89R5240 RAL-F

By: Hinojosa of Hidalgo S.B. No. 1374

A BILL TO BE ENTITLED

AN ACT

relating to the administration of epinephrine medication by public and private schools.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Section 38.0151(f), Education Code, is amended to read as follows:

(f) A school district or open-enrollment charter school that provides for the maintenance, administration, and disposal of epinephrine medication [auto-injectors] under Subchapter E is not required to comply with this section.

SECTION 2. The heading to Subchapter E, Chapter 38, Education Code, is amended to read as follows:

SUBCHAPTER E. MAINTENANCE AND ADMINISTRATION OF EPINEPHRINE

MEDICATION [AUTO-INJECTORS] AND MEDICATION FOR RESPIRATORY

DISTRESS

SECTION 3. Section 38.201, Education Code, is amended by amending Subdivision (3-a) and adding Subdivision (3-b) to read as follows:

(3-a) "Epinephrine medication" means an epinephrine auto-injector, an epinephrine nasal spray, or other medication designated by the executive commissioner of the Health and Human Services Commission for treatment of anaphylaxis under Section 38.208(c).

(3-b) "Medication for respiratory distress" means albuterol, levalbuterol, or another medication designated by the executive commissioner of the Health and Human Services Commission for treatment of respiratory distress under Section 38.208(c).

SECTION 4. Section 38.202(a), Education Code, is amended to read as follows:

(a) The commissioner of state health services shall establish an advisory committee to examine and review the administration, on a campus of a school district, an open-enrollment charter school, a private school, or an institution of higher education, of:

(1) epinephrine medication [auto-injectors] to a person experiencing an anaphylactic reaction; and

(2) medication for respiratory distress to a person experiencing respiratory distress.

SECTION 5. Section 38.207, Education Code, is amended to read as follows:

Sec. 38.207. ADVISORY COMMITTEE: DUTIES. The advisory committee shall advise the commissioner of state health services on:

(1) the storage and maintenance of epinephrine medication [auto-injectors] and medication for respiratory distress on school campuses and campuses of institutions of higher education;

(2) the training of school personnel and school volunteers, and of personnel and volunteers at institutions of higher education, in the administration of [an] epinephrine medication [auto-injector];

(3) the training of school personnel and school volunteers, and of personnel and volunteers at institutions of higher education, in the administration of a medication for respiratory distress; and

(4) a plan for:

(A) one or more school personnel members or school volunteers trained in the administration of [an] epinephrine medication [auto-injector] to be on each school campus;

(B) one or more school personnel members or school volunteers trained in the administration of medication for respiratory distress to be on each school campus;

(C) one or more personnel members or volunteers of an institution of higher education trained in the administration of [an] epinephrine medication [auto-injector] to be on each campus of an institution of higher education; and

(D) one or more personnel members or volunteers of an institution of higher education trained in the administration of medication for respiratory distress to be on each campus of an institution of higher education.

SECTION 6. The heading to Section 38.208, Education Code, is amended to read as follows:

Sec. 38.208. MAINTENANCE AND ADMINISTRATION OF EPINEPHRINE MEDICATION [AUTO-INJECTORS] AND MEDICATION FOR RESPIRATORY DISTRESS.

SECTION 7. Sections 38.208(a), (b), (c), (d), (d-2), and (e), Education Code, are amended to read as follows:

(a) Each school district, open-enrollment charter school, and private school may adopt and implement a policy regarding the maintenance, administration, and disposal of epinephrine medication [auto-injectors] at each campus in the district or school.

(b) If a policy is adopted under Subsection (a), the policy:

(1) must provide that school personnel and school volunteers who are authorized and trained may administer [an] epinephrine medication [auto-injector] to a person who is reasonably believed to be experiencing anaphylaxis on a school campus; and

(2) may provide that school personnel and school volunteers who are authorized and trained may administer [an] epinephrine medication [auto-injector] to a person who is reasonably believed to be experiencing anaphylaxis at an off-campus school event or while in transit to or from a school event.

(c) The executive commissioner of the Health and Human Services Commission, in consultation with the commissioner of education, and with advice from the advisory committee as appropriate, shall adopt rules regarding the maintenance, administration, and disposal of [an] epinephrine medication [auto-injector] at a school campus subject to a policy adopted under Subsection (a) and the maintenance, administration, and disposal of medication for respiratory distress at a school campus subject to a policy adopted under Subsection (a-1). The rules must establish:

(1) the amount [number] of epinephrine medication [auto-injectors] available at each campus;

(2) the amount of medication for respiratory distress available at each campus;

(3) the process for each school district, open-enrollment charter school, and private school to check the inventory of epinephrine medication [auto-injectors] and medication for respiratory distress at regular intervals for expiration and replacement;

(4) the amount of training required for school personnel and school volunteers to administer:

(A) [an] epinephrine medication [auto-injector]; or

(B) medication for respiratory distress; and

(5) the types of medication that may be administered under Subsection (b-1) to persons experiencing respiratory distress, based on a review of the best available medical evidence.

(d) Each school district, open-enrollment charter school, and private school that adopts a policy under Subsection (a) must require that each campus have one or more school personnel members or school volunteers authorized and trained to administer [an] epinephrine medication [auto-injector] present during regular school [all] hours [the campus is open].

