PART 1. DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER 37. MATERNAL AND INFANT HEALTH SERVICES
SUBCHAPTER U. EPINEPHRINE AUTO-INJECTOR POLICIES IN SCHOOLS
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), adopts the repeal of §§37.601 - 37.611, concerning Epinephrine Auto-Injector Policies in Schools. These rules are adopted without changes to the proposed text as published in the August 4, 2023, issue of the Texas Register (48 TexReg 4233) and the sections will not be republished.
BACKGROUND AND JUSTIFICATION
The repeal of 25 Texas Administrative Code (TAC) Chapter 37, Subchapter U, places all stock medication rules under 25 TAC Chapter 40. The new rules for 25 TAC Chapter 40, Subchapter E, Epinephrine Auto-Injector Policies in Schools, is published in the same issue of the Texas Register.
The repeal of §§37.601 - 37.611 removes rules no longer necessary under 25 TAC Chapter 37. The new rules in 25 TAC §§40.81 - 40.89 aligns the rules with similar TAC rules relating to stock medications in schools, youth facilities, and other entities such as amusement parks, restaurants, and sport venues.
COMMENTS
The 31-day comment period ended September 5, 2023.
During this period, DSHS did not receive any comments regarding the proposed rules.
STATUTORY AUTHORITY
The repeals are adopted and authorized by Texas Education Code Chapter 38; and Texas Government Code §531.0055, and Texas Health and Safety Code §1001.075, which authorize the Executive Commissioner of HHSC to adopt rules and policies necessary for the operation and provision of health and human services by DSHS and for the administration of Texas Health and Safety Code Chapter 1001.
The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on October 3, 2023.
TRD-202303681
Cynthia Hernandez
General Counsel
Department of State Health Services
Effective date: November 1, 2023
Proposal publication date: August 4, 2023
For further information, please call: (512) 413-9089
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), adopts new Subchapter E, §§40.61 - 40.71, concerning Epinephrine Auto-Injector Policies in Schools; and new Subchapter F, §§40.81 - 40.89, concerning Opioid Antagonist Medication Requirements in Schools.
Sections 40.61, 40.63 - 40.68, 40.70, 40.71, and §§40.81 - 40.89 are adopted with changes to the proposed text as published in the August 4, 2023, issue of the Texas Register (48 TexReg 4234) and these sections will be republished. Some of these changes provide clarity and consistency throughout the subchapters but do not impact the requirements under Subchapter E or Subchapter F. Sections 40.62 and 40.69 are adopted without changes to the proposed text as published in the August 4, 2023, issue of the Texas Register (48 TexReg 4234) and these sections will not be republished.
This adoption renames 25 Texas Administrative Code (TAC) Chapter 40, as "Stock Medication in Schools and Other Entities" to reflect the broader scope of stock medication rules that will be included under this chapter.
BACKGROUND AND JUSTIFICATION
The adoption implements Senate Bill (S.B.) 629, 88th Legislature, Regular Session, 2023, which amends Texas Education Code Chapter 38 by adding Subchapter E-1. As required by S.B. 629, the Texas Education Agency was consulted and provided comments to the proposed rules relating to maintenance, administration, and disposal of opioid antagonists. S.B. 629 also requires the rules to establish a process for checking inventory and the amount of training for school personnel and volunteers. Finally, S.B. 629 requires schools to report information on the administration of opioid antagonists to the Commissioner of DSHS.
To place all stock medication rules under the same chapter in TAC, this rule adoption adds new Subchapter E, Epinephrine Auto-Injector Policies in Schools, to 25 TAC Chapter 40. The repeal of 25 TAC Chapter 37, Subchapter U is published in this same issue of the Texas Register.
This adoption adds new Subchapter F, Opioid Antagonist Medication Requirements in Schools, as required by S.B. 629.
COMMENTS
The 31-day comment period ended September 5, 2023.
