H.F. 238 Section 1. NEW SECTION . 124.417 Immunity —— persons seeking 1 medical assistance for drug or alcohol overdose or other medical 2 emergency. 3 1. For purposes of this section: 4 a. “Drug or alcohol overdose” means a condition of a person 5 for which each of the following is true: 6 (1) The person requires medical assistance. 7 (2) The person displays symptoms including but not limited 8 to extreme physical illness, decreased level of consciousness, 9 respiratory depression, coma, mania, or death. 10 (3) The person’s condition is the result of, or a layperson 11 would reasonably believe the person’s condition to be the 12 result of, consumption or use of a controlled substance or 13 alcohol or a substance with which the controlled substance or 14 alcohol was combined. 15 b. “Seeks medical assistance” includes but is not limited to 16 reporting a drug or alcohol overdose or other medical emergency 17 to law enforcement, the E911 system, a poison control center, 18 or a medical provider, assisting someone so reporting, or 19 providing care to someone who is experiencing a drug or alcohol 20 overdose or other medical emergency while awaiting the arrival 21 of medical assistance. 22 2. Notwithstanding any other provision of law to the 23 contrary, a person who, in good faith, seeks medical assistance 24 for someone who is experiencing a drug or alcohol overdose or 25 other medical emergency, or a person experiencing a drug or 26 alcohol overdose or other medical emergency who seeks medical 27 assistance or is the subject of such a good-faith request, 28 shall not be arrested, charged, prosecuted, convicted, have 29 property subject to civil forfeiture, or otherwise be penalized 30 for any of the following if the evidence for the arrest, 31 charge, prosecution, conviction, seizure, or penalty was gained 32 as a result of the seeking of medical assistance: 33 a. Possession of a controlled substance under section 34 124.401. 35 -1- LSB 1243YH (3) 86 jh/nh 1/ 7

H.F. 238 b. Possession of an imitation controlled substance under 1 section 124A.4. 2 c. Possession of drug paraphernalia under section 124.414. 3 d. Commission of a prohibited act under section 123.47. 4 e. Violation of a restraining order. 5 f. Violation of probation or parole. 6 3. Notwithstanding any other provision of law to the 7 contrary, the act of seeking medical assistance for someone who 8 is experiencing a drug or alcohol overdose or other medical 9 emergency shall be considered by the court as a mitigating 10 factor in any criminal prosecution for which immunity is not 11 provided by this section. 12 4. This section shall not be used as grounds for the 13 suppression of evidence in a prosecution for any other criminal 14 offense not specified in this section. 15 Sec. 2. NEW SECTION . 124.418 Possession of an opioid 16 antagonist. 17 1. For purposes of this section, “opioid antagonist” 18 means any drug that binds to opioid receptors and blocks or 19 disinhibits the effects of opioids acting on those receptors, 20 including but not limited to naloxone hydrochloride. 21 2. Notwithstanding the provisions of this chapter or any 22 other provision of law, a person acting in good faith may 23 possess an opioid antagonist. 24 Sec. 3. Section 147.107, Code 2015, is amended by adding the 25 following new subsection: 26 NEW SUBSECTION . 5A. a. For purposes of this subsection: 27 (1) “Opioid antagonist” means the same as defined in section 28 124.418. 29 (2) “Opioid-related overdose” means a condition for which 30 each of the following is true: 31 (a) The person requires medical assistance. 32 (b) The person displays symptoms including but not limited 33 to extreme physical illness, decreased level of consciousness, 34 respiratory depression, coma, or death. 35 -2- LSB 1243YH (3) 86 jh/nh 2/ 7

