S.F. _____ Section 1. Section 85.27, Code 2015, is amended by adding 1 the following new subsection: 2 NEW SUBSECTION . 1A. If an employee receives care pursuant 3 to subsection 1 and the treating physician or other health care 4 professional reasonably believes, based on such physician’s or 5 other health care professional’s professional judgment, that 6 the employee is at risk of an opioid-related overdose due to 7 the work-related injury or the treatment of the work-related 8 injury, the cost of an opioid antagonist shall be paid by the 9 employer or the employer’s insurance carrier. For purposes 10 of this subsection, “opioid antagonist” and “opioid-related 11 overdose” mean the same as defined in section 124.418. 12 Sec. 2. NEW SECTION . 124.417 Immunity —— persons seeking 13 medical assistance for a drug-related overdose. 14 1. For purposes of this section, “drug-related overdose” 15 means a condition of a person for which each of the following 16 is true: 17 a. The person requires medical assistance. 18 b. The person displays symptoms including but not limited to 19 extreme physical illness, pinpoint pupils, decreased level of 20 consciousness including coma, or respiratory depression. 21 c. The person’s condition is the result of, or a prudent 22 layperson would reasonably believe the person’s condition to be 23 the result of, consumption or use of a controlled substance. 24 2. Notwithstanding any other provision of law to the 25 contrary, a person acting in good faith who seeks medical 26 assistance for another person who is experiencing a 27 drug-related overdose shall not be charged or prosecuted for 28 the possession, sharing, or use of a controlled substance 29 under section 124.401 or 124.407 or possession of drug 30 paraphernalia under section 124.414, if evidence for the charge 31 or prosecution was obtained as a result of the person’s seeking 32 medical assistance for another person who is experiencing a 33 drug-related overdose and all of the following are true: 34 a. The other person for whom medical assistance is sought is 35 -1- LSB 2093XC (2) 86 jh/nh 1/ 9

S.F. _____ in need of medical assistance for an immediate health or safety 1 concern. 2 b. The person is the first person to seek medical assistance 3 for the person experiencing a drug-related overdose. 4 c. The person provides such person’s name and contact 5 information. 6 d. The person remains on the scene until assistance arrives 7 or is provided. 8 e. The person cooperates with law enforcement and medical 9 personnel. 10 3. Notwithstanding any other provision of law to the 11 contrary, a person who experiences a drug-related overdose 12 and is in need of medical assistance shall not be charged or 13 prosecuted for possession, sharing, or use of a controlled 14 substance under section 124.401 or 124.407 or possession of 15 drug paraphernalia under section 124.414 if evidence for 16 the charge or prosecution was obtained as a result of the 17 drug-related overdose and the seeking of medical assistance. 18 4. A person’s pretrial release, probation, supervised 19 release, or parole shall not be revoked based on an incident 20 for which the person would be immune from prosecution under 21 this section. 22 5. Notwithstanding any other provision of law to the 23 contrary, the act of providing first aid or other medical 24 assistance to someone who is experiencing a drug-related 25 overdose may be considered by the court as a mitigating factor 26 in a criminal prosecution for which immunity is not provided by 27 this section. 28 6. This section shall not be construed to bar the 29 admissibility of any evidence obtained in connection with the 30 investigation and prosecution of any other crime or violation 31 committed by a person who otherwise qualifies for immunity 32 under this section. 33 7. This section shall not preclude the prosecution of a 34 person on the basis of evidence obtained other than as a result 35 -2- LSB 2093XC (2) 86 jh/nh 2/ 9

S.F. _____ of a person seeking medical assistance. 1 Sec. 3. NEW SECTION . 124.418 Possession of an opioid 2 antagonist. 3 1. For purposes of this section: 4 a. “Health care professional” means a physician and surgeon 5 or osteopathic physician and surgeon licensed under chapter 6 148, physician assistant licensed under chapter 148C, advanced 7 registered nurse practitioner licensed under chapter 152 or 8 152E, or pharmacist licensed under chapter 155A. 9 b. “Opioid antagonist” means a drug that binds to opioid 10 receptors and blocks or inhibits the effects of opioids acting 11 on those receptors, including but not limited to naloxone 12 hydrochloride or any other similarly acting drug approved by 13 the United States food and drug administration. 14 c. “Opioid-related overdose” means a condition of a person 15 for which each of the following is true: 16 (1) The person requires medical assistance. 17 (2) The person displays symptoms including but not limited 18 to extreme physical illness, pinpoint pupils, decreased level 19 of consciousness including coma, or respiratory depression. 20 (3) The person’s condition is the result of, or a prudent 21 layperson would reasonably believe the person’s condition to 22 be the result of, consumption or use of an opioid or another 23 substance with which an opioid was combined. 24 2. Notwithstanding the provisions of this chapter or any 25 other law, a person may possess an opioid antagonist if each of 26 the following is true: 27 a. The opioid antagonist is prescribed, dispensed, 28 furnished, distributed, or otherwise provided by a health 29 care professional otherwise authorized to prescribe an opioid 30 antagonist, either directly, by standing order, or through a 31 collaborative agreement. 32 b. The person is a family member or friend of, or 33 other person in a position to assist, a person at risk of 34 experiencing an opioid-related overdose. 35 -3- LSB 2093XC (2) 86 jh/nh 3/ 9

