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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