| 1 | 1 | | By: Herrero H.B. No. 566 |
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| 2 | 2 | | |
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| 3 | 3 | | |
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| 4 | 4 | | A BILL TO BE ENTITLED |
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| 5 | 5 | | AN ACT |
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| 6 | 6 | | relating to the use of epinephrine auto-injectors on public and |
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| 7 | 7 | | open-enrollment charter school campuses and at off-campus |
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| 8 | 8 | | school-sanctioned events. |
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| 9 | 9 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 10 | 10 | | SECTION 1. Subchapter A, Chapter 38, Education Code, is |
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| 11 | 11 | | amended by adding Section 38.0152 to read as follows: |
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| 12 | 12 | | Sec. 38.0152. MAINTENANCE OF SUPPLY OF EPINEPHRINE |
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| 13 | 13 | | AUTO-INJECTORS; PRESCRIBING; TRAINING; AND ADMINISTRATION. (a) In |
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| 14 | 14 | | this section: |
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| 15 | 15 | | (1) "Anaphylaxis" means a sudden, severe, and |
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| 16 | 16 | | potentially life-threatening allergic reaction that occurs when an |
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| 17 | 17 | | individual is exposed to an allergen. |
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| 18 | 18 | | (2) "Epinephrine auto-injector" means a portable, |
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| 19 | 19 | | disposable drug delivery device that contains a premeasured single |
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| 20 | 20 | | dose of epinephrine that is intended to be used to treat |
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| 21 | 21 | | anaphylaxis. |
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| 22 | 22 | | (3) "Open-enrollment charter school" means a school |
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| 23 | 23 | | established under Subchapter D, Chapter 12, of this code. |
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| 24 | 24 | | (4) "Physician" means an individual licensed to |
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| 25 | 25 | | practice medicine in this state. |
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| 26 | 26 | | (5) "Type of individual" means a student at, staff of, |
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| 27 | 27 | | or visitor to a campus or an off-campus school-sanctioned event who |
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| 28 | 28 | | receives administration of an epinephrine auto-injector under this |
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| 29 | 29 | | section. |
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| 30 | 30 | | (b) Each school district and open-enrollment charter school |
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| 31 | 31 | | shall adopt and implement a policy consistent with the requirements |
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| 32 | 32 | | of this section for the possession, administration, and disposal of |
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| 33 | 33 | | epinephrine auto-injectors at every campus within the school |
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| 34 | 34 | | district or open-enrollment charter school so that the epinephrine |
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| 35 | 35 | | auto-injector may be administered by a school employee who is |
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| 36 | 36 | | authorized and trained in the administration of an epinephrine |
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| 37 | 37 | | auto-injector to an individual on the campus or at an off-campus |
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| 38 | 38 | | school-sanctioned event who is reasonably believed to be |
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| 39 | 39 | | experiencing anaphylaxis. |
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| 40 | 40 | | (c)(1) The commissioner of state health services shall |
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| 41 | 41 | | establish within the Department of State Health Services an |
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| 42 | 42 | | advisory committee on the use of epinephrine auto-injectors on |
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| 43 | 43 | | undesignated individuals on the campus of a school district or an |
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| 44 | 44 | | open-enrollment charter school, or at an off-campus |
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| 45 | 45 | | school-sanctioned event. |
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| 46 | 46 | | (2) The commissioner of state health services shall |
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| 47 | 47 | | appoint the members of the advisory committee. |
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| 48 | 48 | | (3) The advisory committee shall advise the |
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| 49 | 49 | | commissioner of state health services on: |
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| 50 | 50 | | (A) the storage of epinephrine auto-injectors on |
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| 51 | 51 | | school campuses as provided in Subsection (d)(1); |
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| 52 | 52 | | (B) the maintenance of epinephrine |
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| 53 | 53 | | auto-injectors while in transit to or from an off-campus |
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| 54 | 54 | | school-sanctioned event as provided in Subsection (d)(1); |
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| 55 | 55 | | (C) the training of school employees as provided |
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| 56 | 56 | | in Subsection (d)(2); and |
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| 57 | 57 | | (D) a plan at each campus for having one or more |
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| 58 | 58 | | trained employees as provided in Subsection (d)(3). |
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| 59 | 59 | | (4) The advisory committee shall include physicians |
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| 60 | 60 | | with expertise in treating anaphylaxis, including physicians who |
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| 61 | 61 | | specialize in the fields of pediatrics, allergy, asthma, and |
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| 62 | 62 | | immunology. |
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| 63 | 63 | | (5) The advisory committee shall elect a presiding |
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| 64 | 64 | | officer. |
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| 65 | 65 | | (6) Members of the advisory committee serve without |
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| 66 | 66 | | compensation but are entitled to reimbursement for the members' |
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| 67 | 67 | | travel expenses as provided by Chapter 660, Government Code, and |
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| 68 | 68 | | the General Appropriations Act. |