H.F. 238 (c) The person’s condition is the result of, or a layperson 1 would reasonably believe the person’s condition to be the 2 result of, consumption or use of an opioid, or another 3 substance with which an opioid was combined. 4 b. Notwithstanding subsection 1 or any other provision 5 of law, a health care professional otherwise authorized to 6 prescribe an opioid antagonist may, directly or by standing 7 order, prescribe and dispense an opioid antagonist to a person 8 at risk of experiencing an opioid-related overdose or to a 9 family member, friend, or other person in a position to assist 10 a person at risk of experiencing an opioid-related overdose. 11 Any such prescription shall be regarded as being issued for a 12 legitimate medical purpose in the usual course of professional 13 practice. 14 c. Notwithstanding subsection 1 or any other provision 15 of law, a person or organization acting under a standing 16 order issued by a health care professional who is otherwise 17 authorized to prescribe an opioid antagonist may store and 18 dispense an opioid antagonist so long as such activities are 19 undertaken without charge or compensation. 20 d. A health care professional who, acting in good faith 21 and with reasonable care, prescribes or dispenses an opioid 22 antagonist shall not be subject to any criminal or civil 23 liability or any professional disciplinary action for 24 prescribing or dispensing an opioid antagonist or any outcome 25 resulting from the eventual administration of the opioid 26 antagonist. 27 e. A person who, acting in good faith and with reasonable 28 care, administers an opioid antagonist to another person whom 29 the person believes to be suffering an opioid-related overdose 30 shall not be subject to any criminal or civil liability or any 31 professional disciplinary action for such act. 32 Sec. 4. Section 147A.8, Code 2015, is amended by adding the 33 following new subsection: 34 NEW SUBSECTION . 3. Administer an opioid antagonist, as 35 -3- LSB 1243YH (3) 86 jh/nh 3/ 7

H.F. 238 defined in section 124.418, as clinically indicated. 1 Sec. 5. NEW SECTION . 155A.45 Dispensing of naloxone 2 hydrochloride. 3 1. A pharmacist may dispense naloxone hydrochloride in 4 accordance with subsection 2 and the rules adopted by the board 5 pursuant to subsection 3. 6 2. Prior to dispensing naloxone hydrochloride, a pharmacist 7 shall complete a training program that consists of at least 8 one hour of continuing education on the use of naloxone 9 hydrochloride. 10 3. The board shall adopt rules to administer this section, 11 including but not limited to rules providing for: 12 a. Procedures to ensure education of the person to whom the 13 naloxone hydrochloride is dispensed, including opioid overdose 14 prevention, recognition, and response, safe administration 15 of naloxone hydrochloride, potential side effects or adverse 16 events, and the imperative to seek emergency medical care for 17 the patient. 18 b. Procedures for the completion of the required continuing 19 education necessary to dispense naloxone hydrochloride. 20 Sec. 6. NEW SECTION . 217.22 Report on unintentional drug 21 overdose. 22 The department of human services shall investigate, 23 document, and publish an annual report on the number, trends, 24 patterns, and risk factors related to unintentional drug 25 overdose fatalities occurring within this state each year. The 26 report shall also provide information on interventions that 27 would be effective in reducing the rate of fatal or nonfatal 28 drug overdose. 29 Sec. 7. Section 249A.20A, Code 2015, is amended by adding 30 the following new subsection: 31 NEW SUBSECTION . 12. Notwithstanding anything in this 32 section to the contrary, the department shall include naloxone 33 hydrochloride on the preferred drug list. 34 Sec. 8. GRANTS FOR DRUG OVERDOSE PROJECTS. The department 35 -4- LSB 1243YH (3) 86 jh/nh 4/ 7

H.F. 238 of human services shall make grants for the fiscal years 1 beginning July 1, 2015, July 1, 2016, and July 1, 2017, using, 2 to the fullest extent feasible, existing resources available to 3 the department for any of the following purposes, as determined 4 by the department: 5 1. Drug overdose prevention, recognition, and response 6 education projects. 7 2. Drug overdose prevention, recognition, and response 8 training for patients receiving opioid antagonists and 9 patients’ families and caregivers. 10 3. Naloxone hydrochloride prescription or distribution 11 projects. 12 4. Education and training projects on drug overdose 13 response and treatment for emergency services and law 14 enforcement personnel, including but not limited to volunteer 15 fire and emergency services. 16 EXPLANATION 17 The inclusion of this explanation does not constitute agreement with 18 the explanation’s substance by the members of the general assembly. 19 This bill relates to drug and alcohol overdose prevention, 20 assistance, and education, provides immunity from certain 21 criminal offenses for a person who seeks medical assistance for 22 a person experiencing an overdose, and authorizes pharmacists 23 to dispense naloxone hydrochloride. 24 The bill provides immunity from certain crimes for persons 25 who seek medical assistance for a drug or alcohol overdose. 26 If a person seeks medical assistance for another person 27 experiencing a drug or alcohol overdose or other medical 28 emergency, or if a person experiencing a drug or alcohol 29 overdose or other medical emergency seeks medical assistance 30 or is the subject of such a request, such person shall not be 31 arrested, charged, prosecuted, convicted, or have property 32 subject to civil forfeiture for certain crimes if the evidence 33 against the person was gained because medical assistance was 34 sought. The crimes are possession of a controlled substance 35 -5- LSB 1243YH (3) 86 jh/nh 5/ 7