During this period, DSHS received comments from five commenters regarding the proposed rules, including the Texas Education Agency, the Texas Association of School Boards, RISE Services, Family Hospital Systems, and Drews27Chains. A summary of comments relating to the rules and DSHS's responses follows.
Comment: One commenter suggested that the definition of "All hours the campus is open" in 25 TAC §40.63(1) be clarified to state "at a minimum, the regular instructional day for the campus" instead of "regular on-campus school hours."
Response: DSHS disagrees and declines to amend the rule. The Stock Epinephrine Advisory Committee recommended that unassigned epinephrine auto-injector policies include all hours when school-sponsored activities occur on a campus where school personnel are present, including outside of normal instructional times.
Comment: One commenter suggested adding open-enrollment charter school to §40.63, concerning Definitions.
Response: DSHS agrees and adds the definition from Texas Education Code §38.151.
Comment: Several commenters suggested that DSHS disseminate transparent and broad statewide opioid antagonist standing orders that state that all Food and Drug Administration approved opioid antagonists are approved for treating suspected poisoning victims that include intramuscular (IM) Naloxone, as the IM route is more effective than the intranasal (IN) route. Commenters stated that one dose of IM opioid antagonist will revive a victim, while it may take 4-5 doses of IN opioid antagonist to revive a victim of an opioid-related drug overdose.
Response: DSHS disagrees and declines to amend Subchapter F. Standing orders are outside the scope of this rule proposal.
Comment: Several commenters suggested that DSHS promote a 4:1 ratio of IN to IM routes of administration of an opioid antagonist. The commenters suggested that the IM route of administration, when using an opioid antagonist auto-injector, is as user friendly as the epinephrine auto-injector and more effective at reviving a victim than intranasal.
Response: DSHS disagrees and declines to amend Subchapter F to specifically mandate what route of administration must be given to a person experiencing an opioid-related overdose. DSHS leaves the option to the school district to decide the route of administration.
Comment: Several commenters suggested placing IN opioid antagonists in the automated external defibrillator case throughout the schools and IM opioid antagonists in the nurse's office to enhance access points.
Response: DSHS disagrees and declines to amend Subchapter F. Texas Education Code §38.222(c)(4) requires that the supply of opioid antagonists at each school campus subject to a policy adopted under Texas Education Code §38.222 must be stored in a secure location and be easily accessible to school personnel and school volunteers authorized and trained to administer an opioid antagonist. DSHS recognizes that each campus is unique and will leave the access points to the discretion of individual campuses.
Comment: Several commenters suggested adding rules that require age-appropriate opioid-related overdose curriculum to be given in health classes if not in all homerooms. Commenters also suggested training all homeroom teachers on how to administer IN and IM opioid antagonists as well as establishing a minimum number of opioid antagonists stocked at each campus.
Response: DSHS disagrees and declines to amend Subchapter F regarding opioid-related overdose curriculum or to mandate the minimum number of opioid antagonists that a campus must stock. These determinations are outside the authority of the department.
Comment: Several commenters suggested the development of a rating system that designates schools that adopt best opioid awareness practices with a rated distinction to help raise community awareness of opioids to ensure student safety.
Response: DSHS disagrees and declines to amend Subchapter F to include an opioid awareness rating system for schools. DSHS will continue to work with stakeholders to ensure student safety by disseminating best practices and raising awareness of opioid-related overdoses and use of unassigned opioid antagonists.
Comment: One commenter suggested that Naloxone training should be standard to all staff, including bus drivers, in the same manner as cardiopulmonary resuscitation is standard training for staff and this training should include awareness of storage locations of the opioid antagonists on campus, as well as locations stored during off campus events.
Response: DSHS disagrees and declines to amend Subchapter F to require that all staff and bus drivers should be trained on opioid-related overdoses and the location and administration of opioid antagonists. Texas Education Code §38.224(a) states that each school district, open-enrollment charter school, and private school that adopts a policy under §38.222(a) or (b) is responsible for training school personnel and school volunteers in the administration of an opioid antagonist and states the training that is required.