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| 69 | 69 | | (7) An advisory committee member serves at the |
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| 70 | 70 | | pleasure of the commissioner of state health services. |
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| 71 | 71 | | (8) A vacancy on the advisory committee shall be |
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| 72 | 72 | | filled by the commissioner of state health services in the same |
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| 73 | 73 | | manner as other appointments to the advisory committee. |
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| 74 | 74 | | (9) Chapter 2110, Government Code, does not apply to |
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| 75 | 75 | | the advisory committee formed under this subsection. |
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| 76 | 76 | | (10) Meetings of the advisory committee are subject to |
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| 77 | 77 | | Chapter 551, Government Code. |
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| 78 | 78 | | (d) In consultation with the commissioner, and after |
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| 79 | 79 | | consideration of advice from the advisory committee described in |
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| 80 | 80 | | Subsection (c), the commissioner of state health services shall |
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| 81 | 81 | | adopt rules for school districts and open-enrollment charter |
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| 82 | 82 | | schools to use in the development of the policy described in |
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| 83 | 83 | | Subsection (b). The rules must establish: |
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| 84 | 84 | | (1) the quantity of epinephrine auto-injectors to be |
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| 85 | 85 | | stored at each campus or maintained while in transit to or from an |
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| 86 | 86 | | off-campus school-sanctioned event and a requirement that stock |
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| 87 | 87 | | inventory be checked at regular intervals for expiration and |
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| 88 | 88 | | replacement; |
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| 89 | 89 | | (2) the level of training required for school |
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| 90 | 90 | | employees in the administration of an epinephrine auto-injector to |
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| 91 | 91 | | an individual who is reasonably believed to be experiencing |
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| 92 | 92 | | anaphylaxis; and |
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| 93 | 93 | | (3) a requirement at each campus for having present, |
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| 94 | 94 | | during all operating hours, one or more trained school employees |
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| 95 | 95 | | described in Subsection (f). |
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| 96 | 96 | | (e) Training described in Subsection (d)(2) must: |
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| 97 | 97 | | (1) include information regarding how to: |
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| 98 | 98 | | (A) recognize the signs and symptoms of |
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| 99 | 99 | | anaphylaxis; |
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| 100 | 100 | | (B) administer an epinephrine auto-injector; |
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| 101 | 101 | | (C) implement emergency procedures, if |
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| 102 | 102 | | necessary, after administering an epinephrine auto-injector; and |
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| 103 | 103 | | (D) properly dispose of used or expired |
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| 104 | 104 | | epinephrine auto-injectors; |
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| 105 | 105 | | (2) be obtained in formal training sessions or through |
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| 106 | 106 | | online education; and |
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| 107 | 107 | | (3) be completed annually. |
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| 108 | 108 | | (f) Each school district and open-enrollment charter school |
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| 109 | 109 | | shall be responsible for ensuring that school employees identified |
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| 110 | 110 | | by the district or the open-enrollment charter school on each |
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| 111 | 111 | | campus, or at an off-campus school-sanctioned event, are trained as |
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| 112 | 112 | | described in Subsection (e) to administer an epinephrine |
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| 113 | 113 | | auto-injector to an individual on the campus or at an off-campus |
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| 114 | 114 | | school-sanctioned event who is reasonably believed to be |
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| 115 | 115 | | experiencing anaphylaxis. Each school district and open-enrollment |
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| 116 | 116 | | charter school shall maintain records on the training of such |
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| 117 | 117 | | employees. |
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| 118 | 118 | | (g) Each school district and open-enrollment charter school |
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| 119 | 119 | | shall maintain at each campus in the district or of the |
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| 120 | 120 | | open-enrollment charter school a supply of epinephrine |
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| 121 | 121 | | auto-injectors that may be administered by a school employee who is |
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| 122 | 122 | | trained as described in Subsection (e) to an individual on a campus |
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| 123 | 123 | | in the district or of the open-enrollment charter school, or at an |
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| 124 | 124 | | off-campus school-sanctioned event, who is reasonably believed to |
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| 125 | 125 | | be experiencing anaphylaxis. The school district or |
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| 126 | 126 | | open-enrollment charter school, as appropriate, shall be |
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| 127 | 127 | | responsible for checking stock inventory of such epinephrine |
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| 128 | 128 | | auto-injectors at regular intervals for expiration and |
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| 129 | 129 | | replacement. In determining the number of epinephrine |
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| 130 | 130 | | auto-injectors to be kept for such purpose on a campus, the school |
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| 131 | 131 | | district or the open-enrollment charter school shall follow the |
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| 132 | 132 | | rules described in Subsection (d). |
