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A BILL TO BE ENTITLED
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AN ACT
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relating to the use of epinephrine auto-injectors and medication |
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designated for treatment of respiratory distress on public and |
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private school campuses. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. The heading to Subchapter E, Chapter 38, |
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Education Code, is amended to read as follows: |
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SUBCHAPTER E. MAINTENANCE AND ADMINISTRATION OF EPINEPHRINE |
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AUTO-INJECTORS AND MEDICATION FOR RESPIRATORY DISTRESS [ASTHMA |
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MEDICINE] |
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SECTION 2. Section 38.201, Education Code, is amended by |
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adding Subdivision (3-a) to read as follows: |
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(3-a) "Medication for respiratory distress" means |
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albuterol, levalbuterol, or another medication designated by the |
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executive commissioner of the Health and Human Services Commission |
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for treatment of respiratory distress under Section 38.208(c). |
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SECTION 3. Section 38.202(a), Education Code, is amended to |
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read as follows: |
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(a) The commissioner of state health services shall |
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establish an advisory committee to examine and review the |
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administration, on a campus of a school district, an |
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open-enrollment charter school, a private school, or an institution |
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of higher education, of: |
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(1) epinephrine auto-injectors to a person |
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experiencing an anaphylactic reaction; and |
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(2) medication for respiratory distress to a person |
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experiencing respiratory distress [on a campus of a school |
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district, an open-enrollment charter school, a private school, or |
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an institution of higher education]. |
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SECTION 4. Section 38.207, Education Code, is amended to |
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read as follows: |
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Sec. 38.207. ADVISORY COMMITTEE: DUTIES. The advisory |
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committee shall advise the commissioner of state health services |
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on: |
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(1) the storage and maintenance of epinephrine |
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auto-injectors and medication for respiratory distress on school |
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campuses and campuses of institutions of higher education; |
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(2) the training of school personnel and school |
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volunteers, and of personnel and volunteers at institutions of |
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higher education, in the administration of an epinephrine |
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auto-injector; |
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(3) the training of school personnel and school |
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volunteers, and of personnel and volunteers at institutions of |
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higher education, in the administration of a medication for |
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respiratory distress; and |
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(4) [(3)] a plan for: |
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(A) one or more school personnel members or |
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school volunteers trained in the administration of an epinephrine |
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auto-injector to be on each school campus; [and] |
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(B) one or more school personnel members or |
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school volunteers trained in the administration of medication for |
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respiratory distress to be on each school campus; |
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(C) one or more personnel members or volunteers |
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of an institution of higher education trained in the administration |
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of an epinephrine auto-injector to be on each campus of an |
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institution of higher education; and |
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(D) one or more personnel members or volunteers |
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of an institution of higher education trained in the administration |
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of medication for respiratory distress to be on each campus of an |
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institution of higher education. |
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SECTION 5. The heading to Section 38.208, Education Code, |
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is amended to read as follows: |
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Sec. 38.208. MAINTENANCE AND ADMINISTRATION OF EPINEPHRINE |
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AUTO-INJECTORS AND MEDICATION FOR RESPIRATORY DISTRESS [ASTHMA |
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MEDICINE]. |
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SECTION 6. Section 38.208, Education Code, is amended by |
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amending Subsections (a-1), (b-1), (c), (e), and (f) and adding |
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Subsections (b-2), (b-3), (d-1), (d-2), and (e-1) to read as |
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follows: |
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(a-1) Each school district, open-enrollment charter school, |
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and private school may adopt and implement a policy regarding the |
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maintenance, administration, and disposal of medication for |
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respiratory distress [authorizing a school nurse to maintain and |
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administer asthma medicine] at each campus in the district or |
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school. |
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(b-1) If a policy is adopted under Subsection (a-1), the |
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policy must provide that school personnel and school volunteers who |
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are authorized and trained [the school nurse] may administer |
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medication for respiratory distress [prescription asthma medicine] |
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to a person reasonably believed to be experiencing respiratory |