Comment: One commenter suggested that all schools should have a specific response plan in place for trained school personnel and school volunteers and that the response plan should be practiced ensuring that staff is adequately trained in case of an opioid-related overdose emergency.
Response: DSHS disagrees and declines to amend Subchapter F and refers to Texas Education Code §38.224(a), which states that each school district, open-enrollment charter school, and private school that adopts a policy under §38.222(a) or (b) is responsible for training school personnel and school volunteers in the administration of an opioid antagonist and states the training that is required. DSHS will continue to work with stakeholders to ensure that resources are available to school districts to tailor training to their campuses that are evidence based and relevant.
Comment: Five comments requested additional or amended rules related to implementation of S.B. 294, 88th Legislature, Regular Session, 2023.
Response: DSHS declines to add or amend rules relating to S.B 294 as part of this rule proposal and will take the comments under advisement when addressing rules to implement S.B. 294.
Comment: One commenter suggested adding open-enrollment charter school and all hours the campus is open to §40.82, concerning Definitions.
Response: DSHS agrees and adds definition for All hours the campus is open--At a minimum, during regular on-campus school hours, and when school personnel are physically on-site for school-sponsored activities, and definition for open-enrollment charter school.
Comment: One commenter requested amending §40.86, concerning Training, by adding Assignment of School Personnel and School Volunteers to be trained.
Response: DSHS disagrees and declines to amend §40.86 from this comment. Each school district, open-enrollment charter school, and private school that adopts a written unassigned opioid antagonist policy under Texas Education Code §38.222, is responsible for training school personnel and school volunteers in the administration of an opioid antagonist. The decision to assign training among school personnel and school volunteers will be at the discretion of the school districts.
Comment: One commenter requested amending §40.87, concerning Report on Administering Unassigned Opioid Antagonist Medication, to include a notice to parents if an unassigned opioid antagonist policy is implemented.
Response: DSHS disagrees and declines to amend §40.87 from this comment. The school district can opt to include a notice of opioid antagonist policy implementation to parents.
Comment: One commenter suggested amending §40.87(b), concerning Report on Administering Unassigned Opioid Antagonist Medication, to include a list of which individuals and entities to submit the report.
Response: DSHS agrees and amends §40.87(b) by adding paragraphs as follows:
(1) the school district, the charter holder if the school is an open-enrollment charter school, or the governing body of the school if the school is a private school;
(2) the physician or other person who prescribed the opioid antagonist; and
(3) the commissioner of the Department of State Health Services (DSHS).
DSHS made edits to the rule language in §§40.61, 40.63 - 40.68, 40.70, 40.71, and §§40.81- 40.89 to provide clarity and consistency throughout the subchapters.
SUBCHAPTER E. EPINEPHRINE AUTO-INJECTOR POLICIES IN SCHOOLS
STATUTORY AUTHORITY
The new rules are required to comply with Texas Education Code Chapter 38, Subchapter E. The new rules are also authorized by Texas Government Code §531.0055 and Texas Health and Safety Code §1001.075, which authorize the Executive Commissioner of HHSC to adopt rules and policies necessary for the operation and provision of health and human services by DSHS and for the administration of Texas Health and Safety Code Chapter 1001.
§40.61.Purpose.
The purpose of this subchapter is to establish minimum standards for administering, maintaining, and disposing of epinephrine auto-injectors in school districts, open-enrollment charter schools, and private schools adopting unassigned epinephrine auto-injector policies. These standards are implemented under Texas Education Code Chapter 38, Subchapter E.
§40.63.Definitions.
The following terms and phrases, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise:
(1) All hours the campus is open--At a minimum, during regular on-campus school hours, and when school personnel are physically on site for school-sponsored activities.
(2) Anaphylaxis--As defined in Texas Education Code §38.201.
(3) Authorized healthcare provider--A physician or person who has been delegated prescriptive authority under Texas Occupations Code Chapter 157.
