[First Reprint]

SENATE, No. 3491

STATE OF NEW JERSEY

219th LEGISLATURE

 

INTRODUCED MARCH 4, 2021

 


 

Sponsored by:

Senator  JOSEPH F. VITALE

District 19 (Middlesex)

Senator  JOSEPH A. LAGANA

District 38 (Bergen and Passaic)

 

Co-Sponsored by:

Senators Diegnan and Gopal

 

 

 

 

SYNOPSIS

     Expands ability of any person to acquire opioid antidotes and to furnish or administer them to others.

 

CURRENT VERSION OF TEXT

     As reported by the Senate Health, Human Services and Senior Citizens Committee on March 9, 2021, with amendments.

  


An Act concerning opioid antidotes 1[and] ,1 supplementing Title 24 of the Revised Statutes 1, amending various parts of the statutory law,1 and repealing 1sections 1 through 6 of1 P.L.2013, c.46 (C.24:6J-1 1[et seq.] through C.24:6J-61 ).

 

     Be It Enacted by the Senate and General Assembly of the State of New Jersey:

 

     1.    (New section) As used in this section:

     a.     "Opioid antidote" means any drug, regardless of dosage amount or method of administration, which has been approved by the United States Food and Drug Administration (FDA) for the treatment of an opioid overdose.  "Opioid antidote” includes, but is not limited to, naloxone hydrochloride, in any dosage amount, which is administered through nasal spray or any other FDA-approved means or methods.

     "Opioid overdose" means an acute condition including, but not limited to, extreme physical illness, decreased level of consciousness, respiratory depression, coma, or death resulting from the consumption or use of an opioid drug or another substance with which an opioid drug was combined, and that a layperson would reasonably believe to require medical assistance.

     b.    (1) 1[Within 90 days of the effective date of this act, any] Any1 person in this State may 1[dispense an opioid antidote to a person who is located in this State] acquire an opioid antidote from a licensed pharmacist or other health care professional authorized pursuant to Title 45 of the Revised Statutes to prescribe and dispense prescription drugs1 .

     (2)   1Any individual who is in possession of an opioid antidote may furnish the opioid antidote to any other person located in this State.  In the case of a pharmacist, the opioid antidote shall not be dispensed by the pharmacist except upon a prescription for the opioid antidote or pursuant to a standing order issued under the provisions of section 1 of P.L.2017, c.88 (C.45:14-67.2).  In the case of a health care professional who is authorized pursuant to Title 45 of the Revised Statutes to prescribe and dispense prescription drugs, the opioid antidote shall not be dispensed by the health care professional except upon a prescription issued by the health care professional.

     (3)1  Any person in this State may administer an opioid antidote to 1[a recipient who is located in this State if] any individual who1 the person believes, in good faith, 1[that the recipient]1 is experiencing an opioid overdose.  1The provisions of this paragraph shall apply regardless of whether the person administering the opioid antidote is doing so in a professional capacity as a licensed health care professional or first responder.1

     1[(3)] c.1  Within 90 days 1[of] after1 the 1[effective]1 date of 1enactment of1 this act, the Department of 1[Health] Human Services1 shall publish on its Internet website guidelines for the dispensation of opioid antidotes that are dispensed pursuant to the provisions of this section.

     1[c.] d.1  Any person who 1prescribes, dispenses, furnishes, or1 administers 1[or dispenses]1 an opioid antidote in good faith, and in accordance with the provisions of this section, shall not, as a result of the person's acts or omissions, be subject to any criminal or civil liability or any professional disciplinary action under Title 45 of the Revised Statutes for such administering or dispensing.

 

     12.   Section 8 of P.L.2013, c.46 (C.2C:35-31) is amended to read as follows:

     8.    a.  A person who experiences a drug overdose and who seeks medical assistance or is the subject of a good faith request for medical assistance [pursuant to section 4 of this act] in connection with a drug overdose or a suspected drug overdose shall not be:

     (1)   arrested, charged, prosecuted, or convicted for obtaining, possessing, using, being under the influence of, or failing to make lawful disposition of, a controlled dangerous substance or controlled substance analog pursuant to subsection a., b., or c. of N.J.S.2C:35-10;

     (2)   arrested, charged, prosecuted, or convicted for inhaling the fumes of or possessing any toxic chemical pursuant to subsection b. of section 7 of P.L.1999, c.90 (C.2C:35-10.4);

