S.F. 410 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 Persons seeking medical 13 assistance for drug-related overdose. 14 1. As used in this section, unless the context otherwise 15 requires: 16 a. “Drug-related overdose” means a condition of a person for 17 which each of the following is true: 18 (1) The person is in need of medical assistance. 19 (2) The person displays symptoms including but not limited 20 to extreme physical illness, pinpoint pupils, decreased level 21 of consciousness including coma, or respiratory depression. 22 (3) The person’s condition is the result of, or a prudent 23 layperson would reasonably believe such condition to be the 24 result of, the consumption or use of a controlled substance. 25 b. “Overdose patient” means a person who is, or would 26 reasonably be perceived to be, suffering a drug-related 27 overdose. 28 c. “Overdose reporter” means a person who seeks medical 29 assistance for an overdose patient. 30 d. “Protected information” means information or evidence 31 collected or derived as a result of any of the following: 32 (1) An overdose patient’s good-faith actions to seek 33 medical assistance while experiencing a drug-related overdose. 34 (2) An overdose reporter’s good-faith actions to seek 35 -1- SF 410 (2) 86 jh/nh/jh 1/ 7

S.F. 410 medical assistance for an overdose patient experiencing a 1 drug-related overdose if all of the following are true: 2 (a) The overdose patient is in need of medical assistance 3 for an immediate health or safety concern. 4 (b) The overdose reporter is the first person to seek 5 medical assistance for the overdose patient. 6 (c) The overdose reporter provides the overdose reporter’s 7 name and contact information to medical or law enforcement 8 personnel. 9 (d) The overdose reporter remains on the scene until 10 assistance arrives or is provided. 11 (e) The overdose reporter cooperates with law enforcement 12 and medical personnel. 13 2. Protected information shall not be considered to support 14 probable cause and shall not be admissible as evidence against 15 an overdose patient or overdose reporter for any of the 16 following offenses: 17 a. Violation of section 124.401, subsection 1. 18 b. Possession of a controlled substance under section 19 124.401, subsection 5. 20 c. Violation of section 124.407. 21 d. Violation of section 124.414. 22 3. A person’s pretrial release, probation, supervised 23 release, or parole shall not be revoked based on protected 24 information. 25 4. Notwithstanding any other provision of law to the 26 contrary, the act of providing first aid or other medical 27 assistance to someone who is experiencing a drug-related 28 overdose may be considered by a court as a mitigating factor in 29 a criminal prosecution. 30 5. This section shall not be construed to limit the use or 31 admissibility of any evidence in a criminal case other than as 32 provided in subsection 2. 33 Sec. 3. NEW SECTION . 124.418 Possession of an opioid 34 antagonist. 35 -2- SF 410 (2) 86 jh/nh/jh 2/ 7

S.F. 410 1. For purposes of this section: 1 a. “Health care professional” means a physician and surgeon 2 or osteopathic physician and surgeon licensed under chapter 3 148, physician assistant licensed under chapter 148C, advanced 4 registered nurse practitioner licensed under chapter 152 or 5 152E, or pharmacist licensed under chapter 155A. 6 b. “Opioid antagonist” means a drug that binds to opioid 7 receptors and blocks or inhibits the effects of opioids acting 8 on those receptors, including but not limited to naloxone 9 hydrochloride or any other similarly acting drug approved by 10 the United States food and drug administration. 11 c. “Opioid-related overdose” means a condition of a person 12 for which each of the following is true: 13 (1) The person requires medical assistance. 14 (2) The person displays symptoms including but not limited 15 to extreme physical illness, pinpoint pupils, decreased level 16 of consciousness including coma, or respiratory depression. 17 (3) The person’s condition is the result of, or a prudent 18 layperson would reasonably believe the person’s condition to 19 be the result of, consumption or use of an opioid or another 20 substance with which an opioid was combined. 21 2. Notwithstanding the provisions of this chapter or any 22 other law, a person may possess an opioid antagonist if each of 23 the following is true: 24 a. The opioid antagonist is prescribed, dispensed, 25 furnished, distributed, or otherwise provided by a health 26 care professional otherwise authorized to prescribe an opioid 27 antagonist, either directly, by standing order, or through a 28 collaborative agreement. 29 b. The person is a family member or friend of, or 30 other person in a position to assist, a person at risk of 31 experiencing an opioid-related overdose. 32 Sec. 4. NEW SECTION . 135.181 Standards and reports on 33 opioid antagonist use. 34 1. For purposes of this section: 35 -3- SF 410 (2) 86 jh/nh/jh 3/ 7

