By: Hinojosa  S.B. No. 66
         (In the Senate - Filed November 10, 2014; January 26, 2015,
  read first time and referred to Committee on Education;
  April 13, 2015, reported adversely, with favorable Committee
  Substitute by the following vote:  Yeas 9, Nays 2; April 13, 2015,
  sent to printer.)
Click here to see the committee vote
 
  COMMITTEE SUBSTITUTE FOR S.B. No. 66 By:  Garcia
 
 
A BILL TO BE ENTITLED
 
AN ACT
 
  relating to the use of epinephrine auto-injectors on public school
  and open-enrollment charter school campuses and at or in transit to
  or from off-campus school events.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  This Act shall be known as the Cameron Espinosa
  Act.
         SECTION 2.  Chapter 38, Education Code, is amended by adding
  Subchapter E to read as follows:
  SUBCHAPTER E.  MAINTENANCE AND ADMINISTRATION OF EPINEPHRINE
  AUTO-INJECTORS
         Sec. 38.201.  DEFINITIONS.  In this subchapter:
               (1)  "Advisory committee" means the committee
  established under Section 38.202.
               (2)  "Anaphylaxis" means a sudden, severe, and
  potentially life-threatening allergic reaction that occurs when a
  person is exposed to an allergen.
               (3)  "Epinephrine auto-injector" means a disposable
  medical drug delivery device that contains a premeasured single
  dose of epinephrine that is intended to be used to treat
  anaphylaxis.
               (4)  "Physician" means a person who holds a license to
  practice medicine in this state.
         Sec. 38.202.  ADVISORY COMMITTEE:  ESTABLISHMENT AND
  COMPOSITION.  (a)  The commissioner of state health services shall
  establish an advisory committee to examine and review:
               (1)  the administration of epinephrine auto-injectors
  on a person experiencing an anaphylactic reaction on a campus of a
  school district or an open-enrollment charter school or at or in
  transit to or from an off-campus school event; and
               (2)  the maintenance and disposal of epinephrine
  auto-injectors by a school district or an open-enrollment charter
  school.
         (b)  The advisory committee shall be composed of members
  appointed by the commissioner of state health services. In making
  appointments, the commissioner shall ensure that:
               (1)  a majority of the members are physicians with
  expertise in treating anaphylaxis, including physicians who
  specialize in the fields of pediatrics, allergies, asthma, and
  immunology; and
               (2)  at least one member is a registered nurse employed
  by a school district or open-enrollment charter school as a school
  nurse.
         (c)  A member of the advisory committee serves at the
  pleasure of the commissioner of state health services.
         (d)  A vacancy on the advisory committee is filled by the
  commissioner of state health services in the same manner as other
  appointments to the advisory committee.
         Sec. 38.203.  ADVISORY COMMITTEE: PRESIDING OFFICER.  The
  advisory committee shall elect a presiding officer.
         Sec. 38.204.  ADVISORY COMMITTEE: COMPENSATION AND
  EXPENSES.  Members of the advisory committee serve without
  compensation but are entitled to reimbursement for travel expenses.
         Sec. 38.205.  ADVISORY COMMITTEE:  APPLICABILITY OF OTHER
  LAW.  Chapter 2110, Government Code, does not apply to the advisory
  committee.
         Sec. 38.206.  ADVISORY COMMITTEE:  OPEN MEETINGS.  Meetings
  of the advisory committee are subject to Chapter 551, Government
  Code.
         Sec. 38.207.  ADVISORY COMMITTEE: DUTIES.  The advisory
  committee shall advise the commissioner of state health services
  on:
               (1)  the storage of epinephrine auto-injectors on
  school campuses;
               (2)  the maintenance of epinephrine auto-injectors
  while in transit to or from an off-campus school event;
               (3)  the training of school personnel in the
  administration of an epinephrine auto-injector; and
               (4)  a plan for one or more school personnel members
  trained in the administration of an epinephrine auto-injector to be
  on each school campus.
         Sec. 38.208.  MAINTENANCE AND ADMINISTRATION OF EPINEPHRINE
  AUTO-INJECTORS.  (a)  Each school district and open-enrollment
  charter school shall adopt and implement a policy requiring the
  maintenance, administration, and disposal of epinephrine
  auto-injectors at each campus in the district or school.
         (b)  The policy adopted under Subsection (a) must provide
  that school personnel who are authorized and trained may administer
  an epinephrine auto-injector to a person who is reasonably believed
