HF 2296 (LSB 5967YH (3) 90)

HOUSE FILE 2296

BY  FORBES

A BILL FOR

An Act relating to the provision of harm reduction vending machines.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  Section 124.414, subsection 1, paragraph b, Code 2024, is amended to read as follows:
   b.  “Drug paraphernalia” does not include hypodermic any of the following: 
   (1)  Hypodermic needles or syringes if manufactured, delivered, sold, or possessed for a lawful purpose.
   (2)  Equipment, products, or materials used to analyze or test for the presence of fentanyl, a fentanyl analog, or a drug adulterant within a controlled substance.
    Sec. 2.  Section 135.190, Code 2024, is amended to read as follows:
   135.190  Possession and administration of opioid antagonists —— harm reduction vending machines —— immunity.
   1.  For purposes of this section subchapter, unless the context otherwise requires:
   a.  “Community-based organization” means a public or private organization that provides health or human services to meet the needs of a community including but not limited to a nonprofit organization, a social service provider, or an organization providing substance abuse disorder prevention, treatment, recovery, or harm reduction services.
   b.  “Fentanyl test strip” means equipment, products, or materials used to analyze or test for the presence of fentanyl, a fentanyl analog, or a drug adulterant within a controlled substance.
   c.  “First responder” means an emergency medical care provider, a registered nurse staffing an authorized service program under section 147A.12, a physician assistant staffing an authorized service program under section 147A.13, a fire fighter, or a peace officer as defined in section 801.4 who is trained and authorized to administer an opioid antagonist.
   d.  “Harm reduction vending machine” means a vending machine stocked with opioid antagonists and fentanyl test strips that are accessed free of charge through an access code obtained by calling the telephone number or visiting the internet site provided on the vending machine.
   b.  e.  “Licensed health care professional” means the same as defined in section 280.16.
   c.  f.  “Opioid antagonist” means the same as defined in section 147A.1.
   d.  g.  “Opioid-related overdose” means the same as defined in section 147A.1.
   e.  h.  “Person in a position to assist” means a family member, friend, caregiver, community-based organization, health care provider, employee of a substance use disorder treatment facility, school employee, first responder as defined in section 147A.1, or other person who may be in a place to render aid to a person at risk of experiencing an opioid-related overdose.
   f.  i.  “Secondary distributor” means a law enforcement agency, emergency medical services program, fire department, school district, health care provider, licensed behavioral health provider, county health department, or the department of health and human services.
   2.  a.  Notwithstanding any other provision of law to the contrary, a licensed health care professional may prescribe an opioid antagonist to a person in a position to assist or to a secondary distributor.
   b.  (1)  Notwithstanding any other provision of law to the contrary, a pharmacist licensed under chapter 155A may, by standing order or through collaborative agreement, dispense, furnish, or otherwise provide an opioid antagonist to a person in a position to assist or to a secondary distributor.
   (2)  A pharmacist or secondary distributor who dispenses, furnishes, or otherwise provides an opioid antagonist pursuant to a valid prescription, standing order, or collaborative agreement shall provide written instruction, which shall include emergency, crisis, and substance use referral contact information, to the recipient in accordance with any protocols and instructions developed by the department under this section.
   3.  A person in a position to assist may possess and provide or administer an opioid antagonist to an individual if the person in a position to assist reasonably and in good faith believes that such individual is experiencing an opioid-related overdose.
   4.  a.  Notwithstanding any other provision of law to the contrary, the chief medical officer of the department may issue a standing order that does not identify individual patients at the time it is issued for the purpose of dispensing opioid antagonists to a person in a position to assist.
   b.  Notwithstanding any provision of law to the contrary, the chief medical officer of the department shall issue a standing order that does not identify individual patients at the time it is issued for the purpose of dispensing opioid antagonists through harm reduction vending machines as provided in section 135.190B.
   5.  A person in a position to assist may distribute an opioid antagonist to any individual pursuant to this section.
   6.  A person in a position to assist, a secondary distributor, or a prescriber of an opioid antagonist who has acted reasonably and in good faith shall not be liable for any injury arising from the provision, administration, or assistance in the administration of an opioid antagonist as provided in this section.
   7.  A school district may obtain a valid prescription for an opioid antagonist and maintain a supply of opioid antagonists in a secure location at each location where a student may be present for use as provided in this section.
   8.  The department may adopt rules pursuant to chapter 17A to implement and administer this section.
    Sec. 3.  Section 135.190A, Code 2024, is amended to read as follows:
   135.190A  Opioid antagonist medication fund.
   1.  An opioid antagonist medication fund for first responders is created within the state treasury under the control of the department. The fund shall consist of moneys appropriated to or deposited into the fund. 