S.F. 410 a. “Emergency medical services” means the same as defined 1 in section 147A.1. 2 b. “First responder” means emergency medical personnel, 3 state and local law enforcement personnel, or fire department 4 personnel who provide emergency medical services. 5 c. “Health care professional” means a physician and surgeon 6 or osteopathic physician and surgeon licensed under chapter 7 148, physician assistant licensed under chapter 148C, advanced 8 registered nurse practitioner licensed under chapter 152 or 9 152E, or pharmacist licensed under chapter 155A. 10 d. “Opioid antagonist” means the same as defined in section 11 124.418. 12 2. The department shall develop standards for recordkeeping 13 and reporting of opioid antagonist use by first responders in 14 this state, and shall provide an annual report to the general 15 assembly with recommendations regarding the use of opioid 16 antagonists in this state. 17 3. The department shall consult with health care 18 professional organizations, organizations representing first 19 responders, and other groups as determined by the department 20 to develop protocols and instructions for the administration 21 of an opioid antagonist by a person who is not a health care 22 professional or a first responder. The department shall make 23 the protocols and instructions developed pursuant to this 24 subsection publicly available on the department’s internet 25 site. 26 Sec. 5. Section 147.107, Code 2015, is amended by adding the 27 following new subsection: 28 NEW SUBSECTION . 5A. a. For purposes of this subsection: 29 (1) “Opioid antagonist” means the same as defined in section 30 124.418. 31 (2) “Opioid-related overdose” means the same as defined in 32 section 124.418. 33 b. Notwithstanding subsection 1 or any other provision 34 of law, a health care professional otherwise authorized to 35 -4- SF 410 (2) 86 jh/nh/jh 4/ 7

S.F. 410 prescribe an opioid antagonist may directly, by standing order, 1 or through collaborative agreement, prescribe, dispense, 2 furnish, or otherwise provide an opioid antagonist to a person 3 at risk of experiencing an opioid-related overdose or to a 4 family member or friend of, or other person whom the health 5 care professional believes to be in a position to assist, a 6 person at risk of experiencing an opioid-related overdose. 7 Any such prescription shall be deemed as being issued for a 8 legitimate medical purpose in the usual course of professional 9 practice. 10 c. A health care professional who prescribes an opioid 11 antagonist shall document the reasons for the prescription or 12 standing order. 13 d. A pharmacist who dispenses, furnishes, or otherwise 14 provides an opioid antagonist pursuant to a valid prescription, 15 standing order, or collaborative agreement shall provide 16 instruction to the recipient in accordance with the protocols 17 and instructions developed by the department of public health 18 under section 135.181. 19 e. A health care professional who is licensed to prescribe 20 an opioid antagonist shall not be subject to any disciplinary 21 action or civil or criminal liability for prescribing an opioid 22 antagonist to a person whom the health care professional 23 reasonably believes may be in a position to assist or 24 administer the opioid antagonist to a person at risk of an 25 opioid-related overdose. 26 Sec. 6. Section 147A.10, Code 2015, is amended by adding the 27 following new subsection: 28 NEW SUBSECTION . 4. a. For purposes of this subsection: 29 (1) “Opioid antagonist” means the same as defined in section 30 124.418. 31 (2) “Opioid-related overdose” means the same as defined in 32 section 124.418. 33 b. An emergency medical care provider or a law enforcement 34 officer who has been trained in the administration of an opioid 35 -5- SF 410 (2) 86 jh/nh/jh 5/ 7

S.F. 410 antagonist and acts with reasonable care in administering an 1 opioid antagonist to another person who the emergency medical 2 care provider or law enforcement officer believes in good faith 3 to be suffering an opioid-related overdose shall not be subject 4 to civil liability, disciplinary action, or a civil or criminal 5 penalty for an act or omission related to or resulting from the 6 administration. 7 Sec. 7. NEW SECTION . 155A.45 Administration of an opioid 8 antagonist. 9 1. For purposes of this section: 10 a. “Opioid antagonist” means the same as defined in section 11 124.418. 12 b. “Opioid-related overdose” means the same as defined in 13 section 124.418. 14 2. A person who is not otherwise licensed by an appropriate 15 state board to prescribe, dispense, or administer opioid 16 antagonists to patients may, in an emergency, administer an 17 opioid antagonist to another person if the person believes in 18 good faith that the other person is suffering an opioid-related 19 overdose, and the person shall not be subject to civil 20 liability, disciplinary action, or a civil or criminal penalty 21 for an act or omission related to or resulting from the 22 administration of an opioid antagonist. 23 Sec. 8. Section 249A.20A, Code 2015, is amended by adding 24 the following new subsection: 25 NEW SUBSECTION . 12. a. For purposes of this subsection, 26 “opioid antagonist” means the same as defined in section 27 124.418. 28 b. Notwithstanding anything in this section to the contrary, 29 the department shall include an opioid antagonist, including 30 any device integral to its administration, on the preferred 31 drug list. Reimbursement under the medical assistance program 32 shall be provided through existing resources. 33 c. A prescription for an opioid antagonist shall not be 34 subject to prior authorization or other utilization management 35 -6- SF 410 (2) 86 jh/nh/jh 6/ 7