     (3)   arrested, charged, prosecuted, or convicted for using, obtaining, attempting to obtain, or possessing any prescription legend drug or stramonium preparation pursuant to subsection b., d., or e. of section 8 of P.L.1999, c.90 (C.2C:35-10.5);

     (4)   arrested, charged, prosecuted, or convicted for acquiring or obtaining possession of a controlled dangerous substance or controlled substance analog by fraud pursuant to N.J.S.2C:35-13;

     (5)   arrested, charged, prosecuted, or convicted for unlawfully possessing a controlled dangerous substance that was lawfully prescribed or dispensed pursuant to P.L.1998, c.90 (C.2C:35-24);

     (6)   arrested, charged, prosecuted, or convicted for using or possessing with intent to use drug paraphernalia pursuant to N.J.S.2C:36-2 or for having under his control or possessing a hypodermic syringe, hypodermic needle, or any other instrument adapted for the use of a controlled dangerous substance or a controlled substance analog pursuant to subsection a. of N.J.S.2C:36-6;

     (7)   subject to revocation of parole or probation based only upon a violation of offenses described in subsection a. (1) through (6) of this section, provided, however, that this circumstance may be considered in establishing or modifying the conditions of parole or probation supervision.

     b.    The provisions of subsection a. of this section shall only apply if the evidence for an arrest, charge, prosecution, conviction or revocation was obtained as a result of the seeking of medical assistance.

     c.     Nothing in this section shall be construed to limit the admissibility of any evidence in connection with the investigation or prosecution of a crime with regard to a defendant who does not qualify for the protections of this act or with regard to other crimes committed by a person who otherwise qualifies for protection pursuant to this act.  Nothing in this section shall be construed to limit any seizure of evidence or contraband otherwise permitted by law.  Nothing herein shall be construed to limit or abridge the authority of a law enforcement officer to detain or take into custody a person in the course of an investigation or to effectuate an arrest for any offense except as provided in subsection a. of this section.  Nothing in this section shall be construed to limit, modify or remove any immunity from liability currently available to public entities or public employees by law.1

(cf: P.L.2013, c.46, s.8)

 

     13.   Section 2 of P.L.2018, c.106 (C.18A:40-12.24) is amended to read as follows:

     2.    a.  Each board of education, board of trustees of a charter school, and chief school administrator of a nonpublic school shall develop a policy, in accordance with guidelines established by the Department of Education pursuant to section 3 of this act, for the emergency administration of an opioid antidote to a student, staff member, or other person who is experiencing an opioid overdose.  The policy shall:

     (1)   require each school that includes any of the grades nine through 12, and permit any other school, to obtain [a standing order for] opioid antidotes pursuant to section [4 of the "Overdose Prevention Act," P.L.2013, c.46 (C.24:6J-4)] section 1 of P.L.    , c.    (C.        ) (pending before the Legislature as this bill), and to maintain a supply of opioid antidotes under the standing order in a secure but unlocked and easily accessible location; and

     (2)   permit the school nurse, or a trained employee designated pursuant to subsection c. of this section, to administer an opioid antidote to any person whom the nurse or trained employee in good faith believes is experiencing an opioid overdose.

     b.    (1) Opioid antidotes shall be maintained by a school pursuant to paragraph (1) of subsection a. of this section in quantities and types deemed adequate by the board of education, board of trustees of a charter school, or chief school administrator of a nonpublic school, in consultation with the Department of Education and the Department of Human Services.

     (2)   The opioid antidotes shall be accessible in the school during regular school hours and during school-sponsored functions that take place in the school or on school grounds adjacent to the school building.  A board of education, board of trustees of a charter school, or chief school administrator of a nonpublic school may, in its discretion, make opioid antidotes accessible during school-sponsored functions that take place off school grounds.

     c.     (1)  The school nurse shall have the primary responsibility for the emergency administration of an opioid antidote in accordance with a policy developed under this section.  The board of education, board of trustees of a charter school, or chief school administrator of a nonpublic school shall designate additional employees of the school district, charter school, or nonpublic school who volunteer to administer an opioid antidote in the event that a person experiences an opioid overdose when the nurse is not physically present at the scene.  The designated employees shall only be authorized to administer opioid antidotes after receiving the training required under subsection b. of section 3 of this act.