  to be experiencing anaphylaxis on a school campus or at an
  off-campus school event.
         (c)  The commissioner of state health services, in
  consultation with the commissioner of education, and with advice
  from the advisory committee, shall adopt rules regarding the
  maintenance, administration, and disposal of an epinephrine
  auto-injector at a school campus or while students are at an
  off-campus school event or in transit to or from an off-campus
  school event.  The rules must establish:
               (1)  the number of epinephrine auto-injectors
  available:
                     (A)  at each campus; and
                     (B)  while students are at an off-campus school
  event or in transit to or from an off-campus school event;
               (2)  the process for each school district and
  open-enrollment charter school to check the inventory of
  epinephrine auto-injectors at regular intervals for expiration and
  replacement; and
               (3)  the amount of training required for school
  personnel to administer an epinephrine auto-injector.
         (d)  Each school district and open-enrollment charter school
  must have a plan requiring that each campus have one or more school
  personnel members authorized and trained to administer an
  epinephrine auto-injector present during all hours the campus is
  open.
         (e)  The supply of epinephrine auto-injectors must:
               (1)  be stored in a secure location on campus and
  securely maintained while at an off-campus school event or in
  transit to or from an off-campus school event; and
               (2)  be easily accessible to school personnel
  authorized and trained to administer an epinephrine auto-injector.
         Sec. 38.209.  REPORT ON ADMINISTERING EPINEPHRINE
  AUTO-INJECTOR.  (a)  Not later than the 10th business day after the
  date a school personnel member administers an epinephrine
  auto-injector, the school shall report the information required
  under Subsection (b) to:
               (1)  the school district or the charter holder if the
  school is an open-enrollment charter school;
               (2)  the physician who prescribed the epinephrine
  auto-injector;
               (3)  the commissioner of education; and
               (4)  the commissioner of state health services.
         (b)  The report required under this section must include the
  following information:
               (1)  the age of the person who received the
  administration of the epinephrine auto-injector;
               (2)  whether the person who received the administration
  of the epinephrine auto-injector was a student, a school personnel
  member, or a visitor;
               (3)  the physical location where the epinephrine
  auto-injector was administered;
               (4)  the number of doses of epinephrine auto-injector
  administered;
               (5)  the title of the person who administered the
  epinephrine auto-injector; and
               (6)  any other information required by the commissioner
  of education.
         Sec. 38.210.  TRAINING. (a)  Each school district and
  open-enrollment charter school is responsible for training school
  personnel in the administration of an epinephrine auto-injector.
         (b)  Training required under this section must:
               (1)  include information on:
                     (A)  recognizing the signs and symptoms of
  anaphylaxis;
                     (B)  administering an epinephrine auto-injector;
                     (C)  implementing emergency procedures, if
  necessary, after administering an epinephrine auto-injector; and
                     (D)  properly disposing of used or expired
  epinephrine auto-injectors; and
               (2)  be provided in a formal training session or
  through online education and be completed annually.
         (c)  Each school district and open-enrollment charter school
  shall maintain records on the training required under this section.
         (d)  School personnel who have received training under this
  section, in accordance with the provisions of this subchapter, may:
               (1)  take an epinephrine auto-injector from a location
  described by Section 38.208(e)(1); and
               (2)  administer the epinephrine auto-injector.
         Sec. 38.211.  PRESCRIPTION OF EPINEPHRINE AUTO-INJECTORS.  
  (a)  A physician may prescribe epinephrine auto-injectors in the
  name of a school district or open-enrollment charter school.
         (b)  The physician shall provide the school district or
  open-enrollment charter school with a standing order for the
  administration of an epinephrine auto-injector to a person
  reasonably believed to be experiencing anaphylaxis.
