By: Herrero H.B. No. 566

A BILL TO BE ENTITLED

AN ACT

relating to the use of epinephrine auto-injectors on public and open-enrollment charter school campuses and at off-campus school-sanctioned events.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Subchapter A, Chapter 38, Education Code, is amended by adding Section 38.0152 to read as follows:

Sec. 38.0152. MAINTENANCE OF SUPPLY OF EPINEPHRINE AUTO-INJECTORS; PRESCRIBING; TRAINING; AND ADMINISTRATION. (a) In this section:

(1) "Anaphylaxis" means a sudden, severe, and potentially life-threatening allergic reaction that occurs when an individual is exposed to an allergen.

(2) "Epinephrine auto-injector" means a portable, disposable drug delivery device that contains a premeasured single dose of epinephrine that is intended to be used to treat anaphylaxis.

(3) "Open-enrollment charter school" means a school established under Subchapter D, Chapter 12, of this code.

(4) "Physician" means an individual licensed to practice medicine in this state.

(5) "Type of individual" means a student at, staff of, or visitor to a campus or an off-campus school-sanctioned event who receives administration of an epinephrine auto-injector under this section.

(b) Each school district and open-enrollment charter school shall adopt and implement a policy consistent with the requirements of this section for the possession, administration, and disposal of epinephrine auto-injectors at every campus within the school district or open-enrollment charter school so that the epinephrine auto-injector may be administered by a school employee who is authorized and trained in the administration of an epinephrine auto-injector to an individual on the campus or at an off-campus school-sanctioned event who is reasonably believed to be experiencing anaphylaxis.

(c)(1) The commissioner of state health services shall establish within the Department of State Health Services an advisory committee on the use of epinephrine auto-injectors on undesignated individuals on the campus of a school district or an open-enrollment charter school, or at an off-campus school-sanctioned event.

(2) The commissioner of state health services shall appoint the members of the advisory committee.

(3) The advisory committee shall advise the commissioner of state health services on:

(A) the storage of epinephrine auto-injectors on school campuses as provided in Subsection (d)(1);

(B) the maintenance of epinephrine auto-injectors while in transit to or from an off-campus school-sanctioned event as provided in Subsection (d)(1);

(C) the training of school employees as provided in Subsection (d)(2); and

(D) a plan at each campus for having one or more trained employees as provided in Subsection (d)(3).

(4) The advisory committee shall include physicians with expertise in treating anaphylaxis, including physicians who specialize in the fields of pediatrics, allergy, asthma, and immunology.

(5) The advisory committee shall elect a presiding officer.

(6) Members of the advisory committee serve without compensation but are entitled to reimbursement for the members' travel expenses as provided by Chapter 660, Government Code, and the General Appropriations Act.

(7) An advisory committee member serves at the pleasure of the commissioner of state health services.

(8) A vacancy on the advisory committee shall be filled by the commissioner of state health services in the same manner as other appointments to the advisory committee.

(9) Chapter 2110, Government Code, does not apply to the advisory committee formed under this subsection.

(10) Meetings of the advisory committee are subject to Chapter 551, Government Code.

(d) In consultation with the commissioner, and after consideration of advice from the advisory committee described in Subsection (c), the commissioner of state health services shall adopt rules for school districts and open-enrollment charter schools to use in the development of the policy described in Subsection (b). The rules must establish:

(1) the quantity of epinephrine auto-injectors to be stored at each campus or maintained while in transit to or from an off-campus school-sanctioned event and a requirement that stock inventory be checked at regular intervals for expiration and replacement;

(2) the level of training required for school employees in the administration of an epinephrine auto-injector to an individual who is reasonably believed to be experiencing anaphylaxis; and

(3) a requirement at each campus for having present, during all operating hours, one or more trained school employees described in Subsection (f).

(e) Training described in Subsection (d)(2) must:

(1) include information regarding how to:

(A) recognize the signs and symptoms of anaphylaxis;

(B) administer an epinephrine auto-injector;

(C) implement emergency procedures, if necessary, after administering an epinephrine auto-injector; and

(D) properly dispose of used or expired epinephrine auto-injectors;

(2) be obtained in formal training sessions or through online education; and

(3) be completed annually.

(f) Each school district and open-enrollment charter school shall be responsible for ensuring that school employees identified by the district or the open-enrollment charter school on each campus, or at an off-campus school-sanctioned event, are trained as described in Subsection (e) to administer an epinephrine auto-injector to an individual on the campus or at an off-campus school-sanctioned event who is reasonably believed to be experiencing anaphylaxis. Each school district and open-enrollment charter school shall maintain records on the training of such employees.

(g) Each school district and open-enrollment charter school shall maintain at each campus in the district or of the open-enrollment charter school a supply of epinephrine auto-injectors that may be administered by a school employee who is trained as described in Subsection (e) to an individual on a campus in the district or of the open-enrollment charter school, or at an off-campus school-sanctioned event, who is reasonably believed to be experiencing anaphylaxis. The school district or open-enrollment charter school, as appropriate, shall be responsible for checking stock inventory of such epinephrine auto-injectors at regular intervals for expiration and replacement. In determining the number of epinephrine auto-injectors to be kept for such purpose on a campus, the school district or the open-enrollment charter school shall follow the rules described in Subsection (d).

