88R20867 CXP-F     By: Menéndez, et al. S.B. No. 629     (Talarico, Oliverson, Leo-Wilson, Howard, Zwiener, et al.)     Substitute the following for S.B. No. 629:  No.       A BILL TO BE ENTITLED   AN ACT   relating to the maintenance, administration, and disposal of opioid   antagonists on public and private school campuses 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.  Chapter 38, Education Code, is amended by adding   Subchapter E-1 to read as follows:   SUBCHAPTER E-1. MAINTENANCE, ADMINISTRATION, AND DISPOSAL OF   OPIOID ANTAGONISTS          Sec. 38.221.  DEFINITIONS. In this subchapter:                (1)  "Opioid antagonist" and "opioid-related drug   overdose" have the meanings assigned by Section 483.101, Health and   Safety Code.                (2)  "Physician" means a person who holds a license to   practice medicine in this state.          Sec. 38.222.  MAINTENANCE, ADMINISTRATION, AND DISPOSAL OF   OPIOID ANTAGONISTS.  (a)  Each school district shall adopt and   implement a policy regarding the maintenance, administration, and   disposal of opioid antagonists at each campus in the district that   serves students in grades 6 through 12 and may adopt and implement   such a policy at each campus in the district, including campuses   serving students in a grade level below grade 6.          (b)  An open-enrollment charter school or private school may   adopt and implement a policy regarding the maintenance,   administration, and disposal of opioid antagonists.  If a school   adopts a policy under this subsection, the school may apply the   policy:                (1)  only at campuses of the school serving students in   grades 6 through 12; or                (2)  at each campus of the school, including campuses   serving students in a grade level below grade 6.          (c)  A policy adopted under this section must:                (1)  provide that school personnel and school   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;                (2)  require that each school campus subject to a   policy adopted under this section have one or more school personnel   members or school volunteers authorized and trained to administer   an opioid antagonist present during regular school hours;                (3)  establish the number of opioid antagonists that   must be available at each campus at any given time; and                (4)  require that the supply of opioid antagonists at   each school campus subject to a policy adopted under this section   must be stored in a secure location and be easily accessible to   school personnel and school volunteers authorized and trained to   administer an opioid antagonist.          (d)  The executive commissioner of the Health and Human   Services Commission, in consultation with the commissioner of   education, shall adopt rules regarding the maintenance,   administration, and disposal of opioid antagonists at a school   campus subject to a policy adopted under this section.  The rules   must establish:                (1)  the process for checking the inventory of opioid   antagonists at regular intervals for expiration and replacement;   and                (2)  the amount of training required for school   personnel and school volunteers to administer an opioid antagonist.          Sec. 38.223.  REPORT ON ADMINISTERING OPIOID ANTAGONIST.     (a)  Not later than the 10th business day after the date a school   personnel member or school volunteer administers an opioid   antagonist in accordance with a policy adopted under Section   38.222(a) or (b), the school shall report the information required   under Subsection (b) of this section 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   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 opioid antagonist;                (2)  whether the person who received the administration   of the opioid antagonist was a student, a school personnel member or   school volunteer, or a 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 education.          Sec. 38.224.  TRAINING.  (a)  Each school district,   open-enrollment charter school, and private school that adopts a   policy under Section 38.222(a) or (b) is responsible for training   school personnel and school 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; and                      (D)  properly disposing of used or expired 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.          (c)  Each school district, open-enrollment charter school,   or private school that adopts a policy under Section 38.222(a) or   (b) must maintain records on the training required under this   section.          Sec. 38.225.  PRESCRIPTION OF OPIOID ANTAGONISTS.  (a)  A   physician or person who has been delegated prescriptive authority   under Chapter 157, Occupations Code, may prescribe opioid   antagonists in the name of a school district, open-enrollment   charter school, or private school.          (b)  A physician or other person who prescribes 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 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 opioid antagonist may be   administered to a person without a previously established   physician-patient relationship.          (d)  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.          (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 opioid antagonists to be obtained   and maintained under the order; and                (4)  the date of issue.          (f)  A pharmacist may dispense an opioid antagonist to a   school district, open-enrollment charter school, or private school   without requiring the name or any other identifying information   relating to the user.          Sec. 38.226.  GIFTS, GRANTS, AND DONATIONS. A school   district, open-enrollment charter school, or private school may   accept gifts, grants, donations, and federal and local funds to   implement this subchapter.          Sec. 38.227.  IMMUNITY FROM LIABILITY. (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 opioid antagonists;                (2)  supervising or delegating the administration of an   opioid antagonist;                (3)  possessing, maintaining, storing, or disposing of   an opioid antagonist;                (4)  prescribing an opioid antagonist;                (5)  dispensing an opioid antagonist;                (6)  administering, or assisting in administering, an   opioid antagonist;                (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.          (b)  The immunities and protections provided by this   subchapter are in addition to other immunities 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 a basis for a cause of action for an act or omission under   this subchapter.          (d)  A cause of action does not arise from an act or omission   described by this section.          (e)  A school district, open-enrollment charter school, or   private school and school personnel and school volunteers are   immune from suit resulting from an act, or failure to act, under   this subchapter, including an act or failure to act under related   policies and procedures.          (f)  An act or failure to act by school personnel or a school   volunteer under this subchapter, including an act or failure to act   under related policies and procedures, is the exercise of judgment   or discretion on the part of the school personnel or school   volunteer and is not considered to be a ministerial act for purposes   of liability of the school district, open-enrollment charter   school, or private school.          Sec. 38.228.  RULES. Except as otherwise provided by this   subchapter, the commissioner of education and the executive   commissioner of the Health and Human Services Commission shall   jointly adopt rules necessary to implement this subchapter.          SECTION 2.  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-1, 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 3.  Not later than November 1, 2023:                (1)  the executive commissioner of the Health and Human   Services Commission shall, in consultation with the commissioner of   education, adopt rules required under Section 38.222, Education   Code, as added by this Act; and                (2)  the commissioner of education and the executive   commissioner of the Health and Human Services Commission shall   jointly adopt rules necessary to implement Subchapter E-1, Chapter   38, Education Code, as added by this Act.          SECTION 4.  Notwithstanding the effective date of this Act,   a school district is not required to comply with Section 38.222,   Education Code, as added by this Act, before January 1, 2024.          SECTION 5.  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.