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.