(4) Campus--A unit of a school district, open-enrollment charter school, or private school with an assigned administrator, has enrolled students who are counted for average daily attendance, has assigned instructional staff, provides instructional services to students, has one or more grades in the range from early childhood education through grade 12 or is ungraded, and complies with relevant Texas laws.
(5) Open-enrollment charter school--As defined in Texas Education Code §38.151.
(6) Physician--As defined in Texas Education Code §38.201.
(7) Private school--As defined in Texas Education Code §38.201.
(8) School nurse--As defined in 19 Texas Administrative Code §153.1022.
(9) School personnel--As defined in Texas Education Code §38.201.
(10) School volunteer--As defined in Texas Education Code §22.053.
(11) Unassigned epinephrine auto-injector--An epinephrine auto-injector prescribed by an authorized healthcare provider in the name of the school issued with a non-patient-specific standing delegation order for the administration of an epinephrine auto-injector, issued by a physician or person who has been delegated prescriptive authority under Texas Occupations Code Chapter 157.
§40.64.Applicability.
This subchapter applies to any school district, open-enrollment charter school, or private school voluntarily choosing to adopt and implement a written policy regarding the maintenance, administration, and disposal of unassigned epinephrine auto-injectors on each school campus.
§40.65.Maintenance, Administration, and Disposal of Unassigned Epinephrine Auto-Injectors.
(a) A school district, open-enrollment charter school, or private school shall obtain a prescription from an authorized healthcare provider each year, to stock, possess, and maintain at least one unassigned adult epinephrine auto-injector pack (two doses) on each school campus as described in Texas Education Code §38.211.
(1) A school may choose to stock unassigned pediatric epinephrine auto-injector packs, based on the need of the school's population.
(2) A school district or the governing body of an open-enrollment charter school or private school may develop, as part of the policy, provisions for additional doses to be stocked and utilized at off campus school events, or in transit to or from school events.
(b) Each school district superintendent, open-enrollment charter school administrator, or private school administrator will designate appropriate school personnel to coordinate and manage policy implementation, including training of school personnel, and the acquisition or purchase, usage, expiration, and disposal of unassigned epinephrine auto-injectors. Throughout the school calendar year, the designated school personnel must coordinate with each campus to ensure the unassigned epinephrine auto-injectors are checked monthly for expiration and usage and the findings are documented.
(c) At least one school personnel or one school volunteer who is authorized and trained to administer an unassigned epinephrine auto-injector must be present on campus during all hours the campus is open for school-sponsored activities.
(d) School personnel or school volunteers who are trained and authorized may administer an unassigned epinephrine auto-injector to a person who is reasonably believed to be experiencing anaphylaxis on a school campus, or as indicated in the school's unassigned epinephrine auto-injector policy.
(e) Local emergency medical services must be promptly notified by the school when an individual is suspected of experiencing anaphylaxis and when an epinephrine auto-injector is administered. If the trained school personnel or school volunteer is the only individual available to notify emergency medical services, the trained individual should administer the unassigned epinephrine auto-injector before notifying emergency medical services.
(f) The parent, legal guardian, or emergency contact must be promptly notified by the school when an unassigned epinephrine auto-injector is utilized on their child as soon as feasible during the emergency response to suspected anaphylaxis. School records of the administration of the unassigned epinephrine auto-injector and suspected anaphylaxis must be provided to the parent or guardian of the recipient upon request.
(g) Records relating to implementation and administration of the school's unassigned epinephrine auto-injector policy shall be retained per the record retention schedule for records of public school districts found in 13 Texas Administrative Code §7.125.
(h) Unassigned epinephrine auto-injectors shall be stored in a secure, easily accessible area for an emergency, in accordance with the manufacturer's guidelines. It is recommended the school administrator develop a map to be placed in high traffic areas indicating the location of the unassigned epinephrine auto-injectors on each school campus. It is recommended the map also indicate the locations of the automated external defibrillator.