     (2)   In the event that a licensed athletic trainer volunteers to administer an opioid antidote pursuant to this act, it shall not constitute a violation of the "Athletic Training Licensure Act," P.L.1984, c.203 (C.45:9-37.35 et seq.).

     d.    A policy developed pursuant to this section shall require the transportation of an overdose victim to a hospital emergency room by emergency services personnel after the administration of an opioid antidote, even if the person's symptoms appear to have resolved.1

(cf: P.L.2018, c.106, s.2)

 

     14.   Section 3 of P.L.2018, c.106 (C.18A:40-12.25) is amended to read as follows:

     3.    a.  The Department of Education, in consultation with the Department of Human Services and appropriate medical experts, shall establish guidelines for the development of a policy by a school district, charter school, or nonpublic school for the emergency administration of opioid antidotes.  Each board of education, board of trustees of a charter school, and chief school administrator of a nonpublic school shall implement the guidelines in developing a policy pursuant to section 2 of this act. 

     b.    The guidelines shall include a requirement that each school nurse, and each employee designated pursuant to subsection c. of section 2 of this act, receive training on standardized protocols for the administration of an opioid antidote to a person who experiences an opioid overdose.  [The training shall include the overdose prevention information described in subsection a. of section 5 of the "Overdose Prevention Act," P.L.2013, c.46 (C.24:6J-5).]  The guidelines shall specify an appropriate entity or entities to provide the training, and a school nurse shall not be solely responsible to train the employees designated pursuant to subsection c. of section 2 of this act.1 

(cf: P.L.2018, c.106, s.3)

 

     15.   Section 4 of P.L.2006, c.99 (C.26:5C-28) is amended to read as follows:

     4.    a. In accordance with the provisions of section 3 of P.L.2006, c.99 (C.26:5C-27), a municipality may establish or authorize establishment of a sterile syringe access program that is approved by the commissioner to provide for the exchange of hypodermic syringes and needles.

     (1)   A municipality that establishes a sterile syringe access program, at a fixed location or through a mobile access component, may operate the program directly or contract with one or more of the following entities to operate the program:  a hospital or other health care facility licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.), a federally qualified health center, a public health agency, a substance abuse treatment program, an AIDS service organization, or another nonprofit entity designated by the municipality.  These entities shall also be authorized to contract directly with the commissioner in any municipality in which the governing body has authorized the operation of sterile syringe access programs by ordinance pursuant to paragraph (2) of this subsection.  The municipality or entity under contract shall implement the sterile syringe access program in consultation with a federally qualified health center and the New Jersey Office on Minority and Multicultural Health in the Department of Health, and in a culturally competent manner.

     (2)   Pursuant to paragraph (2) of subsection a. of section 3 of P.L.2006, c.99 (C.26:5C-27), a municipality whose governing body has authorized the operation of sterile syringe access programs within the municipality may require within the authorizing ordinance that an entity as described in paragraph (1) of this subsection obtain approval from the municipality, in a manner prescribed by the authorizing ordinance, to operate a sterile syringe access program prior to obtaining approval from the commissioner to operate such a program, or may permit the entity to obtain approval to operate such a program by application directly to the commissioner without obtaining prior approval from the municipality.

     (3)   Two or more municipalities may jointly establish or authorize establishment of a sterile syringe access program that operates within those municipalities pursuant to adoption of an ordinance by each participating municipality pursuant to this section.

     b.    A sterile syringe access program shall comply with the following requirements:

     (1)   Sterile syringes and needles shall be provided at no cost to consumers 18 years of age and older;

     (2)   Program staff shall be trained and regularly supervised in:  harm reduction; substance use disorder, medical and social service referrals; and infection control procedures, including universal precautions and needle stick injury protocol; and programs shall maintain records of staff and volunteer training and of hepatitis C and tuberculosis screening provided to volunteers and staff;

     (3)   The program shall offer information about HIV, hepatitis C and other bloodborne pathogens and prevention materials at no cost to consumers, and shall seek to educate all consumers about safe and proper disposal of needles and syringes;

     (4)   The program shall provide information and referrals to consumers, including HIV testing options, access to medication-assisted substance use disorder treatment programs and other substance use disorder treatment programs, and available health and social service options relevant to the consumer's needs.  The program shall encourage consumers to receive an HIV test, and shall, when appropriate, develop an individualized substance use disorder treatment plan for each participating consumer;

     (5)   The program shall screen out consumers under 18 years of age from access to syringes and needles, and shall refer them to substance use disorder treatment and other appropriate programs for youth;