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distress on [student only if the school nurse has written |
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notification from a parent or guardian of the student that the |
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student has been diagnosed as having asthma and stating that the |
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school nurse may administer prescription asthma medicine to the |
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student. A school nurse may administer the prescription asthma |
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medicine only at] a school campus, or at a school-sponsored or |
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school-related activity on or off school property. |
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(b-2) If medication for respiratory distress is |
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administered to a student whose parent or guardian has not provided |
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notification to the school that the student has been diagnosed with |
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asthma, the school must refer the student to the student's primary |
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care provider on the day the medication for respiratory distress is |
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administered and inform the student's parent or guardian regarding |
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the referral. The referral must include: |
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(1) the symptoms of respiratory distress observed; |
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(2) the name of the medication for respiratory |
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distress administered to the student; and |
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(3) any patient care instructions given to the |
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student. |
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(b-3) If a student who has received medication for |
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respiratory distress does not have a primary care provider or the |
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parent or guardian of the student has not engaged a primary care |
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provider for the student, the student's parent or guardian must |
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receive information to assist the parent or guardian in selecting a |
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primary care provider for the student. |
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(c) The executive commissioner of the Health and Human |
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Services Commission, in consultation with the commissioner of |
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education, and with advice from the advisory committee as |
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appropriate, shall adopt rules regarding the maintenance, |
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administration, and disposal of an epinephrine auto-injector at a |
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school campus subject to a policy adopted under Subsection (a) and |
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the maintenance, [and] administration, and disposal of medication |
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for respiratory distress [asthma medicine] at a school campus |
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subject to a policy adopted under Subsection (a-1). The rules must |
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establish: |
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(1) the number of epinephrine auto-injectors |
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available at each campus; |
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(2) the amount of medication for respiratory distress |
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[prescription asthma medicine] available at each campus; |
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(3) the process for each school district, |
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open-enrollment charter school, and private school to check the |
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inventory of epinephrine auto-injectors and medication for |
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respiratory distress [asthma medicine] at regular intervals for |
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expiration and replacement; [and] |
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(4) the amount of training required for school |
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personnel and school volunteers to administer: |
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(A) an epinephrine auto-injector; or |
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(B) medication for respiratory distress; and |
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(5) the types of medication that may be administered |
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under Subsection (b-1) to persons experiencing respiratory |
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distress, based on a review of the best available medical evidence. |
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(d-1) Each school district, open-enrollment charter school, |
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and private school that adopts a policy under Subsection (a-1) must |
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require that each campus have one or more school personnel or school |
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volunteers authorized and trained to administer medication for |
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respiratory distress present during regular school hours. |
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(d-2) A school personnel member or school volunteer may not |
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be subject to any penalty or disciplinary action for refusing to |
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administer or receive training to administer epinephrine |
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auto-injectors or medication for respiratory distress, as |
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applicable, in accordance with a policy adopted under Subsection |
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(a) or (a-1). |
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(e) The supply of epinephrine auto-injectors at each campus |
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must be stored in a secure location and be easily accessible to |
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school personnel and school volunteers authorized and trained to |
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administer an epinephrine auto-injector. [The supply of asthma |
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medicine at each campus must be stored in a secure location and be |
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easily accessible to the school nurse.] |
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(e-1) The supply of medication for respiratory distress at |
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each campus must be stored in a secure location and be easily |
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accessible to authorized school personnel and school volunteers. |
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(f) The policy described by Subsection (a-1) may not require |
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a school district, open-enrollment charter school, or private |
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school to purchase medication for respiratory distress |
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[prescription asthma medicine] or require any other expenditure |
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related to the maintenance or administration of medication for |