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| 133 | 133 | | (h) The supply of epinephrine auto-injectors at each campus |
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| 134 | 134 | | shall be stored in a secure location or maintained securely while in |
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| 135 | 135 | | transit to or from an off-campus school-sanctioned event, and must |
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| 136 | 136 | | be easily accessible to trained school employees. |
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| 137 | 137 | | (i)(1) A physician may prescribe epinephrine auto-injectors |
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| 138 | 138 | | in the name of a school district or open-enrollment charter school |
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| 139 | 139 | | to be maintained for use when necessary. The prescribing physician |
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| 140 | 140 | | shall provide the school district or open-enrollment charter |
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| 141 | 141 | | school, as appropriate, a standing order for the administration of |
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| 142 | 142 | | school-supplied epinephrine auto-injectors to undesignated |
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| 143 | 143 | | individuals who are reasonably believed to be experiencing |
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| 144 | 144 | | anaphylaxis. The order shall not be required to be |
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| 145 | 145 | | patient-specific, and the administration may occur without a prior |
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| 146 | 146 | | established physician-patient relationship. Notwithstanding the |
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| 147 | 147 | | provisions of other law regarding delegation or supervision, |
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| 148 | 148 | | supervision or delegation by a physician shall be adequate if the |
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| 149 | 149 | | physician periodically reviews the order and is available through |
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| 150 | 150 | | direct telecommunication as needed for consultation, assistance, |
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| 151 | 151 | | and direction. |
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| 152 | 152 | | (2) An order issued under this subsection must |
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| 153 | 153 | | contain: |
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| 154 | 154 | | (A) the name and signature of the physician |
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| 155 | 155 | | described in Subdivision (1); |
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| 156 | 156 | | (B) the name of the school district or |
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| 157 | 157 | | open-enrollment charter school to which the order is issued; |
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| 158 | 158 | | (C) the quantity of epinephrine auto-injectors |
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| 159 | 159 | | to be obtained and maintained under the order; and |
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| 160 | 160 | | (D) the date of issue. |
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| 161 | 161 | | (j) A pharmacist may dispense an epinephrine auto-injector |
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| 162 | 162 | | under this section without the name of, or other identifying |
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| 163 | 163 | | information relating to, the ultimate user. |
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| 164 | 164 | | (k) School employees who have received the training |
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| 165 | 165 | | described in Subsection (e) may: |
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| 166 | 166 | | (1) obtain one or more epinephrine auto-injectors from |
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| 167 | 167 | | the locations described in Subsection (h), or maintained while in |
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| 168 | 168 | | transit to or from a school-sanctioned event as described in |
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| 169 | 169 | | Subsection (h), in accordance with the provisions of this section; |
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| 170 | 170 | | and |
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| 171 | 171 | | (2) administer such epinephrine auto-injectors in |
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| 172 | 172 | | accordance with the provisions of this section. |
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| 173 | 173 | | (l)(1) Not later than 10 business days after the |
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| 174 | 174 | | administration of an epinephrine auto-injector by a school employee |
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| 175 | 175 | | under the terms of this section, the school shall report to the |
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| 176 | 176 | | school district, or in the case of an open-enrollment charter |
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| 177 | 177 | | school, the charter school shall document, in a form and manner |
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| 178 | 178 | | prescribed by the commissioner, the following information: |
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| 179 | 179 | | (A) age and type of individual receiving |
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| 180 | 180 | | administration of the epinephrine auto-injector; |
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| 181 | 181 | | (B) physical location on or off campus where the |
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| 182 | 182 | | epinephrine auto-injector was administered; |
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| 183 | 183 | | (C) number of doses administered; |
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| 184 | 184 | | (D) title of person administering the |
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| 185 | 185 | | epinephrine auto-injector; and |
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| 186 | 186 | | (E) any other information required by the |
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| 187 | 187 | | commissioner. |
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| 188 | 188 | | (2) Not later than 10 business days after the |
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| 189 | 189 | | administration of an epinephrine auto-injector by a school employee |
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| 190 | 190 | | under the terms of this section, the school district or the |
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| 191 | 191 | | open-enrollment charter school shall report the information |
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| 192 | 192 | | described in Subdivision (1) to: |
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| 193 | 193 | | (A) the physician described in Subsection (i); |
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| 194 | 194 | | (B) the commissioner; and |
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| 195 | 195 | | (C) the commissioner of state health services. |
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| 196 | 196 | | (m) A school district or an open-enrollment charter school |
