SESSION OF 2024
SUPPLEMENTAL NOTE ON HOUSE BILL NO. 2547
As Amended by Senate Committee on Public
Health and Welfare
Brief*
HB 2547, as amended, would amend law regarding the
stock, maintenance, and administration of emergency
medication kits in schools, including epinephrine and
albuterol.
The bill would provide a level of immunity from liability
for a pharmacist, physician, or a mid-level practitioner who
distributes or prescribes emergency medication to a school or
provides training on the administration of the emergency
medication for school personnel.
The bill would also make technical changes.
Definitions (Section 3)
The bill would amend the current law to add definitions
for terms used throughout the bill. Key terms would include
the following:
●“Albuterol” would mean a short-acting beta-2
agonist-inhaled medication, otherwise known as a
bronchodilator, that is prescribed by a physician or
mid-level practitioner for the treatment of
respiratory distress;
●“Designated school personnel” would mean an
employee, officer, agent, or volunteer of a school
____________________
*Supplemental notes are prepared by the Legislative Research
Department and do not express legislative intent. The supplemental
note and fiscal note for this bill may be accessed on the Internet at
http://www.kslegislature.org who has completed training, documented by the
school nurse, a physician, or a mid-level
practitioner, to administer emergency medication
on a voluntary basis outside of the scope of
employment;
●“Emergency medication” would mean epinephrine
or albuterol;
●“Epinephrine” would mean a medication prescribed
by a physician or mid-level practitioner for the
emergency treatment of anaphylaxis prior to the
arrival of emergency medical system responders;
●“Mid-level practitioner” would mean a certified
nurse-midwife engaging in the independent
practice of midwifery under the Independent
Practice of Midwifery Act, an advanced practice
registered nurse issued a license and who has
authority to prescribe drugs, or a physician
assistant licensed pursuant to the Physician
Assistant Licensure Act who has authority to
prescribe drugs pursuant to a written agreement
with a supervising physician;
●“Pharmacist” would mean any natural person
licensed under the Pharmacy Act to practice
pharmacy;
●“Physician” would mean any person licensed by
the State Board of Healing Arts to practice
medicine and surgery;
●“Respiratory distress” would mean impaired
ventilation of the respiratory system or impaired
oxygenation of the blood;
●“School” would mean any school operated by a
school district organized under the laws of this
state or any accredited nonpublic school that
2- 2547 provides education to elementary or secondary
students;
●“School nurse” would mean a registered nurse
licensed by the Board of Nursing to practice
nursing in Kansas or a licensed practical nurse
working under a registered nurse who is employed
by a school to perform nursing services in a school
setting; and
●“Stock supply” would mean an appropriate quantity
of emergency medication as recommended by a
physician or mid-level practitioner.
Stock Supply (Section 3)
The bill would allow schools to maintain a stock supply
of emergency medications with a prescription from a
physician or mid-level practitioner in the name of the school.
The bill would require a physician or mid-level practitioner to
review a school’s policies and procedures regarding the use,
storage, and maintenance of the stock supply prior to
prescribing the emergency medication.
Type, Doses, and Administration in Emergency Situation
The bill would define the type and doses of epinephrine
that may be in the stock supply as one or more standard-
dose or pediatric-dose epinephrine auto-injectors. The bill
would specify that a school nurse or designated school
personnel may administer the epinephrine in an emergency
situation to any individual who displays the signs and
symptoms of anaphylaxis at school, on school property, or at
a school-sponsored event. The epinephrine would only be
permitted to be administered by the school nurse or
designated school personnel if they reasonably believe that
an individual is exhibiting the signs and symptoms of an
anaphylactic reaction.
3- 2547 The bill would define the type and doses of albuterol that
could be in the stock supply as one or more albuterol
metered-dose inhalers, one or more doses of albuterol
solution, and one or more spacers or nebulizers. The bill
would specify that a school nurse or designated school
personnel may administer the albuterol in an emergency
situation to any individual who displays the signs and
symptoms of respiratory distress at school, on school
property, or at a school-sponsored event. The albuterol would
only be permitted to be administered by the school nurse or
designated school personnel if they reasonably believe that
an individual is exhibiting the signs and symptoms of
respiratory distress.
Policy and Procedures
The bill would require that any school that maintains a
stock supply of emergency medication to establish school
policies and procedures on the following:
●Storage of the emergency medication to include
storage in a safe location that is readily accessible
to the school nurse or designated school personnel
and meets manufacturer ’s temperature
recommendations;
●Periodic monitoring of the inventory and expiration
dates of the emergency medication;
●Administration of emergency medication by
designated school personnel; and
●Training requirements for designated school
personnel, which must be conducted at least
annually by a school nurse, physician, or mid-level
practitioner. The training would include, at
minimum:
○Recognition of the symptoms of anaphylaxis
and respiratory distress;
4- 2547 ○Administration of emergency medications;
○Calling for emergency medical system
responders;
○Monitoring the condition of the individual after
administration of emergency medication;
○Notification of the parent, guardian, or next of
kin; and
○Safe disposal and sanitation of used
equipment.