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respiratory distress [asthma medicine] that would result in a |
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negative fiscal impact on the district or school. |
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SECTION 7. Subchapter E, Chapter 38, Education Code, is |
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amended by adding Section 38.2091 to read as follows: |
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Sec. 38.2091. REPORT ON ADMINISTERING MEDICATION FOR |
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RESPIRATORY DISTRESS. (a) Not later than the 10th business day |
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after the date a school personnel member or school volunteer |
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administers medication for respiratory distress to a person |
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experiencing respiratory distress in accordance with a policy |
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adopted under Section 38.208(a-1), the school shall report the |
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information required under Subsection (b) to: |
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(1) the school district, the charter holder if the |
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school is an open-enrollment charter school, or the governing body |
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of the school if the school is a private school; |
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(2) the physician or other person who prescribed the |
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medication for respiratory distress; and |
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(3) the commissioner of state health services. |
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(b) The report required under this section must include: |
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(1) the age of the person who received the |
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administration of the medication for respiratory distress; |
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(2) whether the person who received the administration |
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of the medication for respiratory distress was a student, a school |
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personnel member or school volunteer, or a visitor; |
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(3) the dosage of the medication for respiratory |
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distress administered; |
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(4) the title of the person who administered the |
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medication for respiratory distress; and |
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(5) any other information required by the commissioner |
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of education. |
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SECTION 8. Section 38.210, Education Code, is amended by |
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amending Subsections (a) and (b) and adding Subsection (a-1) to |
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read as follows: |
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(a) Each school district, open-enrollment charter school, |
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and private school that adopts a policy under Section 38.208(a) is |
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responsible for training school personnel and school volunteers in |
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the administration of an epinephrine auto-injector. The training |
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must include information on: |
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(1) recognizing the signs and symptoms of anaphylaxis; |
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(2) administering an epinephrine auto-injector; |
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(3) implementing emergency procedures, if necessary, |
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after administering an epinephrine auto-injector; and |
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(4) properly disposing of used or expired epinephrine |
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auto-injectors. |
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(a-1) Each school district, open-enrollment charter school, |
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and private school that adopts a policy under Section 38.208(a-1) |
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is responsible for training school personnel and school volunteers |
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in the administration of medication for respiratory distress. The |
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training must include information on: |
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(1) recognizing the signs and symptoms of respiratory |
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distress; |
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(2) administering medication for respiratory |
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distress; |
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(3) implementing emergency procedures, if necessary, |
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after administering medication for respiratory distress; and |
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(4) proper sanitization, reuse, and disposal of |
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medication for respiratory distress. |
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(b) Training required under this section must be provided: |
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(1) [include information on: |
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[(A) recognizing the signs and symptoms of |
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anaphylaxis; |
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[(B) administering an epinephrine auto-injector; |
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[(C) implementing emergency procedures, if |
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necessary, after administering an epinephrine auto-injector; and |
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[(D) properly disposing of used or expired |
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epinephrine auto-injectors; |
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[(2) be provided] in a formal training session or |
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through online education; and |
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(2) [(3) be provided] in accordance with the policy |
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adopted under Section 21.4515. |
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SECTION 9. The heading to Section 38.211, Education Code, |
|
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is amended to read as follows: |
|
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Sec. 38.211. PRESCRIPTION OF EPINEPHRINE AUTO-INJECTORS |
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AND MEDICATION FOR RESPIRATORY DISTRESS [ASTHMA MEDICINE]. |
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SECTION 10. Sections 38.211(a), (b), (c), (e), and (f), |
|
|
Education Code, are amended to read as follows: |
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(a) A physician or person who has been delegated |
|
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prescriptive authority under Chapter 157, Occupations Code, may |
|
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prescribe epinephrine auto-injectors or medication for respiratory |
|
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distress [asthma medicine] in the name of a school district, |
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open-enrollment charter school, or private school. |