(i) The school district, open-enrollment charter school, or private school shall develop a plan to replace, as soon as reasonably possible, any unassigned epinephrine auto-injector used or close to expiration.
(j) Used unassigned epinephrine auto-injectors shall be considered infectious waste and shall be disposed of according to the school's bloodborne pathogen control policy.
(k) Expired unassigned epinephrine auto-injectors shall be disposed of according to the school's medication disposal policy.
§40.66.Assignment and Recruitment of School Personnel and School Volunteers to be Trained to Administer Epinephrine Auto-Injectors.
(a) At each school campus adopting an unassigned epinephrine auto-injector policy, the school principal may:
(1) assign school personnel or school volunteers to be trained to administer unassigned epinephrine auto-injectors; or
(2) seek school personnel or school volunteers who volunteer to be trained to administer unassigned epinephrine auto-injectors.
(b) In order to increase the number of trained individuals in the administration of unassigned epinephrine auto-injectors, schools may distribute to school personnel and school volunteers in the school district, open-enrollment charter school, or private school, at least once per school year, a notice including:
(1) a description of the request seeking volunteers to be trained to administer an epinephrine auto-injector to a person believed to be experiencing anaphylaxis; and
(2) a description of the training the school personnel or school volunteers will receive in the administration of epinephrine with an auto-injector.
(c) Trained school personnel or school volunteers who administer the unassigned epinephrine auto-injector must submit a signed statement indicating they agree to perform the service of administering an unassigned epinephrine auto-injector to a student or individual who may be experiencing anaphylaxis.
§40.67.Training.
Each school district, open-enrollment charter school, or private school that adopts an unassigned epinephrine auto-injector written policy under this subchapter is responsible for training school personnel and school volunteers in the recognition of anaphylaxis signs and symptoms and administration of an unassigned epinephrine auto-injector. Each assigned school personnel or school volunteer shall receive initial training and an annual refresher training. Training shall be consistent with the most recent Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and Education Programs published by the federal Centers for Disease Control and Prevention.
(1) Training may be provided in a formal face-to-face training session or through an online education course.
(2) Training required under this subchapter must meet the requirements found in Texas Education Code §38.210 and include information on properly inspecting unassigned epinephrine auto-injectors for usage and expiration.
(3) The initial training must include hands-on training with an epinephrine auto-injector trainer.
(4) The annual refresher training must include a hands-on demonstration of administration skills.
(5) The training must also include information about promptly notifying local emergency medical services.
(6) Each school campus must maintain training records and make available upon request a list of those school personnel or school volunteers trained and authorized to administer the unassigned epinephrine auto-injector on the campus.
§40.68.Report on Administering Epinephrine Auto-Injectors.
(a) A report must be submitted by the school no later than the 10th business day after the date school personnel or a school volunteer administers an epinephrine auto-injector in accordance with the unassigned epinephrine auto-injector policy adopted under this subchapter. The report shall be submitted to the individuals and entities identified in Texas Education Code §38.209, including the commissioner of the Department of State Health Services (DSHS).
(b) Notifications to the commissioner of DSHS shall be submitted on the designated electronic form available on the DSHS School Health Program website found at dshs.texas.gov.
§40.70.Gifts, Grants, and Donations.
A school district, open-enrollment charter school, or private school may accept gifts, grants, donations, federal funds, and local funds to implement the unassigned epinephrine auto-injector policy in accordance with Texas Education Code §38.213.
§40.71.Immunity from Liability.
A person who in good faith takes, or fails to take, any action under this subchapter or Texas Education Code Chapter 38, Subchapter E is immune from civil or criminal liability or disciplinary action resulting from action or a failure to act in accordance with the Texas Education Code §38.215.
The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on October 3, 2023.
