SF 410 (LSB 2093SV (1) 86)

SENATE FILE 410

BY  COMMITTEE ON HUMAN RESOURCES

(SUCCESSOR TO SSB 1209)

A BILL FOR

An Act relating to drug overdose prevention, including by limiting criminal and civil liability, and modifying penalties.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  Section 85.27, Code 2015, is amended by adding the following new subsection:
   NEW SUBSECTION.  1A.  If an employee receives care pursuant to subsection 1 and the treating physician or other health care professional reasonably believes, based on such physician’s or other health care professional’s professional judgment, that the employee is at risk of an opioid-related overdose due to the work-related injury or the treatment of the work-related injury, the cost of an opioid antagonist shall be paid by the employer or the employer’s insurance carrier. For purposes of this subsection, “opioid antagonist” and “opioid-related overdose” mean the same as defined in section 124.418.
    Sec. 2.  NEW SECTION.  124.417  Immunity —— persons seeking medical assistance for a drug-related overdose.
   1.  For purposes of this section, “drug-related overdose” means a condition of a person 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, pinpoint pupils, decreased level of consciousness including coma, or respiratory depression.
   c.  The person’s condition is the result of, or a prudent layperson would reasonably believe the person’s condition to be the result of, consumption or use of a controlled substance.
   2.  Notwithstanding any other provision of law to the contrary, a person acting in good faith who seeks medical assistance for another person who is experiencing a drug-related overdose shall not be charged or prosecuted for the possession, sharing, or use of a controlled substance under section 124.401 or 124.407 or possession of drug paraphernalia under section 124.414, if evidence for the charge or prosecution was obtained as a result of the person’s seeking medical assistance for another person who is experiencing a drug-related overdose and all of the following are true:
   a.  The other person for whom medical assistance is sought is in need of medical assistance for an immediate health or safety concern.
   b.  The person is the first person to seek medical assistance for the person experiencing a drug-related overdose.
   c.  The person provides such person’s name and contact information.
   d.  The person remains on the scene until assistance arrives or is provided.
   e.  The person cooperates with law enforcement and medical personnel.
   3.  Notwithstanding any other provision of law to the contrary, a person who experiences a drug-related overdose and is in need of medical assistance shall not be charged or prosecuted for possession, sharing, or use of a controlled substance under section 124.401 or 124.407 or possession of drug paraphernalia under section 124.414 if evidence for the charge or prosecution was obtained as a result of the drug-related overdose and the seeking of medical assistance.
   4.  A person’s pretrial release, probation, supervised release, or parole shall not be revoked based on an incident for which the person would be immune from prosecution under this section.
   5.  Notwithstanding any other provision of law to the contrary, the act of providing first aid or other medical assistance to someone who is experiencing a drug-related overdose may be considered by the court as a mitigating factor in a criminal prosecution for which immunity is not provided by this section.
   6.  This section shall not be construed to bar the admissibility of any evidence obtained in connection with the investigation and prosecution of any other crime or violation committed by a person who otherwise qualifies for immunity under this section.
   7.  This section shall not preclude the prosecution of a person on the basis of evidence obtained other than as a result of a person seeking medical assistance.
    Sec. 3.  NEW SECTION.  124.418  Possession of an opioid antagonist.
   1.  For purposes of this section:
   a.  “Health care professional” means a physician and surgeon or osteopathic physician and surgeon licensed under chapter 148, physician assistant licensed under chapter 148C, advanced registered nurse practitioner licensed under chapter 152 or 152E, or pharmacist licensed under chapter 155A.
   b.  “Opioid antagonist” means a drug that binds to opioid receptors and blocks or inhibits the effects of opioids acting on those receptors, including but not limited to naloxone hydrochloride or any other similarly acting drug approved by the United States food and drug administration.
   c.  “Opioid-related 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, pinpoint pupils, decreased level of consciousness including coma, or respiratory depression.
   (3)  The person’s condition is the result of, or a prudent 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.
   2.  Notwithstanding the provisions of this chapter or any other law, a person may possess an opioid antagonist if each of the following is true:
