By: Herrero H.B. No. 566
A BILL TO BE ENTITLED
AN ACT
relating to the use of epinephrine auto-injectors on public and
open-enrollment charter school campuses and at off-campus
school-sanctioned events.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter A, Chapter 38, Education Code, is
amended by adding Section 38.0152 to read as follows:
Sec. 38.0152. MAINTENANCE OF SUPPLY OF EPINEPHRINE
AUTO-INJECTORS; PRESCRIBING; TRAINING; AND ADMINISTRATION. (a) In
this section:
(1) "Anaphylaxis" means a sudden, severe, and
potentially life-threatening allergic reaction that occurs when an
individual is exposed to an allergen.
(2) "Epinephrine auto-injector" means a portable,
disposable drug delivery device that contains a premeasured single
dose of epinephrine that is intended to be used to treat
anaphylaxis.
(3) "Open-enrollment charter school" means a school
established under Subchapter D, Chapter 12, of this code.
(4) "Physician" means an individual licensed to
practice medicine in this state.
(5) "Type of individual" means a student at, staff of,
or visitor to a campus or an off-campus school-sanctioned event who
receives administration of an epinephrine auto-injector under this
section.
(b) Each school district and open-enrollment charter school
shall adopt and implement a policy consistent with the requirements
of this section for the possession, administration, and disposal of
epinephrine auto-injectors at every campus within the school
district or open-enrollment charter school so that the epinephrine
auto-injector may be administered by a school employee who is
authorized and trained in the administration of an epinephrine
auto-injector to an individual on the campus or at an off-campus
school-sanctioned event who is reasonably believed to be
experiencing anaphylaxis.
(c)(1) The commissioner of state health services shall
establish within the Department of State Health Services an
advisory committee on the use of epinephrine auto-injectors on
undesignated individuals on the campus of a school district or an
open-enrollment charter school, or at an off-campus
school-sanctioned event.
(2) The commissioner of state health services shall
appoint the members of the advisory committee.
(3) The advisory committee shall advise the
commissioner of state health services on:
(A) the storage of epinephrine auto-injectors on
school campuses as provided in Subsection (d)(1);
(B) the maintenance of epinephrine
auto-injectors while in transit to or from an off-campus
school-sanctioned event as provided in Subsection (d)(1);
(C) the training of school employees as provided
in Subsection (d)(2); and
(D) a plan at each campus for having one or more
trained employees as provided in Subsection (d)(3).
(4) The advisory committee shall include physicians
with expertise in treating anaphylaxis, including physicians who
specialize in the fields of pediatrics, allergy, asthma, and
immunology.
(5) The advisory committee shall elect a presiding
officer.
(6) Members of the advisory committee serve without
compensation but are entitled to reimbursement for the members'
travel expenses as provided by Chapter 660, Government Code, and
the General Appropriations Act.
(7) An advisory committee member serves at the
pleasure of the commissioner of state health services.
(8) A vacancy on the advisory committee shall be
filled by the commissioner of state health services in the same
manner as other appointments to the advisory committee.
(9) Chapter 2110, Government Code, does not apply to
the advisory committee formed under this subsection.
(10) Meetings of the advisory committee are subject to
Chapter 551, Government Code.
(d) In consultation with the commissioner, and after
consideration of advice from the advisory committee described in
Subsection (c), the commissioner of state health services shall
adopt rules for school districts and open-enrollment charter
schools to use in the development of the policy described in
Subsection (b). The rules must establish:
(1) the quantity of epinephrine auto-injectors to be
stored at each campus or maintained while in transit to or from an
off-campus school-sanctioned event and a requirement that stock
inventory be checked at regular intervals for expiration and
replacement;
(2) the level of training required for school
employees in the administration of an epinephrine auto-injector to
an individual who is reasonably believed to be experiencing
anaphylaxis; and
(3) a requirement at each campus for having present,
during all operating hours, one or more trained school employees
described in Subsection (f).
(e) Training described in Subsection (d)(2) must:
(1) include information regarding how to:
(A) recognize the signs and symptoms of
anaphylaxis;
(B) administer an epinephrine auto-injector;
(C) implement emergency procedures, if
necessary, after administering an epinephrine auto-injector; and
(D) properly dispose of used or expired
epinephrine auto-injectors;
(2) be obtained in formal training sessions or through
online education; and
(3) be completed annually.
(f) Each school district and open-enrollment charter school
shall be responsible for ensuring that school employees identified
by the district or the open-enrollment charter school on each
campus, or at an off-campus school-sanctioned event, are trained as
described in Subsection (e) to administer an epinephrine
auto-injector to an individual on the campus or at an off-campus
school-sanctioned event who is reasonably believed to be
experiencing anaphylaxis. Each school district and open-enrollment
charter school shall maintain records on the training of such
employees.
(g) Each school district and open-enrollment charter school
shall maintain at each campus in the district or of the
open-enrollment charter school a supply of epinephrine
auto-injectors that may be administered by a school employee who is
trained as described in Subsection (e) to an individual on a campus
in the district or of the open-enrollment charter school, or at an
off-campus school-sanctioned event, who is reasonably believed to
be experiencing anaphylaxis. The school district or
open-enrollment charter school, as appropriate, shall be
responsible for checking stock inventory of such epinephrine
auto-injectors at regular intervals for expiration and
replacement. In determining the number of epinephrine
auto-injectors to be kept for such purpose on a campus, the school
district or the open-enrollment charter school shall follow the
rules described in Subsection (d).
