HF 238 (LSB 1243YH (3) 86)

HOUSE FILE 238

BY  ABDUL-SAMAD

A BILL FOR

An Act relating to drug or alcohol overdose prevention, education, and medical assistance, and modifying penalties.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  NEW SECTION.  124.417  Immunity —— persons seeking medical assistance for drug or alcohol overdose or other medical emergency.
   1.  For purposes of this section:
   a.  “Drug or alcohol overdose” means a condition of a person for which each of the following is true:
   (1)  The person requires medical assistance.
   (2)  The person displays symptoms including but not limited to extreme physical illness, decreased level of consciousness, respiratory depression, coma, mania, or death.
   (3)  The person’s condition is the result of, or a layperson would reasonably believe the person’s condition to be the result of, consumption or use of a controlled substance or alcohol or a substance with which the controlled substance or alcohol was combined.
   b.  “Seeks medical assistance” includes but is not limited to reporting a drug or alcohol overdose or other medical emergency to law enforcement, the E911 system, a poison control center, or a medical provider, assisting someone so reporting, or providing care to someone who is experiencing a drug or alcohol overdose or other medical emergency while awaiting the arrival of medical assistance.
   2.  Notwithstanding any other provision of law to the contrary, a person who, in good faith, seeks medical assistance for someone who is experiencing a drug or alcohol overdose or other medical emergency, or a person experiencing a drug or alcohol overdose or other medical emergency who seeks medical assistance or is the subject of such a good-faith request, shall not be arrested, charged, prosecuted, convicted, have property subject to civil forfeiture, or otherwise be penalized for any of the following if the evidence for the arrest, charge, prosecution, conviction, seizure, or penalty was gained as a result of the seeking of medical assistance:
   a.  Possession of a controlled substance under section 124.401.
   b.  Possession of an imitation controlled substance under section 124A.4.
   c.  Possession of drug paraphernalia under section 124.414.
   d.  Commission of a prohibited act under section 123.47.
   e.  Violation of a restraining order.
   f.  Violation of probation or parole.
   3.  Notwithstanding any other provision of law to the contrary, the act of seeking medical assistance for someone who is experiencing a drug or alcohol overdose or other medical emergency shall be considered by the court as a mitigating factor in any criminal prosecution for which immunity is not provided by this section.
   4.  This section shall not be used as grounds for the suppression of evidence in a prosecution for any other criminal offense not specified in this section.
    Sec. 2.  NEW SECTION.  124.418  Possession of an opioid antagonist.
   1.  For purposes of this section, “opioid antagonist” means any drug that binds to opioid receptors and blocks or disinhibits the effects of opioids acting on those receptors, including but not limited to naloxone hydrochloride.
   2.  Notwithstanding the provisions of this chapter or any other provision of law, a person acting in good faith may possess an opioid antagonist.
    Sec. 3.  Section 147.107, Code 2015, is amended by adding the following new subsection:
   NEW SUBSECTION.  5A.  a.  For purposes of this subsection:
   (1)  “Opioid antagonist” means the same as defined in section 124.418.
   (2)  “Opioid-related overdose” means a condition for which each of the following is true:
   (a)  The person requires medical assistance.
   (b)  The person displays symptoms including but not limited to extreme physical illness, decreased level of consciousness, respiratory depression, coma, or death.
   (c)  The person’s condition is the result of, or a layperson would reasonably believe the person’s condition to be the result of, consumption or use of an opioid, or another substance with which an opioid was combined.
   b.  Notwithstanding subsection 1 or any other provision of law, a health care professional otherwise authorized to prescribe an opioid antagonist may, directly or by standing order, prescribe and dispense an opioid antagonist to a person at risk of experiencing an opioid-related overdose or to a family member, friend, or other person in a position to assist a person at risk of experiencing an opioid-related overdose. Any such prescription shall be regarded as being issued for a legitimate medical purpose in the usual course of professional practice.
   c.  Notwithstanding subsection 1 or any other provision of law, a person or organization acting under a standing order issued by a health care professional who is otherwise authorized to prescribe an opioid antagonist may store and dispense an opioid antagonist so long as such activities are undertaken without charge or compensation.
   d.  A health care professional who, acting in good faith and with reasonable care, prescribes or dispenses an opioid antagonist shall not be subject to any criminal or civil liability or any professional disciplinary action for prescribing or dispensing an opioid antagonist or any outcome resulting from the eventual administration of the opioid antagonist.
   e.  A person who, acting in good faith and with reasonable care, administers an opioid antagonist to another person whom the person believes to be suffering an opioid-related overdose shall not be subject to any criminal or civil liability or any professional disciplinary action for such act.
    Sec. 4.  Section 147A.8, Code 2015, is amended by adding the following new subsection:
   NEW SUBSECTION.  3.  Administer an opioid antagonist, as defined in section 124.418, as clinically indicated.
    Sec. 5.  NEW SECTION.  155A.45  Dispensing of naloxone hydrochloride.
   1.  A pharmacist may dispense naloxone hydrochloride in accordance with subsection 2 and the rules adopted by the board pursuant to subsection 3.
   2.  Prior to dispensing naloxone hydrochloride, a pharmacist shall complete a training program that consists of at least one hour of continuing education on the use of naloxone hydrochloride.
   3.  The board shall adopt rules to administer this section, including but not limited to rules providing for:
   a.  Procedures to ensure education of the person to whom the naloxone hydrochloride is dispensed, including opioid overdose prevention, recognition, and response, safe administration of naloxone hydrochloride, potential side effects or adverse events, and the imperative to seek emergency medical care for the patient.
   b.  Procedures for the completion of the required continuing education necessary to dispense naloxone hydrochloride.
    Sec. 6.  NEW SECTION.  217.22  Report on unintentional drug overdose.