(h) The supply of epinephrine auto-injectors at each campus shall be stored in a secure location or maintained securely while in transit to or from an off-campus school-sanctioned event, and must be easily accessible to trained school employees.

(i)(1) A physician may prescribe epinephrine auto-injectors in the name of a school district or open-enrollment charter school to be maintained for use when necessary. The prescribing physician shall provide the school district or open-enrollment charter school, as appropriate, a standing order for the administration of school-supplied epinephrine auto-injectors to undesignated individuals who are reasonably believed to be experiencing anaphylaxis. The order shall not be required to be patient-specific, and the administration may occur without a prior established physician-patient relationship. Notwithstanding the provisions of other law regarding delegation or supervision, supervision or delegation by a physician shall be adequate if the physician periodically reviews the order and is available through direct telecommunication as needed for consultation, assistance, and direction.

(2) An order issued under this subsection must contain:

(A) the name and signature of the physician described in Subdivision (1);

(B) the name of the school district or open-enrollment charter school to which the order is issued;

(C) the quantity of epinephrine auto-injectors to be obtained and maintained under the order; and

(D) the date of issue.

(j) A pharmacist may dispense an epinephrine auto-injector under this section without the name of, or other identifying information relating to, the ultimate user.

(k) School employees who have received the training described in Subsection (e) may:

(1) obtain one or more epinephrine auto-injectors from the locations described in Subsection (h), or maintained while in transit to or from a school-sanctioned event as described in Subsection (h), in accordance with the provisions of this section; and

(2) administer such epinephrine auto-injectors in accordance with the provisions of this section.

(l)(1) Not later than 10 business days after the administration of an epinephrine auto-injector by a school employee under the terms of this section, the school shall report to the school district, or in the case of an open-enrollment charter school, the charter school shall document, in a form and manner prescribed by the commissioner, the following information:

(A) age and type of individual receiving administration of the epinephrine auto-injector;

(B) physical location on or off campus where the epinephrine auto-injector was administered;

(C) number of doses administered;

(D) title of person administering the epinephrine auto-injector; and

(E) any other information required by the commissioner.

(2) Not later than 10 business days after the administration of an epinephrine auto-injector by a school employee under the terms of this section, the school district or the open-enrollment charter school shall report the information described in Subdivision (1) to:

(A) the physician described in Subsection (i);

(B) the commissioner; and

(C) the commissioner of state health services.

(m) A school district or an open-enrollment charter school may each accept gifts, donations, grants, and federal and local funds for the support of that school district or open-enrollment charter school in carrying out the provisions of this section.

(n)(1) Except as provided by Subsection (d) or by Subdivision (2), the commissioner and the commissioner of state health services shall jointly adopt rules to implement this section.

(2) Rules to implement Subsection (c) shall be adopted solely by the commissioner of state health services.

(o) Epinephrine auto-injectors may be administered as provided under this section on campus and at off-campus school-sanctioned events. The immunity provisions of this section shall apply in such cases.

(p) A person who in good faith takes, or fails to take, any of the following actions under this section is immune from liability in any criminal or disciplinary action and for civil damages as a result of that act or failure to act:

(1) issuing an order for epinephrine auto-injectors;

(2) supervising or delegating as described in Subsection (i)(1);

(3) possessing an epinephrine auto-injector;

(4) prescribing an epinephrine auto-injector;

(5) dispensing an epinephrine auto-injector;

(6) administering, or assisting in the administering of, an epinephrine auto-injector;

(7) providing training, consultation, or advice in the development, adoption, or implementation of policies, guidelines, rules, or plans;

(8) assisting in providing training, consultation, or advice in the development, adoption, or implementation of policies, guidelines, rules, or plans; or

(9) undertaking any other required or authorized act.

(q) The immunities and protections granted in this section are in addition to, and not in lieu of, immunity or protection provided pursuant to any other provisions of law.

(r) If a school district or open-enrollment charter school lacks the funding, or other forms of support as described in Subsection (m), that is necessary to meet the requirements of this section, the school district or open-enrollment charter school shall not be required to comply with the requirements of this section.

(s) If a school district or open-enrollment charter school is unable to meet the requirements of this section due to a manufacturer's recall or any other unanticipated loss or reduction in supply of epinephrine auto-injectors that adversely affects the ability of a school district or open-enrollment charter school to obtain epinephrine auto-injectors in quantities that are sufficient to meet the requirements of this section, the school district or open-enrollment charter school shall not be required to comply with such requirements.

(t) Notwithstanding the provisions of Subsections (r) and (s), the immunities and protections granted in this section shall continue in full force and effect.

(u) Notwithstanding any other law, this section does not create a civil, criminal, or administrative cause of action or a standard of care, obligation, or duty that provides a basis for a cause of action.

(v) Notwithstanding the provisions of Subsections (r) and (s), the provisions of Subsection (u) shall continue in full force and effect.

(w) A cause of action does not arise from an act or omission described by Subsection (p).

SECTION 2. This Act takes effect September 1, 2015.