(d-2) A school personnel member or school volunteer may not be subject to any penalty or disciplinary action for refusing to administer or receive training to administer epinephrine medication [auto-injectors] or medication for respiratory distress, as applicable, in accordance with a policy adopted under Subsection (a) or (a-1).

(e) The supply of epinephrine medication [auto-injectors] at each campus must be stored in a secure location and be easily accessible to school personnel and school volunteers authorized and trained to administer [an] epinephrine medication [auto-injector].

SECTION 8. Section 38.209, Education Code, is amended to read as follows:

Sec. 38.209. REPORT ON ADMINISTERING EPINEPHRINE MEDICATION [AUTO-INJECTOR]. (a) Not later than the 10th business day after the date a school personnel member or school volunteer administers [an] epinephrine medication [auto-injector] in accordance with a policy adopted under Section 38.208(a), the school shall report the information required under Subsection (b) to:

(1) the school district, the charter holder if the school is an open-enrollment charter school, or the governing body of the school if the school is a private school;

(2) the physician or other person who prescribed the epinephrine medication [auto-injector]; and

(3) 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 medication [auto-injector];

(2) whether the person who received the administration of the epinephrine medication [auto-injector] was a student, a school personnel member or school volunteer, or a visitor;

(3) the physical location where the epinephrine medication [auto-injector] was administered;

(4) the number of doses of epinephrine medication [auto-injector] administered;

(5) the title of the person who administered the epinephrine medication [auto-injector]; and

(6) any other information required by the commissioner of education.

SECTION 9. Section 38.210(a), Education Code, is amended to read as follows:

(a) Each school district, open-enrollment charter school, and private school that adopts a policy under Section 38.208(a) is responsible for training school personnel and school volunteers in the administration of [an] epinephrine medication [auto-injector]. The training must include information on:

(1) recognizing the signs and symptoms of anaphylaxis;

(2) administering [an] epinephrine medication [auto-injector];

(3) implementing emergency procedures, if necessary, after administering [an] epinephrine medication [auto-injector]; and

(4) properly disposing of used or expired epinephrine medication [auto-injectors].

SECTION 10. The heading to Section 38.211, Education Code, is amended to read as follows:

Sec. 38.211. PRESCRIPTION OF EPINEPHRINE MEDICATION [AUTO-INJECTORS] AND MEDICATION FOR RESPIRATORY DISTRESS.

SECTION 11. Section 38.211, Education Code, is amended by amending Subsections (a), (b), (c), (e), and (f) and adding Subsections (b-1) and (b-2) to read as follows:

(a) A physician or person who has been delegated prescriptive authority under Chapter 157, Occupations Code, may prescribe epinephrine medication [auto-injectors] or medication for respiratory distress in the name of a school district, open-enrollment charter school, or private school.

(b) A physician or other person who prescribes epinephrine medication [auto-injectors] or medication for respiratory distress under Subsection (a) shall provide the school district, open-enrollment charter school, or private school with a standing order for the administration of, as applicable:

(1) [an] epinephrine medication [auto-injector] to a person reasonably believed to be experiencing anaphylaxis; or

(2) medication for respiratory distress to a person reasonably believed to be experiencing respiratory distress.

(b-1) The commissioner of state health services or, if the commissioner is not a physician, the chief medical executive of the Department of State Health Services may issue a statewide standing order prescribing epinephrine medication to a school district, open-enrollment charter school, or private school.

(b-2) If a standing order has not been issued under Subsection (b-1) to a school district, open-enrollment charter school, or private school within 30 days of the beginning of a school year, a regional director of a public health region described by Section 121.007, Health and Safety Code, or a health authority, as defined by Section 121.021, Health and Safety Code, may issue a standing order prescribing epinephrine medication to a school district, open-enrollment charter school, or private school in the director's public health region or health authority's jurisdiction, as applicable, for that school year.

(c) The standing order under Subsection (b), (b-1), or (b-2) is not required to be patient-specific, and the epinephrine medication [auto-injector] or medication for respiratory distress may be administered to a person without a previously established physician-patient relationship.

(e) An order issued under this section must contain:

(1) the name and signature of the prescribing physician or other person;

(2) the name of the school district, open-enrollment charter school, or private school to which the order is issued;

(3) as applicable, the quantity and types of epinephrine medication [auto-injectors] or the quantity and types of medications for respiratory distress to be obtained and maintained under the order; and

(4) the date of issue.

(f) A pharmacist may dispense [an] epinephrine medication [auto-injector] or medication for respiratory distress to a school district, open-enrollment charter school, or private school without requiring the name or any other identifying information relating to the user.

SECTION 12. Section 38.215(a), Education Code, is amended to read as follows:

(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 medication [auto-injectors] or medication for respiratory distress;

(2) supervising or delegating the administration of [an] epinephrine medication [auto-injector] or medication for respiratory distress;

(3) possessing, maintaining, storing, or disposing of [an] epinephrine medication [auto-injector] or medication for respiratory distress;

(4) prescribing [an] epinephrine medication [auto-injector] or medication for respiratory distress;

(5) dispensing:

(A) [an] epinephrine medication [auto-injector]; or

(B) medication for respiratory distress;

(6) administering, or assisting in administering, [an] epinephrine medication [auto-injector] or medication for respiratory distress;

(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, 2025.