S.F. _____ Sec. 4. NEW SECTION . 135.181 Standards and reports on 1 opioid antagonist use. 2 1. For purposes of this section: 3 a. “Emergency medical services” means the same as defined 4 in section 147A.1. 5 b. “First responder” means emergency medical personnel, 6 state and local law enforcement personnel, or fire department 7 personnel who provide emergency medical services. 8 c. “Health care professional” means a physician and surgeon 9 or osteopathic physician and surgeon licensed under chapter 10 148, physician assistant licensed under chapter 148C, advanced 11 registered nurse practitioner licensed under chapter 152 or 12 152E, or pharmacist licensed under chapter 155A. 13 d. “Opioid antagonist” means the same as defined in section 14 124.418. 15 2. The department shall develop standards for recordkeeping 16 and reporting of opioid antagonist use by first responders in 17 this state, and shall provide an annual report to the general 18 assembly with recommendations regarding the use of opioid 19 antagonists in this state. 20 3. The department shall consult with health care 21 professional organizations, organizations representing first 22 responders, and other groups as determined by the department 23 to develop protocols and instructions for the administration 24 of an opioid antagonist by a person who is not a health care 25 professional or a first responder. The department shall make 26 the protocols and instructions developed pursuant to this 27 subsection publicly available on the department’s internet 28 site. 29 Sec. 5. Section 147.107, Code 2015, is amended by adding the 30 following new subsection: 31 NEW SUBSECTION . 5A. a. For purposes of this subsection: 32 (1) “Opioid antagonist” means the same as defined in section 33 124.418. 34 (2) “Opioid-related overdose” means the same as defined in 35 -4- LSB 2093XC (2) 86 jh/nh 4/ 9

S.F. _____ section 124.418. 1 b. Notwithstanding subsection 1 or any other provision 2 of law, a health care professional otherwise authorized to 3 prescribe an opioid antagonist may directly, by standing order, 4 or through collaborative agreement, prescribe, dispense, 5 furnish, or otherwise provide an opioid antagonist to a person 6 at risk of experiencing an opioid-related overdose or to a 7 family member or friend of, or other person whom the health 8 care professional believes to be in a position to assist, a 9 person at risk of experiencing an opioid-related overdose. 10 Any such prescription shall be deemed as being issued for a 11 legitimate medical purpose in the usual course of professional 12 practice. 13 c. A health care professional who prescribes an opioid 14 antagonist shall document the reasons for the prescription or 15 standing order. 16 d. A pharmacist who dispenses, furnishes, or otherwise 17 provides an opioid antagonist pursuant to a valid prescription, 18 standing order, or collaborative agreement shall provide 19 instruction to the recipient in accordance with the protocols 20 and instructions developed by the department of public health 21 under section 135.181. 22 e. A health care professional who is licensed to prescribe 23 an opioid antagonist shall not be subject to any disciplinary 24 action or civil or criminal liability for prescribing an opioid 25 antagonist to a person whom the health care professional 26 reasonably believes may be in a position to assist or 27 administer the opioid antagonist to a person at risk of an 28 opioid-related overdose. 29 Sec. 6. Section 147A.10, Code 2015, is amended by adding the 30 following new subsection: 31 NEW SUBSECTION . 4. a. For purposes of this subsection: 32 (1) “Opioid antagonist” means the same as defined in section 33 124.418. 34 (2) “Opioid-related overdose” means the same as defined in 35 -5- LSB 2093XC (2) 86 jh/nh 5/ 9

S.F. _____ section 124.418. 1 b. An emergency medical care provider or a law enforcement 2 officer who has been trained in the administration of an opioid 3 antagonist and acts with reasonable care in administering an 4 opioid antagonist to another person who the emergency medical 5 care provider or law enforcement officer believes in good faith 6 to be suffering an opioid-related overdose shall not be subject 7 to civil liability, disciplinary action, or a civil or criminal 8 penalty for an act or omission related to or resulting from the 9 administration. 10 Sec. 7. NEW SECTION . 155A.45 Administration of an opioid 11 antagonist. 12 1. For purposes of this section: 13 a. “Opioid antagonist” means the same as defined in section 14 124.418. 15 b. “Opioid-related overdose” means the same as defined in 16 section 124.418. 17 2. A person who is not otherwise licensed by an appropriate 18 state board to prescribe, dispense, or administer opioid 19 antagonists to patients may, in an emergency, administer an 20 opioid antagonist to another person if the person believes in 21 good faith that the other person is suffering an opioid-related 22 overdose, and the person shall not be subject to civil 23 liability, disciplinary action, or a civil or criminal penalty 24 for an act or omission related to or resulting from the 25 administration of an opioid antagonist. 26 Sec. 8. Section 249A.20A, Code 2015, is amended by adding 27 the following new subsection: 28 NEW SUBSECTION . 12. a. For purposes of this subsection, 29 “opioid antagonist” means the same as defined in section 30 124.418. 31 b. Notwithstanding anything in this section to the contrary, 32 the department shall include an opioid antagonist, including 33 any device integral to its administration, on the preferred 34 drug list. Reimbursement under the medical assistance program 35 -6- LSB 2093XC (2) 86 jh/nh 6/ 9