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| 197 | 197 | | may each accept gifts, donations, grants, and federal and local |
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| 198 | 198 | | funds for the support of that school district or open-enrollment |
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| 199 | 199 | | charter school in carrying out the provisions of this section. |
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| 200 | 200 | | (n)(1) Except as provided by Subsection (d) or by |
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| 201 | 201 | | Subdivision (2), the commissioner and the commissioner of state |
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| 202 | 202 | | health services shall jointly adopt rules to implement this |
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| 203 | 203 | | section. |
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| 204 | 204 | | (2) Rules to implement Subsection (c) shall be adopted |
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| 205 | 205 | | solely by the commissioner of state health services. |
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| 206 | 206 | | (o) Epinephrine auto-injectors may be administered as |
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| 207 | 207 | | provided under this section on campus and at off-campus |
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| 208 | 208 | | school-sanctioned events. The immunity provisions of this section |
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| 209 | 209 | | shall apply in such cases. |
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| 210 | 210 | | (p) A person who in good faith takes, or fails to take, any |
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| 211 | 211 | | of the following actions under this section is immune from |
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| 212 | 212 | | liability in any criminal or disciplinary action and for civil |
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| 213 | 213 | | damages as a result of that act or failure to act: |
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| 214 | 214 | | (1) issuing an order for epinephrine auto-injectors; |
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| 215 | 215 | | (2) supervising or delegating as described in |
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| 216 | 216 | | Subsection (i)(1); |
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| 217 | 217 | | (3) possessing an epinephrine auto-injector; |
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| 218 | 218 | | (4) prescribing an epinephrine auto-injector; |
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| 219 | 219 | | (5) dispensing an epinephrine auto-injector; |
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| 220 | 220 | | (6) administering, or assisting in the administering |
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| 221 | 221 | | of, an epinephrine auto-injector; |
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| 222 | 222 | | (7) providing training, consultation, or advice in the |
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| 223 | 223 | | development, adoption, or implementation of policies, guidelines, |
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| 224 | 224 | | rules, or plans; |
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| 225 | 225 | | (8) assisting in providing training, consultation, or |
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| 226 | 226 | | advice in the development, adoption, or implementation of policies, |
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| 227 | 227 | | guidelines, rules, or plans; or |
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| 228 | 228 | | (9) undertaking any other required or authorized act. |
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| 229 | 229 | | (q) The immunities and protections granted in this section |
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| 230 | 230 | | are in addition to, and not in lieu of, immunity or protection |
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| 231 | 231 | | provided pursuant to any other provisions of law. |
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| 232 | 232 | | (r) If a school district or open-enrollment charter school |
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| 233 | 233 | | lacks the funding, or other forms of support as described in |
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| 234 | 234 | | Subsection (m), that is necessary to meet the requirements of this |
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| 235 | 235 | | section, the school district or open-enrollment charter school |
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| 236 | 236 | | shall not be required to comply with the requirements of this |
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| 237 | 237 | | section. |
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| 238 | 238 | | (s) If a school district or open-enrollment charter school |
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| 239 | 239 | | is unable to meet the requirements of this section due to a |
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| 240 | 240 | | manufacturer's recall or any other unanticipated loss or reduction |
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| 241 | 241 | | in supply of epinephrine auto-injectors that adversely affects the |
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| 242 | 242 | | ability of a school district or open-enrollment charter school to |
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| 243 | 243 | | obtain epinephrine auto-injectors in quantities that are |
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| 244 | 244 | | sufficient to meet the requirements of this section, the school |
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| 245 | 245 | | district or open-enrollment charter school shall not be required to |
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| 246 | 246 | | comply with such requirements. |
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| 247 | 247 | | (t) Notwithstanding the provisions of Subsections (r) and |
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| 248 | 248 | | (s), the immunities and protections granted in this section shall |
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| 249 | 249 | | continue in full force and effect. |
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| 250 | 250 | | (u) Notwithstanding any other law, this section does not |
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| 251 | 251 | | create a civil, criminal, or administrative cause of action or a |
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| 252 | 252 | | standard of care, obligation, or duty that provides a basis for a |
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| 253 | 253 | | cause of action. |
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| 254 | 254 | | (v) Notwithstanding the provisions of Subsections (r) and |
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| 255 | 255 | | (s), the provisions of Subsection (u) shall continue in full force |
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| 256 | 256 | | and effect. |
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| 257 | 257 | | (w) A cause of action does not arise from an act or omission |
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| 258 | 258 | | described by Subsection (p). |
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| 259 | 259 | | SECTION 2. This Act takes effect September 1, 2015. |
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