Senate Bill 25-164 Reengrossed

A Bill for an Act

• Page 1, Line 101Concerning opioid antagonists with a primary focus on the

• Page 1, Line 102youth opioid epidemic, and, in connection therewith,

• Page 1, Line 103clarifying requirements for school policies about

• Page 1, Line 104possession and administration of opioid antagonists,

• Page 1, Line 105requiring the state board of health to determine who

• Page 1, Line 106a prescriber may prescribe or dispense an opioid

• Page 1, Line 107antagonist to, and requiring the state board to

• Page 1, Line 108consult with the Colorado youth advisory council on

• Page 1, Line 109issues relating to the youth opioid epidemic.

Bill Summary

(Note: This summary applies to this bill as introduced and does not reflect any amendments that may be subsequently adopted. If this bill passes third reading in the house of introduction, a bill summary that applies to the reengrossed version of this bill will be available at http://leg.colorado.gov.)

The bill requires the state board of health (board) to allow the Colorado youth advisory council to present to the board twice a year on issues regarding the youth opioid epidemic and other health issues. The bill also requires the board to consult the council when the board engages in its rule-making authority regarding opioid antagonists.

Under current law, a school district, the state charter school institute, or a governing board of a nonpublic school may adopt and implement a policy that allows:

• A school to acquire and maintain a stock supply of opioid antagonists on school grounds or on a school bus;
• A school employee or agent who has received relevant training to administer an opioid antagonist to a person who is at risk of experiencing an opioid-related overdose; and
• A school employee or agent to furnish an opioid antagonist to any individual, including a student, if the student has received relevant training.
• Permits a school to maintain an opioid antagonist in an automated external defibrillator or defibrillator cabinet in the school or on a school bus;
• Repeals the requirement that a school employee or agent must receive training prior to administering an opioid antagonist; and
• Creates an exception that a school employee or agent may furnish an opioid antagonist to a student who has not received relevant training if the employee or agent believes that the student is in a position to assist an individual who is suffering from an opioid-related drug overdose event or who is at risk of experiencing an opioid-related drug overdose event.

The bill:

Current law provides a specific list of eligible entities that a prescriber may prescribe or dispense an opioid antagonist to. The bill eliminates the specific list and instead requires the state board of health to establish a list of eligible entities that a prescriber may prescribe or dispense an opioid antagonist to.

The bill creates a standing order allowing all eligible entities to distribute opioid antagonists.

The bill requires the department of public health and environment to furnish a report detailing youth overdose prevention during "SMART Act" hearings.

• Page 3, Line 1Be it enacted by the General Assembly of the State of Colorado:

• Page 3, Line 2SECTION 1.  In Colorado Revised Statutes, 2-2-1304, add (1)(e) and (1)(f) as follows:

• Page 3, Line 32-2-1304.  Duties - meetings - community outreach -

• Page 3, Line 4designation of organization to accept donations - authority to

• Page 3, Line 5contract. (1)  The council shall have the following duties and responsibilities:

• Page 3, Line 6(e)  To present to the state board of health twice a year

• Page 3, Line 7on issues including the youth opioid epidemic and other health issues; and

• Page 3, Line 8(f)  To consult with the prevention services division within

• Page 3, Line 9the department of public health and environment during the

• Page 3, Line 10stakeholder process for rule-making regarding opioid antagonists.

• Page 3, Line 11SECTION 2.  In Colorado Revised Statutes, 25-1-108, add (6) as follows:

• Page 3, Line 1225-1-108.  Powers and duties of state board of health - rules.

• Page 3, Line 13(6)   The board shall allow the Colorado youth advisory

• Page 3, Line 14council, as established in section 2-2-1302, to present to the

• Page 3, Line 15board twice a year on issues including the youth opioid epidemic and other health issues.

• Page 3, Line 17SECTION 3.  In Colorado Revised Statutes, 22-1-119.1, amend (1) as follows:

• Page 3, Line 1822-1-119.1.  Policy for employee and agent possession and

• Page 3, Line 19administration of opioid antagonists - definitions. (1)  A school district

• Page 3, Line 20board of education of a public school, the state charter school institute for

• Page 4, Line 1an institute charter school, or the governing board of a nonpublic school may adopt and implement a policy whereby:

• Page 4, Line 2(a)  A school under its jurisdiction may acquire and maintain a

• Page 4, Line 3stock supply of opioid antagonists on school grounds; on a school bus

• Page 4, Line 4operated by a district school, a school district, the charter school institute,

• Page 4, Line 5an institute charter school, or a nonpublic school; or both. In addition to

• Page 4, Line 6acquiring and maintaining a stock supply of opioid antagonists,

• Page 4, Line 7the school may maintain an opioid antagonist in an automated

• Page 4, Line 8external defibrillator or defibrillator cabinet in the school or on a school bus.