     (6)   The program shall develop a plan for the handling and disposal of used syringes and needles in accordance with requirements set forth at N.J.A.C.7:26-3A.1 et seq. for regulated medical waste disposal pursuant to the "Comprehensive Regulated Medical Waste Management Act," P.L.1989, c.34 (C.13:1E-48.1 et al.), and shall also develop and maintain protocols for post-exposure treatment;

     (7)   (a) The program may [obtain a standing order, pursuant to the "Overdose Prevention Act," P.L.2013, c.46 (C.24:6J-1 et seq.), authorizing] authorize program staff to carry and [dispense] furnish naloxone hydrochloride or another opioid antidote to consumers and to the family members and friends [thereof] of consumers;

     (b)   [The program shall provide overdose prevention information to consumers, the family members and friends thereof, and other persons associated therewith, as appropriate, in accordance with the provisions of section 5 of the "Overdose Prevention Act," P.L.2013, c.46 (C.24:6J-5)] (deleted by amendment, P.L.    , c.    ) (pending before the Legislature as this bill);

     (8)   The program shall maintain the confidentiality of consumers by the use of confidential identifiers, which shall consist of the first two letters of the first name of the consumer's mother and the two-digit day of birth and two-digit year of birth of the consumer, or by the use of such other uniform Statewide mechanism as may be approved by the commissioner for this purpose;

     (9)   The program shall provide a uniform identification card that has been approved by the commissioner to consumers and to staff and volunteers involved in transporting, exchanging or possessing syringes and needles, or shall provide for such other uniform Statewide means of identification as may be approved by the commissioner for this purpose;

     (10)    The program shall provide consumers at the time of enrollment with a schedule of program operation hours and locations, in addition to information about prevention and harm reduction and substance use disorder treatment services; and

     (11)    The program shall establish and implement accurate data collection methods and procedures as required by the commissioner for the purpose of evaluating the sterile syringe access programs, including the monitoring and evaluation on a quarterly basis of:

     (a)   sterile syringe access program participation rates, including the number of consumers who enter substance use disorder treatment programs and the status of their treatment;

     (b)   the effectiveness of the sterile syringe access programs in meeting their objectives, including, but not limited to, return rates of syringes and needles distributed to consumers and the impact of the sterile syringe access programs on intravenous drug use; and

     (c)   the number and type of referrals provided by the sterile syringe access programs and the specific actions taken by the sterile syringe access programs on behalf of each consumer.

     c.     A municipality may terminate a sterile syringe access program established or authorized pursuant to this act, which is operating within that municipality, if its governing body approves such an action by ordinance, in which case the municipality shall notify the commissioner of its action in a manner prescribed by regulation of the commissioner.1

(cf: P.L.2017, c.131, s.104)

 

     16.   Section 1 of P.L.2017, c.88 (C.45:14-67.2) is amended to read as follows:

     1.    a. Notwithstanding any other law or regulation to the contrary, a pharmacist may dispense an opioid antidote to any patient, regardless of whether the patient holds an individual prescription for the opioid antidote, pursuant to a standing order issued by a prescriber or pursuant to the standing order issued pursuant to subsection b. of this section.  [A pharmacist who dispenses an opioid antidote pursuant to this section shall comply with the provisions of the "Overdose Prevention Act," P.L.2013, c.46 (C.24:6J-1 et al.).]

     b.    The Commissioner of Health, or, if the commissioner is not a duly licensed physician, the Deputy Commissioner for Public Health Services, shall issue [, upon request by a pharmacist licensed to practice in this State,] a standing order authorizing [the pharmacist] all licensed pharmacists in the State to dispense an opioid antidote to any patient, regardless of whether the patient holds an individual prescription for the opioid antidote [, provided the pharmacist complies with the requirements of the "Overdose Prevention Act," P.L.2013, c.46 (C.24:6J-1 et al.)] .

     c.     As used in this section:

     "Opioid antidote" means naloxone hydrochloride, or any other similarly acting drug approved by the United States Food and Drug Administration for self-administration for the treatment of an opioid overdose.

     "Patient" means the same as that term is defined in section 3 of P.L.2013, c.46 (C.24:6J-3).

     "Prescriber" means the same as that term is defined in section 3 of P.L.2013, c.46 (C.24:6J-3).1

(cf: P.L.2017, c.88, s.1)

 

     1[2.] 7. Sections 1 through 6 of1 P.L.2013, c.46 (C.24:6J-1 1[et seq.] through C.24:6J-61 ) 1[is] are1 repealed.

 

     1[3.] 8.1  This act shall take effect 1[immediately] 90 days after the date of enactment1 .