   a.  The opioid antagonist is prescribed, dispensed, furnished, distributed, or otherwise provided by a health care professional otherwise authorized to prescribe an opioid antagonist, either directly, by standing order, or through a collaborative agreement.
   b.  The person is a family member or friend of, or other person in a position to assist, a person at risk of experiencing an opioid-related overdose.
    Sec. 4.  NEW SECTION.  135.181  Standards and reports on opioid antagonist use.
   1.  For purposes of this section:
   a.  “Emergency medical services” means the same as defined in section 147A.1.
   b.  “First responder” means emergency medical personnel, state and local law enforcement personnel, or fire department personnel who provide emergency medical services.
   c.  “Health care professional” means a physician and surgeon or osteopathic physician and surgeon licensed under chapter 148, physician assistant licensed under chapter 148C, advanced registered nurse practitioner licensed under chapter 152 or 152E, or pharmacist licensed under chapter 155A.
   d.  “Opioid antagonist” means the same as defined in section 124.418.
   2.  The department shall develop standards for recordkeeping and reporting of opioid antagonist use by first responders in this state, and shall provide an annual report to the general assembly with recommendations regarding the use of opioid antagonists in this state.
   3.  The department shall consult with health care professional organizations, organizations representing first responders, and other groups as determined by the department to develop protocols and instructions for the administration of an opioid antagonist by a person who is not a health care professional or a first responder. The department shall make the protocols and instructions developed pursuant to this subsection publicly available on the department’s internet site.
    Sec. 5.  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 the same as defined in section 124.418.
   b.  Notwithstanding subsection 1 or any other provision of law, a health care professional otherwise authorized to prescribe an opioid antagonist may directly, by standing order, or through collaborative agreement, prescribe, dispense, furnish, or otherwise provide an opioid antagonist to a person at risk of experiencing an opioid-related overdose or to a family member or friend of, or other person whom the health care professional believes to be in a position to assist, a person at risk of experiencing an opioid-related overdose. Any such prescription shall be deemed as being issued for a legitimate medical purpose in the usual course of professional practice.
   c.  A health care professional who prescribes an opioid antagonist shall document the reasons for the prescription or standing order.
   d.  A pharmacist who dispenses, furnishes, or otherwise provides an opioid antagonist pursuant to a valid prescription, standing order, or collaborative agreement shall provide instruction to the recipient in accordance with the protocols and instructions developed by the department of public health under section 135.181.
   e.  A health care professional who is licensed to prescribe an opioid antagonist shall not be subject to any disciplinary action or civil or criminal liability for prescribing an opioid antagonist to a person whom the health care professional reasonably believes may be in a position to assist or administer the opioid antagonist to a person at risk of an opioid-related overdose.
    Sec. 6.  Section 147A.10, Code 2015, is amended by adding the following new subsection:
   NEW SUBSECTION.  4.  a.  For purposes of this subsection:
   (1)  “Opioid antagonist” means the same as defined in section 124.418.
   (2)  “Opioid-related overdose” means the same as defined in section 124.418.
   b.  An emergency medical care provider or a law enforcement officer who has been trained in the administration of an opioid antagonist and acts with reasonable care in administering an opioid antagonist to another person who the emergency medical care provider or law enforcement officer believes in good faith to be suffering an opioid-related overdose shall not be subject to civil liability, disciplinary action, or a civil or criminal penalty for an act or omission related to or resulting from the administration.
    Sec. 7.  NEW SECTION.  155A.45  Administration of an opioid antagonist.
   1.  For purposes of this section:
   a.  “Opioid antagonist” means the same as defined in section 124.418.
   b.  “Opioid-related overdose” means the same as defined in section 124.418.
   2.  A person who is not otherwise licensed by an appropriate state board to prescribe, dispense, or administer opioid antagonists to patients may, in an emergency, administer an opioid antagonist to another person if the person believes in good faith that the other person is suffering an opioid-related overdose, and the person shall not be subject to civil liability, disciplinary action, or a civil or criminal penalty for an act or omission related to or resulting from the administration of an opioid antagonist.