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(b) A physician or other person who prescribes epinephrine |
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auto-injectors or medication for respiratory distress [asthma |
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medicine] under Subsection (a) shall provide the school district, |
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open-enrollment charter school, or private school with a standing |
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order for the administration of, as applicable: |
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(1) an epinephrine auto-injector to a person |
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reasonably believed to be experiencing anaphylaxis; or |
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(2) medication for respiratory distress [asthma |
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medicine] to a person reasonably believed to be experiencing |
|
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respiratory distress [a symptom of asthma and who has provided |
|
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written notification and permission as required by Section |
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38.208(b-1)]. |
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(c) The standing order under Subsection (b) is not required |
|
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to be patient-specific, and the epinephrine auto-injector or |
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medication for respiratory distress [asthma medicine] may be |
|
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administered to a person without a previously established |
|
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physician-patient relationship. |
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(e) An order issued under this section must contain: |
|
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(1) the name and signature of the prescribing |
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physician or other person; |
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(2) the name of the school district, open-enrollment |
|
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charter school, or private school to which the order is issued; |
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(3) as applicable, the quantity of epinephrine |
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auto-injectors or the quantity and types of medications for |
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respiratory distress [asthma medicine] to be obtained and |
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maintained under the order; and |
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(4) the date of issue. |
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(f) A pharmacist may dispense an epinephrine auto-injector |
|
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or medication for respiratory distress [asthma medicine] to a |
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school district, open-enrollment charter school, or private school |
|
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without requiring the name or any other identifying information |
|
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relating to the user. |
|
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SECTION 11. Section 38.212, Education Code, is amended to |
|
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read as follows: |
|
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Sec. 38.212. NOTICE TO PARENTS; WRITTEN CONSENT. (a) If a |
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school district, open-enrollment charter school, or private school |
|
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implements a policy under this subchapter, the district or school |
|
|
shall: |
|
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(1) provide written notice of the policy to a parent or |
|
|
guardian of each student enrolled in the district or school; and |
|
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(2) obtain written consent from a parent or guardian |
|
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of each student on the student's enrollment in the district or |
|
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school to administer an epinephrine auto-injector or medication for |
|
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respiratory distress, as applicable, to the student in accordance |
|
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with the policy. |
|
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(b) Notice required under Subsection (a)(1) [this section] |
|
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must be provided before a policy is implemented by the district or |
|
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school under this subchapter and before the start of each school |
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year. |
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(c) Subsection (a)(2) does not prohibit a school personnel |
|
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member or school volunteer from administering in good faith an |
|
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epinephrine auto-injector to a student reasonably believed to be |
|
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experiencing anaphylaxis or medication for respiratory distress to |
|
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a student reasonably believed to be experiencing respiratory |
|
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distress, as applicable, in accordance with a policy implemented |
|
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under this subchapter, regardless of whether the student's parent |
|
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or guardian has provided written consent under Subsection (a)(2). |
|
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SECTION 12. Section 38.215(a), Education Code, is amended |
|
|
to read as follows: |
|
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(a) A person who in good faith takes, or fails to take, any |
|
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action under this subchapter is immune from civil or criminal |
|
|
liability or disciplinary action resulting from that action or |
|
|
failure to act, including: |
|
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(1) issuing an order for epinephrine auto-injectors or |
|
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medication for respiratory distress [asthma medicine]; |
|
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(2) supervising or delegating the administration of an |
|
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epinephrine auto-injector or medication for respiratory distress |
|
|
[asthma medicine]; |
|
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(3) possessing, maintaining, storing, or disposing of |
|
|
an epinephrine auto-injector or medication for respiratory |
|
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distress [asthma medicine]; |
|
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(4) prescribing an epinephrine auto-injector or |
|
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medication for respiratory distress [asthma medicine]; |
|
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(5) dispensing: |
|
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(A) an epinephrine auto-injector; or |
|
|
(B) medication for respiratory distress [asthma |
|
|
medicine, provided that permission has been granted as provided by |
|
|
Section 38.208(b-1)]; |
|
|
(6) administering, or assisting in administering, an |
|
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epinephrine auto-injector or medication for respiratory distress |
|
|
[asthma medicine, provided that permission has been granted as |
|
|
provided by Section 38.208(b-1)]; |
|
|
(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. |
|
|
SECTION 13. 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, 2023. |
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* * * * * |