By: Cortez (Senate Sponsor - Lucio) H.B. No. 4260
         (In the Senate - Received from the House May 6, 2019;
  May 6, 2019, read first time and referred to Committee on Health &
  Human Services; May 19, 2019, reported adversely, with favorable
  Committee Substitute by the following vote:  Yeas 9, Nays 0;
  May 19, 2019, sent to printer.)
Click here to see the committee vote
 
  COMMITTEE SUBSTITUTE FOR H.B. No. 4260 By:  Perry
 
 
A BILL TO BE ENTITLED
 
AN ACT
 
  relating to the possession and administration of an epinephrine
  auto-injector by certain entities.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  The heading to Section 773.014, Health and
  Safety Code, is amended to read as follows:
         Sec. 773.014.  ADMINISTRATION OF EPINEPHRINE BY EMERGENCY
  MEDICAL SERVICES PERSONNEL.
         SECTION 2.  Subchapter A, Chapter 773, Health and Safety
  Code, is amended by adding Section 773.0145 to read as follows:
         Sec. 773.0145.  POSSESSION AND ADMINISTRATION OF
  EPINEPHRINE BY CERTAIN ENTITIES. (a) This section applies to:
               (1)  an amusement park, as defined by Section 46.035,
  Penal Code;
               (2)  a child-care facility, as defined by Section
  42.002, Human Resources Code;
               (3)  a day camp or youth camp, as defined by Section
  141.002;
               (4)  a private or independent institution of higher
  education, as defined by Section 61.003, Education Code;
               (5)  a restaurant, as defined by Section 17.821,
  Business & Commerce Code;
               (6)  a sports venue, as defined by Section 504.151,
  Local Government Code;
               (7)  a youth center, as defined by Section 481.134; or
               (8)  subject to Subsection (b), any other entity that
  the executive commissioner by rule designates as an entity that
  would benefit from the possession and administration of epinephrine
  auto-injectors.
         (b)  This section does not apply to a governmental entity.
         (c)  An entity described by Subsection (a) may adopt a policy
  regarding the maintenance, administration, and disposal of
  epinephrine auto-injectors.
         (d)  A policy adopted under Subsection (c) must provide that
  only an entity employee or volunteer who is authorized and trained
  may administer an epinephrine auto-injector to a person who is
  reasonably believed to be experiencing anaphylaxis on the premises
  of the entity.
         (e)  The executive commissioner shall adopt rules regarding
  the maintenance, administration, and disposal of an epinephrine
  auto-injector by an entity subject to a policy adopted under
  Subsection (c).  The rules must establish:
               (1)  the number of epinephrine auto-injectors and the
  dosages of the auto-injectors available at each entity;
               (2)  the process for each entity to verify the
  inventory of epinephrine auto-injectors at regular intervals for
  expiration and replacement; and
               (3)  the amount of training required for an entity
  employee or volunteer to administer an epinephrine auto-injector.
         (f)  Each entity that adopts a policy under Subsection (c)
  must have at least one entity employee or volunteer authorized and
  trained to administer an epinephrine auto-injector present during
  all hours the entity is open to the public or to the population that
  the entity serves, as applicable.
         (g)  The supply of epinephrine auto-injectors at each entity
  must:
               (1)  be stored in accordance with the manufacturer's
  instructions in a secure location; and
               (2)  be easily accessible to an entity employee or
  volunteer authorized and trained to administer an epinephrine
  auto-injector.
         (h)  Each entity that adopts a policy under Subsection (c) is
  responsible for training the entity's employees and volunteers in
  the administration of an epinephrine auto-injector.
         (i)  Employee and volunteer training under this section
  must:
               (1)  include information on:
                     (A)  the signs and symptoms of anaphylaxis;
                     (B)  the recommended dosages for an adult and a
  child;
                     (C)  the administration of an epinephrine
  auto-injector;
                     (D)  the implementation of emergency procedures,
  if necessary, after administering an epinephrine auto-injector;
  and
                     (E)  the proper disposal of used or expired
  epinephrine auto-injectors; and
               (2)  be completed annually in a formal training session
  or through online education.
         (j)  Each entity shall maintain records on the training
  completed by each employee and volunteer under this section.
         (k)  A physician or person who has been delegated
  prescriptive authority under Chapter 157, Occupations Code, may
  prescribe epinephrine auto-injectors in the name of an entity.
         (l)  A physician or other person who prescribes epinephrine
  auto-injectors under Subsection (k) shall provide the entity with a
  standing order for the administration of an epinephrine
  auto-injector to a person reasonably believed to be experiencing
  anaphylaxis.
         (m)  The standing order under Subsection (l) 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.
         (n)  Notwithstanding any other 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.
         (o)  For purposes of Subsection (n)(2), a person who has been
  delegated prescriptive authority under Chapter 157, Occupations
  Code, is not engaged in the unauthorized practice of telemedicine
  or acting outside the person's scope of practice by consulting a
  physician as provided by that subdivision when prescribing an
  epinephrine auto-injector in accordance with this section.
         (p)  An order issued under this section must contain:
               (1)  the name and signature of the prescriber;
               (2)  the name of the entity 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.
         (q)  A pharmacist may dispense an epinephrine auto-injector
  to an entity without requiring the name or any other identifying
  information relating to the user.
         (r)  A person who in good faith takes, or fails to take, any
  action under this section 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, storing, 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 section.
         (s)  The immunities and protections provided by this section
  are in addition to other immunities or limitations of liability
  provided by law.
         (t)  Notwithstanding any other law, this section 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 for an act or omission under
  this section.
         (u)  A cause of action does not arise from an act or omission
  described by this section.
         (v)  An entity and entity employees or volunteers are immune
  from suit resulting from an act, or failure to act, under this
  section, including an act or failure to act under related policies
  and procedures.
         (w)  An act or failure to act by entity employees or
  volunteers under this section, including an act or failure to act
  under related policies and procedures, is the exercise of judgment
  or discretion on the part of the entity employee or volunteer and is
  not considered to be a ministerial act for purposes of liability of
  the entity. 
         SECTION 3.  This Act takes effect September 1, 2019.
 
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