    Sec. 8.  Section 249A.20A, Code 2015, is amended by adding the following new subsection:
   NEW SUBSECTION.  12.  a.  For purposes of this subsection, “opioid antagonist” means the same as defined in section 124.418.
   b.  Notwithstanding anything in this section to the contrary, the department shall include an opioid antagonist, including any device integral to its administration, on the preferred drug list. Reimbursement under the medical assistance program shall be provided through existing resources.
   c.  A prescription for an opioid antagonist shall not be subject to prior authorization or other utilization management if the prescriber deems the opioid antagonist medically necessary.
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 overdose prevention and the prescription and administration of opioid antagonists, and provides immunity from certain criminal offenses for a person who seeks medical assistance for a person experiencing an overdose.
   The bill defines an “opioid antagonist” as a drug that binds to opioid receptors and blocks or inhibits the effects of opioids acting on those receptors, including but not limited to naloxone hydrochloride or any other similarly acting drug approved by the United States food and drug administration.
   The bill provides that if an employee is provided care under Code chapter 85 (workers’ compensation), and the health care professional providing care believes the employee is at risk of an opioid-related overdose, the cost of a prescription for an opioid antagonist shall be paid by the employer or insurance carrier.
   The bill provides immunity from certain crimes for persons who seek medical assistance for a drug overdose. If a person seeks medical assistance for another person experiencing a drug overdose, or if a person experiencing a drug overdose seeks medical assistance or is the subject of such a request, the person is immune from prosecution for the possession or use of a controlled substance or possession of drug paraphernalia. Immunity for a person who seeks medical assistance for another is only available if the person provided such person’s name and contact information, remained on the scene until assistance arrived or was provided, and cooperated with the authorities.
   The bill provides that a person who is a friend or family member of, or is otherwise in position to assist, a person at risk of an opioid-related overdose may possess an opioid antagonist.
   The bill directs the department of public health to develop standards for recordkeeping and reporting of opioid-antagonist use by first responders and to provide an annual report to the general assembly with recommendations regarding the use of opioid antagonists. The bill further directs the department of public health to develop protocols and instructions for the administration of an opioid antagonist and make the protocols and instructions publicly available.
   The bill provides that a health care professional otherwise authorized to prescribe an opioid antagonist may directly, by standing order, or through collaborative agreement, prescribe or furnish an opioid antagonist to a person at risk of experiencing an opioid-related overdose or to a family member or friend of, or other person in a position to assist, a person at risk of experiencing an opioid-related overdose. The bill provides that a health care professional licensed to prescribe an opioid antagonist is not subject to civil liability, disciplinary action, or a civil or criminal penalty for prescribing an opioid antagonist to a person whom the health care professional reasonably believes may be in a position to assist or administer the opioid antagonist to a person at risk of an opioid-related overdose.
   The bill provides that an emergency medical care provider or a law enforcement officer who has been trained in the administration of an opioid antagonist and acts with reasonable care in administering an opioid antagonist to another person who the emergency medical care provider or law enforcement officer believes in good faith to be suffering an opioid-related overdose is not subject to civil liability, disciplinary action, or a civil or criminal penalty for an act or omission related to or resulting from the administration.
   The bill provides that a person who is not licensed to prescribe, dispense, or administer opioid antagonists may, in an emergency, administer an opioid antagonist if the person believes in good faith that the other person is suffering an opioid-related overdose. The bill further provides that the person is not subject to civil liability, disciplinary action, or a civil or criminal penalty for an act or omission related to or resulting from the administration of the opioid antagonist.
   The bill directs the department of human services to include an opioid antagonist on the medical assistance preferred drug list. The bill provides that, under the medical assistance program, a prescription for an opioid antagonist is not subject to prior authorization or other utilization management if the prescriber deems the opioid antagonist medically necessary.