   The department of human services shall investigate, document, and publish an annual report on the number, trends, patterns, and risk factors related to unintentional drug overdose fatalities occurring within this state each year. The report shall also provide information on interventions that would be effective in reducing the rate of fatal or nonfatal drug overdose.
    Sec. 7.  Section 249A.20A, Code 2015, is amended by adding the following new subsection:
   NEW SUBSECTION.  12.  Notwithstanding anything in this section to the contrary, the department shall include naloxone hydrochloride on the preferred drug list.
    Sec. 8.  GRANTS FOR DRUG OVERDOSE PROJECTS.  The department of human services shall make grants for the fiscal years beginning July 1, 2015, July 1, 2016, and July 1, 2017, using, to the fullest extent feasible, existing resources available to the department for any of the following purposes, as determined by the department:
   1.  Drug overdose prevention, recognition, and response education projects.
   2.  Drug overdose prevention, recognition, and response training for patients receiving opioid antagonists and patients’ families and caregivers.
   3.  Naloxone hydrochloride prescription or distribution projects.
   4.  Education and training projects on drug overdose response and treatment for emergency services and law enforcement personnel, including but not limited to volunteer fire and emergency services.
EXPLANATION
The inclusion of this explanation does not constitute agreement with

the explanation’s substance by the members of the general assembly.
   This bill relates to drug and alcohol overdose prevention, assistance, and education, provides immunity from certain criminal offenses for a person who seeks medical assistance for a person experiencing an overdose, and authorizes pharmacists to dispense naloxone hydrochloride.
   The bill provides immunity from certain crimes for persons who seek medical assistance for a drug or alcohol overdose. If a person seeks medical assistance for another person experiencing a drug or alcohol overdose or other medical emergency, or if a person experiencing a drug or alcohol overdose or other medical emergency seeks medical assistance or is the subject of such a request, such person shall not be arrested, charged, prosecuted, convicted, or have property subject to civil forfeiture for certain crimes if the evidence against the person was gained because medical assistance was sought. The crimes are possession of a controlled substance under Code section 124.401, possession of an imitation controlled substance under Code section 124A.4, possession of drug paraphernalia under section 124.414, commission of a prohibited act under Code section 123.47 (crimes related to a person’s possession of alcohol under the legal age), or violation of a restraining order, probation, or parole. Evidence of other crimes discovered because a person sought medical assistance shall not be suppressed.
   If a person seeks medical assistance for another person who is experiencing a drug or alcohol overdose or other medical emergency and is not immune from criminal liability, the bill provides that a court shall consider the person’s seeking medical assistance as a mitigating factor.
   The bill provides that possession of an opioid antagonist in good faith is not a violation of Code chapter 124 or any other law. The bill defines “opioid antagonist” as any drug that binds to opioid receptors and blocks or disinhibits the effects of opioids acting on those receptors, including but not limited to naloxone hydrochloride.
   The bill provides that a pharmacist may dispense naloxone hydrochloride after completing a training program. The board of pharmacy is directed to adopt rules related to education requirements for pharmacists to dispense naloxone hydrochloride and procedures to educate persons regarding naloxone hydrochloride, opioid overdose prevention, and the safe administration of naloxone hydrochloride.
   The bill directs the department of human services to publish an annual report on the number, trends, patterns, and risk factors related to unintentional drug overdose fatalities in Iowa. The bill also directs the department of human services to make grants for FY 2015-2016, FY 2016-2017, and FY 2017-2018, to the fullest extent feasible, from existing resources for drug overdose prevention projects, naloxone hydrochloride prescription or distribution projects, or education and training projects on drug overdose response and treatment for emergency services and law enforcement personnel.
   The bill directs the department of human services to add naloxone hydrochloride to the Medicaid preferred drug list under Code section 249A.20A.
   The bill provides that an emergency medical care provider properly certified under Code chapter 147A may administer an opioid antagonist.
   The bill provides that a health care professional authorized to prescribe an opioid antagonist may prescribe and dispense an opioid antagonist to a person at risk of experiencing an opioid-related overdose or to a family member, friend, or other person who may be able to assist a person at risk of an opioid-related overdose. A person or organization acting under a standing order from a health care professional authorized to prescribe an opioid antagonist may store and dispense an opioid antagonist so long as such person or organization does not charge or receive compensation for such activities. A health care professional who acts in good faith and with reasonable care while prescribing or dispensing an opioid antagonist shall not be subject to any criminal or civil liability or any professional disciplinary action. A person who acts in good faith and with reasonable care while administering an opioid antagonist to another person whom the person believes to be suffering an opioid-related overdose shall be immune from criminal or civil liability or any professional disciplinary action.