area to be served by the grant.

c. In awarding any grant, the commissioner shall give preference to applications that include one or more of the following elements:

(1) the prescription and distribution of [naloxone hydrochloride or any other similarly acting drug approved by the United States Food and Drug Administration for the treatment of an opioid overdose] opioid antidotes;

(2) policies and projects to encourage persons, including drug users, to call 911 for emergency assistance when they witness a potentially fatal opioid overdose;

(3) opioid overdose prevention, recognition, and response education projects in syringe access programs, drug treatment centers, outreach programs, and other programs operated by organizations that work with, or have access to, opioid users and their families and communities;

(4) opioid overdose recognition and response training, including rescue breathing, in drug treatment centers and for other organizations that work with, or have access to, opioid users and their families and communities;

(5) the production and distribution of targeted or mass media materials on opioid overdose prevention and response;

(6) the institution of education and training projects on opioid overdose response and treatment for emergency services and law enforcement personnel; and

(7) a system of parent, family, and survivor education and mutual support groups.

d. In addition to any moneys appropriated by the Legislature, the commissioner may seek money from the federal government, private foundations, and any other source to fund the grants established pursuant to this section, as well as to fund on-going monitoring and evaluation of the programs supported by the grants.

(cf: P.L.2013, c.46, s.6)

6. This act shall take effect on the first day of the first month next following enactment, except that the Commissioner of Health shall take anticipatory administrative action, in advance thereof, as may be necessary for the implementation of this act.

STATEMENT

This bill would amend the State's "Overdose Prevention Act" (OPA), P.L.2013, c.46 (C.24:6J-1 et al.), in order to authorize first responders and first response entities (i.e., law enforcement officers; law enforcement agencies; emergency medical responders, including emergency medical technicians, paramedics, and firefighters; and emergency medical response entities) to obtain, administer, and dispense naloxone hydrochloride and other opioid antidotes, with immunity, pursuant to a Statewide standing order issued by a State health official.

Under the existing provisions of the OPA, law enforcement officials are included under the same rubric of provisions that relate to "professionals" and "professional entities," while emergency medical responders and response entities are covered under their own, unique provisions. Under the existing law, professionals and professional entities are required to request and obtain a standing order from an individual health care practitioner before they will be authorized to administer or dispense opioid antidotes with immunity. Emergency medical responders and response entities must go through the same standing order request procedure, but may only be authorized by a standing order to administer opioid antidotes to overdose victims. The existing law does not authorize emergency medical responders to further dispense opioid antidotes to other recipients for administration thereby. In order to ensure that all first responders are subject to the same authorizations and immunities under the OPA, this bill would excise law enforcement officers and law enforcement agencies from the provisions of the OPA that relate to professionals and professional entities; it would eliminate the existing provisions of the OPA that relate solely to emergency medical responders and response entities; and it would incorporate new provisions that are universally applicable to all first responders, including both law enforcement officers and emergency medical responders, and which authorize all first responders to both administer and dispense opioid antidotes pursuant to a Statewide standing order.

Although the OPA generally requires a health care practitioner, before prescribing or dispensing any opioid antidotes, to make a determination as to whether the recipient of the antidote is capable of administering or dispensing the drug, as appropriate, or whether the recipient, if an entity, employs persons who are so capable, the bill would provide that such a determination need not be made in the case of first responders. Instead, the bill would specify that a law enforcement officer or emergency medical responder is to be presumed, as a matter of law, to be capable of both administering and dispensing opioid antidotes. The bill would further require the Commissioner of Health, or, if the commissioner is not a licensed physician, the Deputy Commissioner for Public Health Services, to immediately issue, upon the bill's effective date, a Statewide standing order authorizing each law enforcement officer who is employed by a law enforcement agency, and each emergency medical responder who is employed by an emergency medical response entity in the State to administer opioid antidotes to overdose victims in an emergency, and to dispense opioid antidotes to patients and other recipients who are deemed capable of administering the antidote to a third-party overdose victim.

The State health official who issues the Statewide standing order for first responders would be required to provide overdose prevention information, under the existing provisions of the OPA, to every law enforcement agency and emergency medical response entity in the State that is covered by the Statewide order. Each such agency or entity, and the employees thereof, would then be required, when dispensing opioid antidotes to other recipients, to ensure that a copy of the overdose prevention information is provided to each antidote recipient.

Any law enforcement officer or agency, and any emergency medical responder or response entity, which has received overdose prevention information, and which administers or dispenses an opioid antidote pursuant to the Statewide standing order issued under the bill's provisions, would be immune from civil or criminal liability, as well as from professional disciplinary action, for any acts or omissions that may be associated with such administration or dispensation. The bill would further specify that nothing in its provisions, or in any other law or regulation, may be deemed to require a law enforcement officer or emergency medical responder to possess an individual prescription or an officer-specific, responder-specific, or agency-specific standing order, in order to carry, administer, or dispense opioid antidotes.

The bill would also make minor technical and clarifying corrections to existing provisions of the OPA, in order to eliminate internal inconsistencies and redundancies, clarify and harmonize existing language, and more clearly distinguish the requirements and immunities that apply to the various types of actors who may be authorized to administer or dispense opioid antidotes.

For instance, the bill would clarify, consistent with existing law, that nothing in the OPA, or in any other law or regulation, may be deemed to require a professional actor to obtain an individual prescription or a professional-specific standing order, in order to carry, administer, or dispense opioid antidotes; provided that the entity employing such professional is in possession of a standing order, issued by an individual prescriber under the OPA, which authorizes the professionals in the entity's employ to engage in such activities.

More significantly, the bill would clarify the existing immunity provisions that are applicable to professionals and professional entities under the OPA. These immunity provisions are currently split into two subsections, which may create confusion in practice, particularly in light of the changes that are being made by this bill. The first subsection applies to professional actors who engage in the dispensation of opioid antidotes, while the second subsection is a catch-all provision that applies to both professional actors and ordinary patients who administer opioid antidotes. This split between subsections has resulted in an unintentional gap in the immunities that are provided to professionals and professional entities under the OPA. Specifically, professional actors are immunized against professional liability only under the first subsection, regarding their dispensation of opioid antidotes, but they are not immunized against professional liability under the second subsection, regarding their administration of opioid antidotes. Because the OPA was clearly intended to provide full immunity to these actors, regardless of whether they are engaged in the administration or dispensation of opioid antidotes, this bill would address the gap in the law by combining the immunity provisions that are applicable to professionals into a single subsection, in a manner that mirrors the phrasing of the new immunity provisions that are applicable to first responders.

The bill would also amend the OPA to replace references to the Department and Commissioner of Human Services with references to the Department and Commissioner of Health. This change is necessary to reflect the fact that the functions of the Division of Mental Health and Addiction Services, which oversees the implementation of the OPA, have now been transferred from the Department of Human Services to the Department of Health, pursuant to Reorganization Plan 001-2017 (Christie).