Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_01-cv-01351/USCOURTS-cand-3_01-cv-01351-383/pdf.json

Nature of Suit Code: 440
Nature of Suit: Other Civil Rights
Cause of Action: 42:1983 Prisoner Civil Rights

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STIPULATION AND [PROPOSED] ORDER RE ADMINISTRATION OF NALOXONE

CASE NO. C01-1351 TEH 

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FUTTERMAN DUPREE

DODD CROLEY 

MAIER LLP

FUTTERMAN DUPREE DODD CROLEY MAIER LLP

MARTIN H. DODD (104363) 

180 Sansome Street, 17th Floor 

San Francisco, California 94104 

Telephone: (415) 399-3840 

Facsimile: (415) 399-3838 

mdodd@fddcm.com

Attorneys for Receiver

J. Clark Kelso

UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF CALIFORNIA

MARCIANO PLATA, et al.,

Plaintiffs,

 v. 

EDMUND G. BROWN, JR., et al.,

Defendants.

Case No. 01-cv-1351-TEH 

STIPULATION FOR AN AMENDED

ORDER AND [PROPOSED] ORDER

WAIVING STATE LAW AS IT

PERTAINS TO THE INTRANASAL

ADMINISTRATION OF NALOXONE BY

LICENSED VOCATIONAL NURSES

AND PSYCHIATRIC TECHNICIANS

WORKING IN CDCR INSTITUTIONS

1. On March 10, 2017, the Court entered a stipulated order (Doc. No. 2929) waiving 

state law as it pertains to the administration of naloxone1 to inmate/patients by licensed

vocational nurses (“LVNs”) working in institutions under the jurisdiction of the California

Department of Corrections and Rehabilitation (“CDCR”).

2. Subsequently, the parties to this stipulation determined that interpretations of 

existing state law, regulations, policies, and procedures may, in the absence of direction by a 

physician or registered nurse, prohibit psychiatric technicians (“PTs”), as well as LVNs, from

carrying naloxone to the location of a medical emergency, assessing whether a patient requires

the administration of the drug and then administering naloxone intranasally to the patient.2

1 Naloxone, also available under the brands of Narcan®, Evzio®, and other trade names, is an opioid

antagonist, used to counteract the depression of respiratory function during an opioid overdose.

2 For example, Business and Professions Code section 2860.5 states that a licensed vocational nurse “... 

when directed by a physician and surgeon ...” may administer medications via hypodermic needle.

Case 3:01-cv-01351-JST Document 2950 Filed 06/12/17 Page 1 of 5
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STIPULATION AND [PROPOSED] ORDER RE ADMINISTRATION OF NALOXONE

CASE NO. C01-1351 TEH 

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FUTTERMAN DUPREE

DODD CROLEY 

MAIER LLP

3. Permitting an independent assessment for the administration of naloxone by PTs

as well as LVNs, and administration of the drug by PTs and LVNs in a medical emergency will

maximize the utility of this drug and result in more rapid response to inmates who are 

experiencing depression of respiratory function due to an opioid overdose.

4. California Correctional Health Care Services has claimed that failure to do so may 

result in an impermissible risk of serious harm to California’s inmates, in violation of their

Eighth Amendment right to be free from cruel and unusual punishment.

5. The purpose of this stipulation is to amend the March 10 order to reflect the

parties’ agreement and mutual request that the court issue an order waiving state law and 

regulations that create an actual or perceived bar to LVNs and PTs (a) administering naloxone to

inmate/patients; independently, without physician or registered nurse involvement, assessing the

patient; and alone determining the need for administration of naloxone intranasally to

inmate/patients and (b) authorizing California Correctional Health Care Services to develop

policies and procedures to permit LVNs and PTs to assess the need for administration of 

naloxone, carry naloxone to site of an emergency and then administer naloxone intranasally, even 

in the absence of a patient specific prescription from a physician or registered nurse.

6. Specifically, the parties agree and by this stipulation request that the court issue an 

order waiving the following provisions, only to the extent that they would or may otherwise bar a 

licensed vocational nurse and/or a psychiatric technician from carrying or administering naloxone 

to an inmate housed in an institution under the jurisdiction of the California Department of 

Corrections and Rehabilitation:

a. California Business and Professions Code, Division 2, Chapter 6.5, 

Vocational Nursing;

Similarly, Business and Professions Code section 2859 refers to the practice of vocational nursing as the

provision of services “... practiced under the direction of a licensed physician, or registered professional

nurse ...” And Business and Professions Code section 4502 (e.g., subsection (b)) states that in part the

responsibilities of a psychiatric technician can include “... the carrying out of treatments and medications

as prescribed by a licensed physician and surgeon or a psychiatrist.” These provisions have, in some

cases, created the perception that LVNs and PTs would need to receive an order from a physician that

naloxone be administered to the particular patient who is experiencing the medical emergency, and that,

absent that order, the administration of naloxone by the LVN or PT would be in violation of law. 