• Page 4, Line 9(b)  An employee or agent of the school, or an employee or agent

• Page 4, Line 10of a school district, a district school, the charter school institute, an

• Page 4, Line 11institute charter school, or a nonpublic school who operates or is on a

• Page 4, Line 12school bus, or both, may after receiving appropriate training administer

• Page 4, Line 13an opioid antagonist on school grounds or a school bus to assist an

• Page 4, Line 14individual who whom the employee or agent believes to be

• Page 4, Line 15suffering from an opioid-related drug overdose event or is at risk

• Page 4, Line 16of experiencing an opioid-related drug overdose event. The training

• Page 4, Line 17provided pursuant to this subsection (1)(b) must include A school

• Page 4, Line 18district board of education of a public school, the state charter

• Page 4, Line 19school institute for an institute charter school, or the

• Page 4, Line 20governing board of a nonpublic school that adopts and

• Page 4, Line 21implements a policy pursuant to this subsection (1)(b) is

• Page 4, Line 22encouraged to provide training to its employees or agents,

• Page 4, Line 23including risk factors for overdose, recognizing an overdose, calling

• Page 4, Line 24emergency medical services, rescue breathing, and administering an

• Page 4, Line 25opioid antagonist. and

• Page 5, Line 1(c)  An employee or agent of the school may furnish opiate opioid

• Page 5, Line 2antagonists on school grounds or on a school bus to any individual,

• Page 5, Line 3including a student, but shall only furnish an opiate opioid antagonist to

• Page 5, Line 4a student if the student has received appropriate school-sponsored

• Page 5, Line 5training; except that an employee or agent of the school may

• Page 5, Line 6furnish an opioid antagonist to a student who has not received

• Page 5, Line 7appropriate school-sponsored training if the employee or agent

• Page 5, Line 8believes that the student is in a position to assist an individual

• Page 5, Line 9who is suffering from an opioid-related drug overdose event or

• Page 5, Line 10who is at risk of experiencing an opioid-related drug overdose event.

• Page 5, Line 11SECTION 4.  In Colorado Revised Statutes, add 25-1.5-115.1 as follows:

• Page 5, Line 1225-1.5-115.1.  Opioid antagonist distribution - eligible entity

• Page 5, Line 13list - standing order - annual youth overdose prevention report.

• Page 5, Line 14(1)  The state board of health created in section 25-1-103 shall

• Page 5, Line 15establish an eligible entity list of entities eligible to be

• Page 5, Line 16prescribed or dispensed, directly or in accordance with standing orders and protocols, an opioid antagonist from a prescriber.

• Page 5, Line 17(2)  The state's chief medical officer, as described in

• Page 5, Line 18section 25-1-105, may grant a standing order allowing all

• Page 5, Line 19entities included on the state board of health's eligible entity

• Page 5, Line 20list created pursuant to subsection (1) of this section to

• Page 5, Line 21distribute opioid antagonists, consistent with the laws of this state.

• Page 5, Line 22(3)  Beginning in January 2026, and in January each year

• Page 5, Line 23thereafter, the department shall include, as part of its

• Page 6, Line 1presentation during its "SMART Act" hearing required by

• Page 6, Line 2section 2-7-203, information concerning youth overdose prevention.

• Page 6, Line 3SECTION 5.  In Colorado Revised Statutes, 25-1.5-115, amend (5)(a) as follows:

• Page 6, Line 425-1.5-115.  Opioid antagonist bulk purchase fund - creation

• Page 6, Line 5- rules - report - appropriation - definitions. (5)  As used in this section:

• Page 6, Line 6(a)  "Eligible entity" means a person or an entity described in

• Page 6, Line 7section 12-30-110 (1)(a) included on the state board of health's

• Page 6, Line 8eligible entity list created pursuant to section 25-1.5-115.1 (1);

• Page 6, Line 9except that an employee or agent of a school must be acting in accordance

• Page 6, Line 10with section 12-30-110 (1)(b), (2)(b), and (4)(b) and, as applicable, section 22-1-119.1.