TRD-202303682
Cynthia Hernandez
General Counsel
Department of State Health Services
Effective date: November 1, 2023
Proposal publication date: August 4, 2023
For further information, please call: (512) 413-9089
STATUTORY AUTHORITY
The new rules are required to comply with Texas Education Code Chapter 38, Subchapter E. The new rules are also authorized by Texas Government Code §531.0055 and Texas Health and Safety Code §1001.075, which authorize the Executive Commissioner of HHSC to adopt rules and policies necessary for the operation and provision of health and human services by DSHS and for the administration of Texas Health and Safety Code Chapter 1001.
§40.81.Purpose.
The purpose of this subchapter is to establish minimum standards for administering, maintaining, and disposing of opioid antagonist medication in school districts, open-enrollment charter schools, and private schools adopting opioid antagonist medicine policies. These standards are implemented under Texas Education Code Chapter 38, Subchapter E-1.
§40.82.Definitions.
The following terms and phrases, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise:
(1) All hours the campus is open--At a minimum, during regular on-campus school hours, and when school personnel are physically on site for school-sponsored activities.
(2) Authorized healthcare provider--A physician, as defined in Texas Education Code §38.201, or person who has been delegated prescriptive authority by a physician under Texas Occupations Code Chapter 157.
(3) Campus--A unit of a school district, open-enrollment charter school, or private school with an assigned administrator, has enrolled students who are counted for average daily attendance, has assigned instructional staff, provides instructional services to students, has one or more grades in the range from early childhood education through grade 12 or is ungraded, and complies with relevant Texas laws.
(4) Open-enrollment charter school--As defined in Texas Education Code §38.151.
(5) Opioid antagonist--As defined in Texas Health and Safety Code §483.101, any drug that binds to opioid receptors and blocks or otherwise inhibits the effects of opioids acting on those receptors.
(6) Opioid-related drug overdose--As defined in Texas Health and Safety Code §483.101, a condition, evidenced by symptoms of extreme physical illness, decreased level of consciousness, constriction of the pupils, respiratory depression, or coma, that a layperson would reasonably believe to be the result of the consumption or use of an opioid.
(7) Private school--As defined in Texas Education Code §38.201.
(8) School personnel--As defined in Texas Education Code §38.201.
(9) School volunteer--As defined in Texas Education Code §22.053.
§40.83.Applicability.
This subchapter applies to any school district, open-enrollment charter school, or private school adopting and implementing a written policy regarding the maintenance, administration, and disposal of opioid antagonist medication on a campus or campuses.
§40.84.Required and Voluntary Opioid Antagonist Policies.
(a) Each school district must adopt and implement a policy regarding the maintenance, administration, and disposal of opioid antagonists at each campus in the district serving students in grades 6 through 12 and may voluntarily adopt and implement such a policy at each campus in the district, including campuses serving students in a grade level below grade 6.
(b) An open-enrollment charter school or private school may adopt and implement a policy regarding the maintenance, administration, and disposal of opioid antagonists. If an open-enrollment charter or private school adopts a policy under this subchapter, the opioid antagonist policy must comply with the Texas Education Code §38.222. The policy may apply:
(1) only at campuses of the school serving students in grades 6 through 12; or
(2) at each campus of the school, including campuses serving students in a grade level below grade 6.
(c) A policy adopted under this subchapter must:
(1) provide that school personnel and school volunteers who are authorized and trained may administer an opioid antagonist to a person who they reasonably believe is experiencing an opioid-related drug overdose;
(2) require each school campus, subject to a policy adopted under this subchapter, have one or more school personnel members or school volunteers authorized and trained to administer an opioid antagonist present during regular school hours;
(3) establish the number of opioid antagonists that must be available at each campus at any given time; and
(4) require the supply of opioid antagonists at each school campus, subject to a policy adopted under this subchapter, be stored in a secure location and be easily accessible to school personnel and school volunteers authorized and trained to administer an opioid antagonist.
§40.85.Maintenance, Administration, and Disposal of Opioid Antagonist Medication.
(a) Once a school district, open-enrollment charter school, or private school adopts an opioid antagonist medication policy, a campus implementing an opioid policy must stock opioid antagonist medication as defined by §40.84 of this subchapter (relating to Required and Voluntary Opioid Antagonist Policies).