H.F. 238 under Code section 124.401, possession of an imitation 1 controlled substance under Code section 124A.4, possession 2 of drug paraphernalia under section 124.414, commission of 3 a prohibited act under Code section 123.47 (crimes related 4 to a person’s possession of alcohol under the legal age), 5 or violation of a restraining order, probation, or parole. 6 Evidence of other crimes discovered because a person sought 7 medical assistance shall not be suppressed. 8 If a person seeks medical assistance for another person who 9 is experiencing a drug or alcohol overdose or other medical 10 emergency and is not immune from criminal liability, the bill 11 provides that a court shall consider the person’s seeking 12 medical assistance as a mitigating factor. 13 The bill provides that possession of an opioid antagonist in 14 good faith is not a violation of Code chapter 124 or any other 15 law. The bill defines “opioid antagonist” as any drug that 16 binds to opioid receptors and blocks or disinhibits the effects 17 of opioids acting on those receptors, including but not limited 18 to naloxone hydrochloride. 19 The bill provides that a pharmacist may dispense naloxone 20 hydrochloride after completing a training program. The 21 board of pharmacy is directed to adopt rules related to 22 education requirements for pharmacists to dispense naloxone 23 hydrochloride and procedures to educate persons regarding 24 naloxone hydrochloride, opioid overdose prevention, and the 25 safe administration of naloxone hydrochloride. 26 The bill directs the department of human services to publish 27 an annual report on the number, trends, patterns, and risk 28 factors related to unintentional drug overdose fatalities 29 in Iowa. The bill also directs the department of human 30 services to make grants for FY 2015-2016, FY 2016-2017, and 31 FY 2017-2018, to the fullest extent feasible, from existing 32 resources for drug overdose prevention projects, naloxone 33 hydrochloride prescription or distribution projects, or 34 education and training projects on drug overdose response and 35 -6- LSB 1243YH (3) 86 jh/nh 6/ 7

H.F. 238 treatment for emergency services and law enforcement personnel. 1 The bill directs the department of human services to add 2 naloxone hydrochloride to the Medicaid preferred drug list 3 under Code section 249A.20A. 4 The bill provides that an emergency medical care provider 5 properly certified under Code chapter 147A may administer an 6 opioid antagonist. 7 The bill provides that a health care professional authorized 8 to prescribe an opioid antagonist may prescribe and dispense 9 an opioid antagonist to a person at risk of experiencing an 10 opioid-related overdose or to a family member, friend, or 11 other person who may be able to assist a person at risk of an 12 opioid-related overdose. A person or organization acting under 13 a standing order from a health care professional authorized to 14 prescribe an opioid antagonist may store and dispense an opioid 15 antagonist so long as such person or organization does not 16 charge or receive compensation for such activities. A health 17 care professional who acts in good faith and with reasonable 18 care while prescribing or dispensing an opioid antagonist 19 shall not be subject to any criminal or civil liability or any 20 professional disciplinary action. A person who acts in good 21 faith and with reasonable care while administering an opioid 22 antagonist to another person whom the person believes to be 23 suffering an opioid-related overdose shall be immune from 24 criminal or civil liability or any professional disciplinary 25 action. 26 -7- LSB 1243YH (3) 86 jh/nh 7/ 7