• Page 6, Line 11SECTION 6.  In Colorado Revised Statutes, 12-30-110, amend (1)(a), (1)(b) introductory portion, (2)(b), (3)(c), and (4)(b) as follows:

• Page 6, Line 1212-30-110.  Prescribing or dispensing opioid antagonists -

• Page 6, Line 13authorized recipients - definitions. (1) (a)  A prescriber may prescribe

• Page 6, Line 14or dispense, directly or in accordance with standing orders and protocols,

• Page 6, Line 15an opioid antagonist to an entity on the state board of health's eligible entity list created pursuant to section 25-1.5-115.1 (1).

• Page 6, Line 16(I)  An individual at risk of experiencing an opioid-related drug overdose event;

• Page 6, Line 17(II)  A family member, friend, or other person in a position to

• Page 6, Line 18assist an individual at risk of experiencing an opioid-related drug overdose event;

• Page 6, Line 19(III)  An employee or volunteer of a harm reduction organization;

• (IV)  A law enforcement agency or first responder;

• Page 7, Line 1(V)  A school district, school, or employee or agent of a school or

• Page 7, Line 2an employee or agent of the school district, a district school, the charter

• Page 7, Line 3school institute, an institute charter school, or a nonpublic school who operates or is on a school bus;

• Page 7, Line 4(VI)  A person described in section 25-20.5-1001;

• (VII)  A unit of local government;

• Page 7, Line 5(VIII)  An institution of higher education or an employee or agent of the institution of higher education;

• Page 7, Line 6(IX)  A library or an employee or agent of the library;

• Page 7, Line 7(X)  A community service organization or an employee or agent of the community service organization;

• Page 7, Line 8(XI)  A religious organization or an employee or agent of the religious organization;

• Page 7, Line 9(XII)  A local jail or an employee or agent of the local jail;

• Page 7, Line 10(XIII)  A multijurisdictional jail or an employee or agent of the multijurisdictional jail;

• Page 7, Line 11(XIV)  A municipal jail or an employee or agent of the municipal jail;

• Page 7, Line 12(XV)  A correctional facility or an employee or agent of the correctional facility;

• Page 7, Line 13(XVI)  A private contract prison or an employee or agent of the private contract prison;

• Page 7, Line 14(XVII)  A community corrections program or an employee or agent of the community corrections program;

• Page 7, Line 15(XVIII)  A pretrial services program or an employee or agent of

• Page 7, Line 16the pretrial services program;

• Page 8, Line 1(XIX)  A probation department or an employee or agent of the probation department;

• Page 8, Line 2(XX)  A local public health agency or an employee or agent of the local public health agency; or

• Page 8, Line 3(XXI)  A mental health professional.

• Page 8, Line 4(b)  A person or An eligible entity described insubsection (1)(a)

• Page 8, Line 5of this section section 25-1.5-115.1 (1) may, pursuant to an order or standing orders and protocols:

• Page 8, Line 6(2) (b)  An eligible entity described in subsection (1)(a) of this

• Page 8, Line 7section section 25-1.5-115.1 (1) is strongly encouraged to educate

• Page 8, Line 8employees, agents, and volunteers, as well as persons receiving an opioid

• Page 8, Line 9antagonist from the an eligible entity described in subsection (1)(a) of

• Page 8, Line 10this section section 25-1.5-115.1 (1), on the use of an opioid antagonist

• Page 8, Line 11for overdose, including instruction concerning risk factors for overdose,

• Page 8, Line 12recognizing an overdose, calling emergency medical services, rescue breathing, and administering an opioid antagonist.

• Page 8, Line 13(3)  A prescriber described in subsection (7)(h) of this section does

• Page 8, Line 14not engage in unprofessional conduct or is not subject to discipline

• Page 8, Line 15pursuant to section 12-240-121, 12-255-120, or 12-280-126, as

• Page 8, Line 16applicable, if the prescriber issues standing orders and protocols

• Page 8, Line 17regarding opioid antagonists or prescribes or dispenses, pursuant to an

• Page 8, Line 18order or standing orders and protocols, an opioid antagonist in a good faith effort to assist:

• Page 8, Line 19(c)  A person or An eligible entity described in subsection (1)(a)

• Page 8, Line 20of this section section 25-1.5-115.1 (1), in responding to, treating, or

• Page 8, Line 21otherwise assisting an individual who is experiencing or is at risk of

• Page 8, Line 22experiencing an opioid-related drug overdose event or a friend, family member, or other person in a position to assist an at-risk individual.