         (c)  The standing order under Subsection (b) is not required
  to be patient-specific, and the epinephrine auto-injector may be
  administered to a person without a previously established
  physician-patient relationship.
         (d)  Notwithstanding any other provisions of law,
  supervision or delegation by a physician is considered adequate if
  the physician:
               (1)  periodically reviews the order; and
               (2)  is available through direct telecommunication as
  needed for consultation, assistance, and direction.
         (e)  An order issued under this section must contain:
               (1)  the name and signature of the prescribing
  physician;
               (2)  the name of the school district or open-enrollment
  charter school to which the order is issued;
               (3)  the quantity of epinephrine auto-injectors to be
  obtained and maintained under the order; and
               (4)  the date of issue.
         (f)  A pharmacist may dispense an epinephrine auto-injector
  to a school district or open-enrollment charter school without
  requiring the name or any other identifying information relating to
  the user.
         Sec. 38.212.  FUNDING. (a)  A school district or
  open-enrollment charter school is required to comply with this
  subchapter only if sufficient funds are available.
         (b)  A school district or open-enrollment charter school may
  accept gifts, grants, donations, and federal and local funds to
  implement this subchapter.
         Sec. 38.213.  UNANTICIPATED LOSS OF EPINEPHRINE
  AUTO-INJECTORS.  If a school district or open-enrollment charter
  school cannot maintain an inventory of epinephrine auto-injectors
  because of a manufacturer's recall or any other unanticipated loss
  or reduction, the district or school is not required to comply with
  this subchapter.
         Sec. 38.214.  RULES. Except as otherwise provided by this
  subchapter, the commissioner of education and the commissioner of
  state health services shall jointly adopt rules necessary to
  implement this subchapter.
         Sec. 38.215.  IMMUNITY FROM LIABILITY. (a)  A person who in
  good faith takes, or fails to take, any action under this subchapter
  is immune from civil or criminal liability or disciplinary action
  resulting from that action or failure to act, including:
               (1)  issuing an order for epinephrine auto-injectors;
               (2)  supervising or delegating the administration of an
  epinephrine auto-injector;
               (3)  possessing, maintaining, or disposing of an
  epinephrine auto-injector;
               (4)  prescribing an epinephrine auto-injector;
               (5)  dispensing an epinephrine auto-injector;
               (6)  administering, or assisting in administering, an
  epinephrine auto-injector;
               (7)  providing, or assisting in providing, training,
  consultation, or advice in the development, adoption, or
  implementation of policies, guidelines, rules, or plans; or
               (8)  undertaking any other act permitted or required
  under this subchapter.
         (b)  The immunities and protections provided by this
  subchapter are in addition to other immunity or limitations of
  liability provided by law.
         (c)  Notwithstanding any other law, this subchapter does not
  create a civil, criminal, or administrative cause of action or
  liability or create a standard of care, obligation, or duty that
  provides a basis for a cause of action or liability.
         (d)  A cause of action does not arise from an act or omission
  described by this section.
         (e)  The immunities and protections provided by this
  subchapter shall continue in full force and effect, regardless of
  whether a school district or open-enrollment charter school is
  excused under Section 38.212 or 38.213 from complying with this
  subchapter.
         SECTION 3.  Section 38.0151, Education Code, is amended by
  adding Subsection (f) to read as follows:
         (f)  A school district or open-enrollment charter school
  that provides for the maintenance, administration, and disposal of
  epinephrine auto-injectors under Subchapter E is not required to
  comply with this section.
         SECTION 4.  This Act applies beginning with the 2015-2016
  school year.
         SECTION 5.  This Act takes effect immediately if it receives
  a vote of two-thirds of all the members elected to each house, as
  provided by Section 39, Article III, Texas Constitution.  If this
  Act does not receive the vote necessary for immediate effect, this
  Act takes effect September 1, 2015.
 
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