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STIPULATION AND [PROPOSED] ORDER RE ADMINISTRATION OF NALOXONE

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FUTTERMAN DUPREE

DODD CROLEY 

MAIER LLP

b. California Code of Regulations, Title 16, Division 25, Chapter 1, 

Vocational Nursing;

c. California Business and Professions Code, Division 2, Chapter 10, 

Psychiatric Technicians;

d. California Code of Regulations, Title 16, Division 25, Chapter 2, 

Psychiatric Technicians; and, 

e. California Civil Code § 1714.22(f) (regarding administration of an opioid

antagonist (naloxone)). 

 In addition, the parties request that the Court specifically authorize California

Correctional Health Care Services to adopt amended policies and procedures permitting LVNs

and PTs independently, without physician or registered nurse involvement, to assess need for 

administration of naloxone to inmate/patients; to carry naloxone to the site of a medical

emergency and then administer naloxone intranasally to inmate/patients.

7. This stipulation may be executed in counterparts and, as so executed, shall

constitute one Agreement binding on all Parties. Any signed copy of this stipulation or of any 

document or agreement referred to herein, or copy or counterpart thereof, delivered by facsimile

or email transmission, shall, for all purposes, be deemed an original signed copy notwithstanding 

that one or more parties’ signature appears as a copy or facsimile copy, and such copy or 

facsimile copy signature(s) shall be binding upon each party in the same manner as though an 

original signed copy had been delivered. 

IT IS SO STIPULATED AND AGREED.

/s/ J. Clark Kelso Dated: June 8, 2017 

J. CLARK KELSO, Receiver

/s/ Maneesh Sharma Dated: June 8, 2017 

MANEESH SHARMA

Deputy Attorney General

California Department of Justice 

Attorney for Defendants

///

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STIPULATION AND [PROPOSED] ORDER RE ADMINISTRATION OF NALOXONE

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FUTTERMAN DUPREE

DODD CROLEY 

MAIER LLP

/s/ Donald Specter Dated: June 8, 2017 

 DONALD SPECTER, Director 

Prison Law Office

 Attorney for Plaintiffs

/s/ Martin Dodd Dated: June 8, 2017__ 

MARTIN H. DODD 

FUTTERMAN DUPREE DODD CROLEY MAIER, LLP

 Attorney for Receiver

Pursuant to Local Rule 5.1. I hereby attest that I have on file all holograph signatures for 

any signatures indicated by a “conformed” signature (/s/) within this efiled document.

/s/ Martin Dodd 

MARTIN H. DODD 

[PROPOSED] ORDER

Pursuant to the foregoing stipulation, supported by the Declaration of Receiver J. Clark 

Kelso, filed herein on March 8, 2017 (Doc. No. 2928-1) and the Supplemental Declaration of 

Receiver J. Clark Kelso, simultaneously submitted with the stipulation, the Court finds that the

constraints currently imposed by state law on the intranasal administration of naloxone by 

licensed vocational nurses and psychiatric technicians working under the jurisdiction of CDCR

are clearly preventing the Receiver from carrying out his duties prescribed in the Order 

Appointing Receiver, dated February 14, 2006 and that other alternatives are inadequate.

Accordingly, the Court hereby waives the following provisions of state law, but only to the extent

that they would otherwise bar a licensed vocational nurse or psychiatric technician working under 

the jurisdiction of CDCR from independently assessing that an inmate/patient is in need of the

administration of naloxone and, in the absence of a patient specific prescription, carrying 

naloxone to the site of a medical emergency and/or administering naloxone intranasally to an 

inmate/patient housed in an institution under the jurisdiction of the CDCR:

a) California Business and Professions Code, Division 2, Chapter 6.5, Vocational

Nursing;

b) California Code of Regulations, Title 16, Division 25, Chapter 1, Vocational

Nursing;

c) California Business and Professions Code, Division 2, Chapter 10, Psychiatric

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STIPULATION AND [PROPOSED] ORDER RE ADMINISTRATION OF NALOXONE

CASE NO. C01-1351 TEH 

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FUTTERMAN DUPREE

DODD CROLEY 

MAIER LLP

Technicians;

d) California Code of Regulations, Title 16, Division 25, Chapter 2, Psychiatric

Technicians and, 

e) California Civil Code § 1714.22(f) (regarding administration of an opioid

antagonist (naloxone)). 

In addition, California Correctional Health Care Services is hereby authorized to adopt

amended policies and procedures to effectuate this order, including specifically to permit

licensed vocational nurses and psychiatric technicians independently, without physician or 

registered nurse involvement, to assess the patient; to carry naloxone to the site of a medical

emergency and to administer naloxone intranasally to inmate/patients.

The Court finds that the foregoing relief is necessary to correct the violation of California

inmates’ Eighth Amendment rights and that the requested relief is narrowly drawn, extends no 

further than necessary, and is the least intrusive means necessary to correct this violation.

This Order supersedes the order, dated March 10, 2017 (Doc. No. 2929), waiving state

law. 

IT IS SO ORDERED. 

Dated: _____________________________________ THELTON E. HENDERSON

United States District Judge 

June 12, 2017

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