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Bill Summary · HB 431

Overview

HB 431 (2026 Regular Session, Kentucky) seeks to expand the use of opioid antagonists (e.g., naloxone) and create a comprehensive framework for their distribution, administration, and funding as part of a broader opioid abatement effort. The bill establishes authorization for multiple actors to dispense and administer opioid antagonists under standardized protocols, provides civil and criminal immunity for good-faith actions, creates a state Opioid Abatement Advisory Commission, and directs funding to a wide range of treatment, recovery, and prevention activities, including campus access and harm-reduction programs.

Purpose and Intent

  • Improve access to opioid antagonists to prevent overdose deaths.
  • Create consistent protocols and training for dispensing and administering antagonists.
  • Support a broad slate of opioid-use disorder (OUD) treatment, recovery, and prevention initiatives through the Kentucky Opioid Abatement Trust Fund.
  • Foster collaboration among state agencies, health providers, educational institutions, law enforcement, schools, and local communities.

Key Provisions

Section 1: Opioid Antagonists (KRS 217.186)

  • Defines “opioid antagonist” as naloxone or any FDA-approved overdose-reversal drug.
  • Protects good-faith prescribers/dispensers from discipline when providing antagonists for emergency use.
  • Expands eligible dispensing/administration to include pharmacists with Board of Pharmacy certification enabling dispensing under physician-approved protocols.
  • Allows third-party administration of the antagonist when prescribed for use by a specified third party (with required immediate notification to local public safety answering points).
  • Enables various entities (peace officers, jailers, firefighters, EMTs, school staff, etc.) to receive, possess, and administer antagonists; permits distribution as part of harm-reduction programs.
  • Immunity for good-faith provision or administration; liability protection except in cases of gross negligence or willful misconduct.
  • Requires the Board of Pharmacy (in consultation with the Board of Medical Licensure) to promulgate regulations establishing certification, education, and protocol requirements; define minimum components of protocols; mandate education on mechanism/circumstances; allow sharing dispensing records with physicians under protocol.
  • Local schools may keep antagonists on premises and administer them; DHCS (Department for Public Health) to develop clinical protocols for school supplies and administration.
  • Public postsecondary institutions must provide access to antagonists at campuses, with cabinets and accompanying safety equipment; institutions may seek funds from the opioid abatement trust fund.
  • Allows dispensing of antagonists to entities operating harm-reduction training programs, with dispensing documentation meeting regulatory requirements.

Section 2: Kentucky Opioid Abatement Advisory Commission (KRS 15.291)

  • Establishes an Opioid Abatement Advisory Commission under the Department of Law.
  • Voting members include: Attorney General (chair), State Treasurer, Health and Family Services secretary, academic representation (UK HEALing Communities Study), victims, drug treatment/prevention representatives, law enforcement, and two citizens at large.
  • Nonvoting members from the House Speaker and Senate President.
  • Terms: officers’ appointees serve concurrent terms; other members have staggered two-year terms.
  • No compensation, but travel reimbursements allowed.
  • Quorum and voting: five voting members for quorum; simple majority to act.
  • Responsibilities: award funds from the Opioid Abatement Trust Fund to reimburse costs or fund projects addressing OUD/SUD/MH.
  • Eligible projects and reimbursements cover a broad suite: outpatient/residential treatment (including MAT and services for incarcerated individuals), emergency response costs, and costs of administering antagonists.
  • Eligible project investments include: housing (supportive/recovery), transportation, employment/education services, call centers, crisis stabilization centers, oversight of treatment programs, scholarships/training for clinicians, education on prescribing/monitoring, law enforcement training, mental health trauma support, community engagement with faith groups, programs addressing pregnant women and Neonatal Abstinence Syndrome, home-based wrap-around services, foster care-related supports, public education on opioids/disposal, drug take-back programs, and pre-trial/treatment/recovery court supports, among others.
  • The Commission may pursue additional duties (reporting, setting priorities, policy recommendations).
  • Public reporting: must maintain a website with minutes, attendance, and funding information; may issue emergency regulations to accelerate funding distribution.

Who is Affected

  • Healthcare providers and pharmacists (through expanded authority and required certification/protocols).
  • Law enforcement, first responders, school personnel, and school districts (allowed to carry and use antagonists; support harm-reduction activities).
  • Public and private colleges/universities (campus access to antagonists and funding opportunities).
  • Local health departments, health providers, and school communities (collaborative protocol development and administration).
  • Individuals with OUD or co-occurring SUD/MH issues, their families, and those involved in treatment, recovery, and harm-reduction programs.
  • General public via expanded access to antagonists and enhanced overdose response infrastructure.
  • State agencies and stakeholders involved in opioid abatement funding and program delivery.

Procedural and Timeline Aspects

  • Regulatory Promulgation: Board of Pharmacy and Board of Medical Licensure to establish certification, education, and protocol requirements; potential for emergency administrative regulations to expedite funding and implementation.
  • Commission Operations: Must meet at least twice yearly; five-member quorum; website to publish minutes and funding data; ability to adopt emergency regulations.
  • Funding Mechanism: Funds from the Opioid Abatement Trust Fund (KRS 15.293) to reimburse costs and support a broad range of programs; campuses may seek funds for antagonist access and related needs.
  • Implementation is contingent on regulatory development and fund allocation, with potential for rapid deployment via emergency regulations.

Potential Impact

  • Increased access to opioid antagonists across healthcare, emergency services, schools, and harm-reduction programs.
  • Standardized training and protocols to improve safe dispensing and administration.
  • Expanded protections for providers acting in good faith, potentially reducing overdose fatalities and encouraging intervention.
  • A dedicated funding framework to support treatment, recovery, housing, prevention, and systemic improvements in response to the opioid epidemic.
  • Greater coordination among state agencies and stakeholders to address OUD, with ongoing reporting and auditing through the Commission and its website.

Compiled from official sources — confirm details with the bill’s official record.

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