(h) The supply of epinephrine auto-injectors at each campus
shall be stored in a secure location or maintained securely while in
transit to or from an off-campus school-sanctioned event, and must
be easily accessible to trained school employees.
(i)(1) A physician may prescribe epinephrine auto-injectors
in the name of a school district or open-enrollment charter school
to be maintained for use when necessary. The prescribing physician
shall provide the school district or open-enrollment charter
school, as appropriate, a standing order for the administration of
school-supplied epinephrine auto-injectors to undesignated
individuals who are reasonably believed to be experiencing
anaphylaxis. The order shall not be required to be
patient-specific, and the administration may occur without a prior
established physician-patient relationship. Notwithstanding the
provisions of other law regarding delegation or supervision,
supervision or delegation by a physician shall be adequate if the
physician periodically reviews the order and is available through
direct telecommunication as needed for consultation, assistance,
and direction.
(2) An order issued under this subsection must
contain:
(A) the name and signature of the physician
described in Subdivision (1);
(B) the name of the school district or
open-enrollment charter school to which the order is issued;
(C) the quantity of epinephrine auto-injectors
to be obtained and maintained under the order; and
(D) the date of issue.
(j) A pharmacist may dispense an epinephrine auto-injector
under this section without the name of, or other identifying
information relating to, the ultimate user.
(k) School employees who have received the training
described in Subsection (e) may:
(1) obtain one or more epinephrine auto-injectors from
the locations described in Subsection (h), or maintained while in
transit to or from a school-sanctioned event as described in
Subsection (h), in accordance with the provisions of this section;
and
(2) administer such epinephrine auto-injectors in
accordance with the provisions of this section.
(l)(1) Not later than 10 business days after the
administration of an epinephrine auto-injector by a school employee
under the terms of this section, the school shall report to the
school district, or in the case of an open-enrollment charter
school, the charter school shall document, in a form and manner
prescribed by the commissioner, the following information:
(A) age and type of individual receiving
administration of the epinephrine auto-injector;
(B) physical location on or off campus where the
epinephrine auto-injector was administered;
(C) number of doses administered;
(D) title of person administering the
epinephrine auto-injector; and
(E) any other information required by the
commissioner.
(2) Not later than 10 business days after the
administration of an epinephrine auto-injector by a school employee
under the terms of this section, the school district or the
open-enrollment charter school shall report the information
described in Subdivision (1) to:
(A) the physician described in Subsection (i);
(B) the commissioner; and
(C) the commissioner of state health services.
(m) A school district or an open-enrollment charter school
may each accept gifts, donations, grants, and federal and local
funds for the support of that school district or open-enrollment
charter school in carrying out the provisions of this section.
(n)(1) Except as provided by Subsection (d) or by
Subdivision (2), the commissioner and the commissioner of state
health services shall jointly adopt rules to implement this
section.
(2) Rules to implement Subsection (c) shall be adopted
solely by the commissioner of state health services.
(o) Epinephrine auto-injectors may be administered as
provided under this section on campus and at off-campus
school-sanctioned events. The immunity provisions of this section
shall apply in such cases.
(p) A person who in good faith takes, or fails to take, any
of the following actions under this section is immune from
liability in any criminal or disciplinary action and for civil
damages as a result of that act or failure to act:
(1) issuing an order for epinephrine auto-injectors;
(2) supervising or delegating as described in
Subsection (i)(1);
(3) possessing an epinephrine auto-injector;
(4) prescribing an epinephrine auto-injector;
(5) dispensing an epinephrine auto-injector;
(6) administering, or assisting in the administering
of, an epinephrine auto-injector;
(7) providing training, consultation, or advice in the
development, adoption, or implementation of policies, guidelines,
rules, or plans;
(8) assisting in providing training, consultation, or
advice in the development, adoption, or implementation of policies,
guidelines, rules, or plans; or
(9) undertaking any other required or authorized act.
(q) The immunities and protections granted in this section
are in addition to, and not in lieu of, immunity or protection
provided pursuant to any other provisions of law.
(r) If a school district or open-enrollment charter school
lacks the funding, or other forms of support as described in
Subsection (m), that is necessary to meet the requirements of this
section, the school district or open-enrollment charter school
shall not be required to comply with the requirements of this
section.
(s) If a school district or open-enrollment charter school
is unable to meet the requirements of this section due to a
manufacturer's recall or any other unanticipated loss or reduction
in supply of epinephrine auto-injectors that adversely affects the
ability of a school district or open-enrollment charter school to
obtain epinephrine auto-injectors in quantities that are
sufficient to meet the requirements of this section, the school
district or open-enrollment charter school shall not be required to
comply with such requirements.
(t) Notwithstanding the provisions of Subsections (r) and
(s), the immunities and protections granted in this section shall
continue in full force and effect.
(u) Notwithstanding any other law, this section does not
create a civil, criminal, or administrative cause of action or a
standard of care, obligation, or duty that provides a basis for a
cause of action.
(v) Notwithstanding the provisions of Subsections (r) and
(s), the provisions of Subsection (u) shall continue in full force
and effect.
(w) A cause of action does not arise from an act or omission
described by Subsection (p).
SECTION 2. This Act takes effect September 1, 2015.