• Page 9, Line 1(4) (b)  A person or An eligible entity described in subsection

• Page 9, Line 2(1)(a) of this section section 25-1.5-115.1 (1) acting in accordance with

• Page 9, Line 3this section is not subject to civil liability or criminal prosecution, as specified in sections 13-21-108.7 (3) and 18-1-712 (2), respectively.

• Page 9, Line 4SECTION 7.  In Colorado Revised Statutes, 13-21-108.7, amend (3)(b)(I) as follows:

• Page 9, Line 513-21-108.7.  Persons rendering emergency assistance through

• Page 9, Line 6the administration of an opioid antagonist - limited immunity -

• Page 9, Line 7legislative declaration - definitions. (3)  General immunity. (b)  This subsection (3) also applies to:

• Page 9, Line 8(I)  A person or An eligible entity described in section 12-30-110

• Page 9, Line 9(1)(a) section 25-1.5-115.1 (1); except that an employee or agent of a

• Page 9, Line 10school, or an employee or agent of a school district, a district school, the

• Page 9, Line 11charter school institute, an institute charter school, or a nonpublic school

• Page 9, Line 12who operates or is on a school bus, must be acting in accordance with

• Page 9, Line 13section 12-30-110 (1)(b), (2)(b), and (4)(b), and, as applicable, section 22-1-119.1; and

• Page 9, Line 14SECTION 8.  In Colorado Revised Statutes, 18-1-712, amend (2)(b)(I) as follows:

• Page 9, Line 1518-1-712.  Immunity for a person who administers an opioid

• Page 9, Line 16antagonist during an opioid-related drug overdose event - definitions.(2)  General immunity. (b)  This subsection (2) also applies to:

• Page 9, Line 17(I)  A person or An eligible entity described in section 12-30-110

• Page 9, Line 18(1)(a) section 25-1.5-115.1 (1); except that an employee or agent of a

• Page 9, Line 19school, or an employee or agent of a school district, a district school, the

• Page 9, Line 20charter school institute, an institute charter school, or a nonpublic school

• Page 10, Line 1who operates or is on a school bus, must be acting in accordance with

• Page 10, Line 2section 12-30-110 (1)(b), (2)(b), and (4)(b), and, as applicable, section 22-1-119.1; and

• Page 10, Line 3SECTION 9.  In Colorado Revised Statutes, 18-18-403.5, amend (6) as follows:

• Page 10, Line 418-18-403.5.  Unlawful possession of a controlled substance -

• Page 10, Line 5notice to revisor of statutes - repeal. (6)  Notwithstanding subsection (2)

• Page 10, Line 6of this section to the contrary, a peace officer shall not arrest and a district

• Page 10, Line 7attorney shall not charge or prosecute an employee, agent, or volunteer of

• Page 10, Line 8an eligible entity described in section 12-30-110 (1)(a) section

• Page 10, Line 925-1.5-115.1 (1) who, in the performance of the person's duties, is in

• Page 10, Line 10possession of a controlled substance, including fentanyl, carfentanil,

• Page 10, Line 11benzimidazole opiate, or an analog thereof as described in section

• Page 10, Line 1218-18-204 (2)(g), for the purpose of safe disposal of the controlled

• Page 10, Line 13substance, including fentanyl, carfentanil, benzimidazole opiate, or an

• Page 10, Line 14analog thereof as described in section 18-18-204 (2)(g), in accordance

• Page 10, Line 15with applicable law. As used in this subsection (6), "safe disposal" means

• Page 10, Line 16the procedure and process for depositing the controlled substance,

• Page 10, Line 17including fentanyl, carfentanil, benzimidazole opiate, or an analog thereof

• Page 10, Line 18as described in section 18-18-204 (2)(g), in a secure container for law enforcement to subsequently access and dispose of.

• Page 10, Line 19SECTION 10.  Act subject to petition - effective date. This act

• Page 10, Line 20takes effect at 12:01 a.m. on the day following the expiration of the

• Page 10, Line 21ninety-day period after final adjournment of the general assembly; except

• Page 10, Line 22that, if a referendum petition is filed pursuant to section 1 (3) of article V

• Page 10, Line 23of the state constitution against this act or an item, section, or part of this

• Page 10, Line 24act within such period, then the act, item, section, or part will not take

• Page 11, Line 1effect unless approved by the people at the general election to be held in

• Page 11, Line 2November 2026 and, in such case, will take effect on the date of the official declaration of the vote thereon by the governor.