PURSUANT TO THE PROVISIONS OF THE State Administrative Procedure Act, NOTICE is hereby given of the following action:
Action taken:
Addition of section 136.8 to Title 8 NYCRR.
Statutory authority:
Education Law, sections 207(not subdivided), 305(1), (2), 922(1) and (2); L. 2015, ch. 57, part 5
Subject:
Opioid Overdose Prevention.
Purpose:
To establish standards for the elective participation by school districts, boards of cooperative educational services, county vocational education and extension boards, charter schools, and non-public elementary and secondary schools.
Text or summary was published
in the July 8, 2015 issue of the Register, I.D. No. EDU-27-15-00009-P.
Final rule as compared with last published rule:
No changes.
Text of rule and any required statements and analyses may be obtained from:
Kirti Goswami, State Education Department, Office of Counsel, State Education Building, Room 148, 89 Washington Avenue, Albany, NY 12234, (518) 474-6400, email: legal@mail.nysed.gov
Initial Review of Rule
As a rule that requires a RFA, RAFA or JIS, this rule will be initially reviewed in the calendar year 2020, which is the 4th or 5th year after the year in which this rule is being adopted. This review period, justification for proposing same, and invitation for public comment thereon, were contained in a RFA, RAFA or JIS.
An assessment of public comment on the 4 or 5-year initial review period is not attached because no comments were received on the issue.
Assessment of Public Comment
Since publication of a Notice of Proposed Rule Making in the State Register on July 8, 2015, the State Education Department received the following comments:
1. COMMENT:
Would a volunteer, trained teacher taking students overseas in a non-school sponsored trip, be allowed to carry Naloxone on that trip?
DEPARTMENT RESPONSE:
Pursuant to the provisions of Education Law section 922, as added by Part V of Chapter 57 of the Laws of 2015, the purpose of this rule is for school districts who choose to participate as an opioid antagonist recipient pursuant to the provisions of Public Health Law section 3309, to permit any person employed by such entity who has been trained by a program approved under that section to administer an opioid antagonist to any student or staff having symptoms of an opioid overdose in an instructional school facility, in the event of an emergency pursuant to the requirements of Public Health Law section 3309. An instructional school facility is defined as any building or other facility maintained by a school district, board of cooperative educational services (BOCES), county vocational education and extension board, charter school, or non-public elementary or secondary school where instruction is provided to students pursuant to its curriculum. Accordingly, in the event of an emergency, unlicensed trained school personnel may provide an opioid antagonist to students or staff at any school sponsored activity occurring on-site in an instructional school facility. Therefore, the provisions of this rule governing a school district’s participation as an opioid antagonist recipient would not be applicable to the scenario presented in the above comment.
2. COMMENT:
Is it the intention of the program to allow volunteer, unlicensed personnel to administer naloxone only during the school day? I would think that once they are trained, they could provide that care during a school activity, when it may be more likely to happen, especially at a dance or football game (often evening events) that are often held on school grounds or in the school building where the naloxone is readily available along with an AED. I know that the police carry intranasal (IN) naloxone on their person. Is it the intention of this program to allow the volunteer, unlicensed school employee to carry that medication as well?
DEPARTMENT RESPONSE:
Education Law section 922 provides that school districts, boards of cooperative educational services (BOCES), county vocational education and extension boards, charter schools, and non-public elementary and secondary schools may participate in the opioid overdose prevention program as an opioid antagonist recipient pursuant to the provisions of Public Health Law section 3309. For school districts who choose to participate as an opioid antagonist recipient pursuant to the provisions of Public Health Law section 3309, any person employed by such entity who has been trained by a program approved under that section may administer an opioid antagonist to any student or staff having symptoms of an opioid overdose in an instructional school facility, in the event of an emergency pursuant to the requirements of Public Health Law section 3309. An instructional school facility is defined as any building or other facility maintained by a school district, board of cooperative educational services (BOCES), county vocational education and extension board, charter school, or non-public elementary or secondary school where instruction is provided to students pursuant to its curriculum. Accordingly, in the event of an emergency unlicensed trained school personnel may provide an opioid antagonist to students or staff at any school sponsored activity occurring on-site in an instructional school facility.
3. COMMENT:
Is this already provided through hospitals?
DEPARTMENT RESPONSE:
Pursuant to the provisions of Education Law section 922, the proposed rule sets forth standards for the elective participation by school districts, boards of cooperative educational services, county vocational education and extension boards, charter schools, and non-public elementary and secondary schools in an opioid overdose prevention program pursuant to the provisions of Public Health Law section 3309.
The proposed rule is not related to the general manner and methods of obtaining Naloxone in a hospital setting. Naloxone is routinely stocked in hospital pharmacies for the treatment of patients, primarily in their emergency departments. There are hospitals that are registered opioid overdose programs. Some of those hospital-based programs happen to be based in—or focused on—emergency departments for purposes of providing naloxone to patients at risk of (another) overdose. Some other hospital-based programs are focused on behavioral health patients. A hospital is not routinely a place where individuals can obtain naloxone.
4. COMMENT:
This law says the school is allowed—does this mean we are not required?
DEPARTMENT RESPONSE:
Correct. The proposed rule sets forth the standards for the elective participation by school districts, boards of cooperative educational services, county vocational education and extension boards, charter schools, and non-public elementary and secondary schools in an opioid overdose prevention program pursuant to the provisions of Public Health Law section 3309. Schools are allowed, but not required, to implement an opioid overdose program.
5. COMMENT:
If a school district chooses to participate, can an RN administer Naloxone without a patient-specific order? Is there liability should the district decide against stocking Narcan?
DEPARTMENT RESPONSE:
Part V of Chapter 57 of the Laws of 2015 permits, but does not require, school districts to participate in an opioid overdose prevention program pursuant to the provisions of Public Health Law section 3309. If a school district chooses to participate, the school district’s medical director, who is required to be a licensed physician or a certified nurse practitioner, may write a non-patient specific order, under which the registered professional nurse can administer naloxone. Part V of Chapter 57 also includes amendments to Education Law § § 6527 and 6909 to authorize registered professional nurses (RNs) to administer opioid-related overdose treatment pursuant to a non-patient specific order and protocol prescribed by a licensed physician or a certified nurse practitioner (i.e., school district medical director).
6. COMMENT:
Is there an opioid school policy template?
DEPARTMENT RESPONSE:
Currently, there is not an opioid overdose prevention school policy template, however comprehensive guidance on the Opioid Overdose Prevention Program is available from the New York Statewide School Health Services Center site – http://www.schoolhealthservicesny.com/azindex.cfm?subpage=367