   2.  Moneys in the fund are appropriated to the department for the purchase, maintenance, and replacement of opioid antagonist medication antagonists administered by first responders to persons experiencing an opioid-related overdose, and for the purchase, maintenance, and replacement of opioid antagonists provided through harm reduction vending machines pursuant to section 135.190B. The department is authorized to may designate moneys in the fund for the purchase, maintenance, and replacement of opioid antagonist medication antagonists used by the department or other entities under this section. 
   3.  First responders may contact the department for the procurement of opioid antagonist medication antagonists, and community-based organizations may contact the department for the procurement of opioid antagonists to be placed in harm reduction vending machines. The department shall keep a record of the distribution of moneys from the fund.
   4.  The fund may consist of available federal or state moneys available, as well as any available opioid lawsuit settlement moneys. Funds may be transferred between other state agencies and the fund as appropriate.
   5.  Notwithstanding section 8.33, moneys in the fund that remain unencumbered or unobligated at the close of a fiscal year shall not revert but shall remain available for expenditure for the purposes designated unless federal regulations otherwise require. Notwithstanding section 12C.7, subsection 2, interest or earnings on moneys in the fund shall be credited to the fund.
   6.  The department shall submit a report to the general assembly on or before December 31 of each year which shall contain a list of deposits and expenditures from the fund for the prior fiscal year and the amount of carryover funds, if any, to be distributed in the next fiscal year.
   7.  For purposes of this section:
   a.  “First responder” means an emergency medical care provider, a registered nurse staffing an authorized service program under section 147A.12, a physician assistant staffing an authorized service program under section 147A.13, a fire fighter, or a peace officer as defined in section 801.4 who is trained and authorized to administer an opioid antagonist.
   b.  “Opioid antagonist” means the same as defined in section 147A.1.
   c.  “Opioid-related overdose” means the same as defined in section 147A.1.
    Sec. 4.  NEW SECTION.  135.190B  Harm reduction vending machines —— immunity —— rules.
   1.  The department shall collaborate with the department of public safety, the Iowa harm reduction coalition, and community-based organizations to develop and implement a strategic plan to place and continuously stock harm reduction vending machines to make opioid antagonists and fentanyl test strips readily available to the public in areas throughout the state with the highest prevalence of opioid-related overdose.
   2.  A person who controls, manages, or legally accesses a harm reduction vending machine and who acts reasonably and in good faith shall not be liable for any injury arising from the provision, administration, or assistance in the administration of an opioid antagonist accessed through a harm reduction vending machine as provided in this section.
   3.  The department shall adopt rules pursuant to chapter 17A to administer this section.
    Sec. 5.  CODE EDITOR DIRECTIVE.  The Code editor is directed to rename subchapter XXXIII in chapter 135 “OPIOID ANTAGONISTS —— QUALIFIED IMMUNITY —— FUND —— HARM REDUCTION VENDING MACHINES” and include sections 135.190 through 135.190B.
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 the provision of harm reduction vending machines. The bill amends Code section 135.190 (possession and administration of opioid antagonists —— immunity) to provide definitions used in the bill including “harm reduction vending machine” which is defined as a vending machine stocked with opioid antagonists and fentanyl test strips that are accessed free of charge through the use of an access code obtained by calling the telephone number or visiting the internet site provided on the vending machine. Code section 135.190 is also amended to require that, notwithstanding any provision of law to the contrary, the chief medical officer of the department of health and human services (HHS) shall issue a standing order that does not identify individual patients at the time it is issued for the purpose of dispensing opioid antagonists through harm reduction vending machines.
   The bill amends Code section 135.190A (opioid antagonist medication fund) to provide that the moneys in the fund and appropriated to HHS may be used for the purchase, maintenance, and replacement of opioid antagonists to be placed in harm reduction vending machines; and to provide that community-based organizations may contact HHS for the procurement of opioid antagonists to be placed in harm reduction vending machines.
   The bill creates new Code section 135.190B (harm reduction vending machines —— immunity —— rules). The bill requires HHS to collaborate with the department of public safety, the Iowa harm reduction coalition, and community-based organizations to develop and implement a strategic plan to place and continuously stock harm reduction vending machines to make opioid antagonists and fentanyl test strips available to the public in areas throughout the state with the highest prevalence of opioid-related overdose. The bill provides that a person who controls, manages, or legally accesses a harm reduction vending machine and who acts reasonably and in good faith shall not be liable for any injury arising from the provision, administration, or assistance in the administration of an opioid antagonist accessed through a harm reduction vending machine. HHS shall adopt administrative rules to administer the new Code section.
   Under current Code section 124.414 (drug paraphernalia) a person who knowingly or intentionally manufactures, delivers, sells, or possesses drug paraphernalia commits a simple misdemeanor. A simple misdemeanor is punishable by confinement for no more than 30 days and a fine of at least $105 but not more than $855. The bill exempts from the definition of “drug paraphernalia” equipment, products, or materials used to analyze or test for the presence of fentanyl, a fentanyl analog, or a drug adulterant within a controlled substance.