The bill would also require the school to publish
information related to the school’s policies and procedures
regarding emergency medication and maintain training
records of designated school personnel.
The bill would also authorize a school to accept
monetary gifts, grants, and donations as well as donations of
emergency medications authorized under the bill from a
manufacturer or wholesaler.
Pharmacists (Section 1)
The bill would allow a pharmacist to distribute a stock
supply of emergency medications, including standard-dose
and pediatric-dose epinephrine auto-injectors and albuterol
metered-dose inhalers, albuterol solution, and spacers to a
school pursuant to a prescription from a physician or mid-
level practitioner in the name of the school.
The bill would provide for a pharmacist that distributes a
stock supply of emergency medication to not be liable for civil
damages resulting from the administration of the emergency
medication.
[Note: Current law provides for the State Board of
Pharmacy to adopt rules and regulations to provide for the
maintenance of epinephrine kits maintained in accredited
schools.]
5- 2547 Administration of Emergency Medication (Section 2)
Current law provides that administration of epinephrine
in emergency situations to a student or member of school
staff when certain conditions are met is not construed to be
included in the practice of the healing arts. The bill would
extend that exception to add the administration of albuterol in
emergency situations and apply it to any individual receiving
the emergency medication when certain conditions are met,
including if:
●The person administering the epinephrine
reasonably believes the individual is exhibiting the
signs and symptoms of an anaphylactic reaction; or
●The person administering the albuterol reasonably
believes the individual is exhibiting the signs and
symptoms of respiratory distress;
●A physician or mid-level practitioner, after reviewing
the school’s policies and procedures, has
authorized, in writing, the school to maintain a
stock supply of emergency medication; and
●The emergency medication is administered at
school on school property or at a school-sponsored
event.
The bill would remove the current liability protections for
any person who gratuitously and in good faith renders
emergency care or treatment through the administration of
epinephrine to a student or member of a school staff at
school, school property, or at a school-sponsored event.
The bill would limit the liability of a physician or mid-level
practitioner who writes a prescription for the stock supply of
emergency medication, or who provides training to school
personnel on the administration of emergency medication in
that the medical professional would not be liable for civil
6- 2547 damages resulting from the administration of the emergency
medication.
Background
The bill was introduced in the House Committee on
Health and Human Services at the request of Representative
Eplee on behalf of the Kansas School Nurses Organization.
House Committee on Health and Human Services
In the House Committee hearing on January 30, 2024,
representatives of the State Board of Pharmacy (Board) and
the Kansas School Nurses Association provided proponent
testimony. The proponents stated generally the bill would
remove the barriers regarding the availability of a stock
supply of epinephrine and albuterol in schools and permit the
administration of the medication in an emergency or time-
sensitive situation.
Written-only proponent testimony was provided by
representatives of the Board of Nursing, Kansas Action for
Children, Kansas Association of School Boards, Kansas
Chapter of the American Academy of Pediatrics, and four
private citizens.
No other testimony was provided.
Senate Committee on Public Health and Welfare
In the Senate Committee hearing on March 12, 2024,,
proponent testimony was provided by representatives of the
Board, Kansas Association of School Boards, and Kansas
School Nurses Organization. Proponents generally stated the
bill would remove barriers regarding the availability of a stock
supply of epinephrine and albuterol in schools and permit the
administration of medication in an emergency or time-
sensitive situation.
7- 2547 Written-only proponent testimony was provided by
representatives of the American Lung Association of Kansas,
Board of Nursing, Kansas Action for Children, Kansas
Chapter of the American Academy of Pediatrics, and Kansas
Public Health Association, and a private citizen.
No other testimony was provided.
The Senate Committee amended the bill to clarify that
training over the use of emergency medication must be
provided by a school nurse, physician, or mid-level
practitioner. The Senate Committee also amended the bill to
remove the civil liability waiver for non-medical personnel who
administer the emergency medication.
Fiscal Information
According to the fiscal note prepared by the Division of
the Budget on the bill, as introduced, the State Board of
Healing Arts indicates that any resulting actionable
complaints could be managed with its existing budget
authority. The Board of Nursing indicates the agency would
communicate information to its licensees if the bill becomes
law; however, enactment of the bill would have no fiscal effect
for the agency outside of normal administrative functions. The
State Board of Pharmacy indicates that enactment of the bill
would not have a fiscal effect on the agency. The Department
of Education (Department) indicates the bill would have no
fiscal effect on state aid to school districts. The Kansas
Association of School Boards and the Department noted the
cost of any emergency medications would be borne by local
school districts. The Department notes that a school would be
able to accept monetary gifts, grants, and donations to
implement provisions of the bill, as well as being able to
accept medication gifts from a manufacturer or wholesaler.
Emergency medication kits; albuterol; pharmacist; school nurses; epinephrine;
physicians; mid-level practitioner
8- 2547