S.F. _____ shall be provided through existing resources. 1 c. A prescription for an opioid antagonist shall not be 2 subject to prior authorization or other utilization management 3 if the prescriber deems the opioid antagonist medically 4 necessary. 5 EXPLANATION 6 The inclusion of this explanation does not constitute agreement with 7 the explanation’s substance by the members of the general assembly. 8 This bill relates to drug overdose prevention and the 9 prescription and administration of opioid antagonists, and 10 provides immunity from certain criminal offenses for a person 11 who seeks medical assistance for a person experiencing an 12 overdose. 13 The bill defines an “opioid antagonist” as a drug that binds 14 to opioid receptors and blocks or inhibits the effects of 15 opioids acting on those receptors, including but not limited 16 to naloxone hydrochloride or any other similarly acting drug 17 approved by the United States food and drug administration. 18 The bill provides that if an employee is provided care under 19 Code chapter 85 (workers’ compensation), and the health care 20 professional providing care believes the employee is at risk of 21 an opioid-related overdose, the cost of a prescription for an 22 opioid antagonist shall be paid by the employer or insurance 23 carrier. 24 The bill provides immunity from certain crimes for persons 25 who seek medical assistance for a drug overdose. If a person 26 seeks medical assistance for another person experiencing a drug 27 overdose, or if a person experiencing a drug overdose seeks 28 medical assistance or is the subject of such a request, the 29 person is immune from prosecution for the possession or use of 30 a controlled substance or possession of drug paraphernalia. 31 Immunity for a person who seeks medical assistance for another 32 is only available if the person provided such person’s name and 33 contact information, remained on the scene until assistance 34 arrived or was provided, and cooperated with the authorities. 35 -7- LSB 2093XC (2) 86 jh/nh 7/ 9

S.F. _____ The bill provides that a person who is a friend or family 1 member of, or is otherwise in position to assist, a person 2 at risk of an opioid-related overdose may possess an opioid 3 antagonist. 4 The bill directs the department of public health to develop 5 standards for recordkeeping and reporting of opioid-antagonist 6 use by first responders and to provide an annual report to the 7 general assembly with recommendations regarding the use of 8 opioid antagonists. The bill further directs the department 9 of public health to develop protocols and instructions for the 10 administration of an opioid antagonist and make the protocols 11 and instructions publicly available. 12 The bill provides that a health care professional otherwise 13 authorized to prescribe an opioid antagonist may directly, by 14 standing order, or through collaborative agreement, prescribe 15 or furnish an opioid antagonist to a person at risk of 16 experiencing an opioid-related overdose or to a family member 17 or friend of, or other person in a position to assist, a person 18 at risk of experiencing an opioid-related overdose. The bill 19 provides that a health care professional licensed to prescribe 20 an opioid antagonist is not subject to civil liability, 21 disciplinary action, or a civil or criminal penalty for 22 prescribing an opioid antagonist to a person whom the health 23 care professional reasonably believes may be in a position to 24 assist or administer the opioid antagonist to a person at risk 25 of an opioid-related overdose. 26 The bill provides that an emergency medical care provider 27 or a law enforcement officer who has been trained in the 28 administration of an opioid antagonist and acts with 29 reasonable care in administering an opioid antagonist to 30 another person who the emergency medical care provider or law 31 enforcement officer believes in good faith to be suffering an 32 opioid-related overdose is not subject to civil liability, 33 disciplinary action, or a civil or criminal penalty for an act 34 or omission related to or resulting from the administration. 35 -8- LSB 2093XC (2) 86 jh/nh 8/ 9

S.F. _____ The bill provides that a person who is not licensed to 1 prescribe, dispense, or administer opioid antagonists may, in 2 an emergency, administer an opioid antagonist if the person 3 believes in good faith that the other person is suffering 4 an opioid-related overdose. The bill further provides that 5 the person is not subject to civil liability, disciplinary 6 action, or a civil or criminal penalty for an act or omission 7 related to or resulting from the administration of the opioid 8 antagonist. 9 The bill directs the department of human services to include 10 an opioid antagonist on the medical assistance preferred drug 11 list. The bill provides that, under the medical assistance 12 program, a prescription for an opioid antagonist is not subject 13 to prior authorization or other utilization management if the 14 prescriber deems the opioid antagonist medically necessary. 15 -9- LSB 2093XC (2) 86 jh/nh 9/ 9