(b) A campus must obtain a prescription from a physician or a person who has been delegated prescriptive authority to stock, possess, and maintain the established number of doses of opioid antagonists as determined by a school district, on each campus as described in Texas Education Code §38.225.
(1) The campus must renew this prescription or obtain a new prescription annually.
(2) The number of additional doses may be determined by an individual campus review led by a physician or a person who has been delegated prescriptive authority.
(c) A physician or other person who has been delegated prescriptive authority under Texas Occupations Code Chapter 157 and prescribes opioid antagonist medication under subsection (a) of this section, must provide the school district, open-enrollment charter school, or private school a standing order for administration of an opioid antagonist medication to a person who is reasonably believed to be experiencing an opioid-related drug overdose. The standing order must comply with the Texas Education Code §38.225.
(d) The unassigned opioid antagonist medication must be stored in a secure location and be easily accessible, in accordance with the manufacturer's guidelines and local policy of the school district, open-enrollment charter school, or private school.
(e) Used, unassigned opioid antagonists are considered infectious waste and must be disposed of according to the school's blood-borne pathogen control policy.
(f) Expired, unassigned opioid antagonists must be disposed of in accordance with the Federal Drug Administration's disposal of unused medications guidelines and local policy of the school district, open-enrollment charter school, or private school.
§40.86.Training.
(a) Each school district, open-enrollment charter school, and private school adopting a written unassigned opioid antagonist policy under Texas Education Code §38.222, is responsible for training school personnel and school volunteers in the administration of an opioid antagonist.
(b) Training under this subchapter must:
(1) include information on:
(A) recognizing the signs and symptoms of an opioid-related drug overdose;
(B) responding to an opioid-related drug overdose and administering an opioid antagonist;
(C) implementing emergency procedures, after administering an opioid antagonist;
(D) understanding the medical purpose and misuse of opioids; and
(E) properly disposing of used or expired opioid antagonists;
(2) be provided annually in a formal training session or through online education, including practicing the administration of an opioid antagonist with an opioid antagonist trainer device; and
(3) be provided in accordance with the policy adopted under Texas Education Code §21.4515.
(c) Each campus must maintain training records and must make available upon request a list of school personnel and school volunteers who are trained and authorized to administer the unassigned opioid antagonist medication on the campus.
§40.87.Report on Administering Unassigned Opioid Antagonist Medication.
(a) Records relating to implementing and administering the school district, open-enrollment charter school, or private school's unassigned opioid antagonist medication policy must be retained per the campus record retention schedule.
(b) The campus must submit the report no later than the 10th business day after the date a school personnel member or school volunteer administers an opioid antagonist in accordance with the unassigned opioid antagonist medication policy adopted under this subchapter. The report shall be submitted to the individuals and entities identified in Texas Education Code §38.223:
(1) the school district, the charter holder if the school is an open-enrollment charter school, or the governing body of the school if the school is a private school;
(2) the physician or other person who prescribed the opioid antagonist; and
(3) the commissioner of the Department of State Health Services (DSHS).
(c) Notifications to the commissioner of DSHS must be submitted on the designated electronic form available on DSHS School Health Program website found at dshs.texas.gov.
§40.88.Gifts, Grants, and Donations.
A school district, open-enrollment charter school, or private school may accept gifts, grants, donations, federal funds, and local funds to implement this subchapter.
§40.89.Immunity from Liability.
A person who in good faith takes, or fails to take, any action under this subchapter, or Texas Education Code Chapter 38, Subchapter E-1, is immune from civil or criminal liability or disciplinary action resulting from action or a failure to act in accordance with Texas Education Code §38.227.
The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on October 3, 2023.
TRD-202303683
Cynthia Hernandez
General Counsel
Department of State Health Services
Effective date: November 1, 2023
Proposal publication date: August 4, 2023
For further information, please call: (512) 413-9089