86R9126 CAE-F By: Oliverson H.B. No. 2243 A BILL TO BE ENTITLED AN ACT relating to the use of prescription asthma medicine on public and private school campuses. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTION 1. The heading to Subchapter E, Chapter 38, Education Code, is amended to read as follows: SUBCHAPTER E. MAINTENANCE AND[,] ADMINISTRATION[, AND DISPOSAL] OF EPINEPHRINE AUTO-INJECTORS AND ASTHMA MEDICINE SECTION 2. The heading to Section 38.208, Education Code, is amended to read as follows: Sec. 38.208. MAINTENANCE AND ADMINISTRATION OF EPINEPHRINE AUTO-INJECTORS AND ASTHMA MEDICINE. SECTION 3. Section 38.208, Education Code, is amended by adding Subsections (a-1), (b-1), and (f) and amending Subsections (c) and (e) to read as follows: (a-1) Each school district, open-enrollment charter school, and private school may adopt and implement a policy authorizing a school nurse to maintain and administer asthma medicine at each campus in the district or school. (b-1) If a policy is adopted under Subsection (a-1), the policy must provide that the school nurse may administer prescription asthma medicine to a student only if the school nurse has written notification from a parent or guardian of the student that the student has been diagnosed as having asthma and stating that the school nurse may administer prescription asthma medicine to the student. A school nurse may administer the prescription asthma medicine only at a school campus. (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 auto-injector at a school campus subject to a policy adopted under Subsection (a) and the maintenance and administration of asthma medicine at a school campus subject to a policy adopted under Subsection (a-1). The rules must establish: (1) the number of epinephrine auto-injectors available at each campus; (2) the amount of prescription asthma medicine available at each campus; (3) the process for each school district, open-enrollment charter school, and private school to check the inventory of epinephrine auto-injectors and asthma medicine at regular intervals for expiration and replacement; and (4) [(3)] the amount of training required for school personnel and school volunteers to administer an epinephrine auto-injector. (e) The supply of epinephrine 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 auto-injector. The supply of asthma medicine at each campus must be stored in a secure location and be easily accessible to the school nurse. (f) The policy described by Subsection (a-1) may not require a school district, open-enrollment charter school, or private school to purchase prescription asthma medicine or require any other expenditure related to the maintenance or administration of asthma medicine that would result in a negative fiscal impact on the district or school. SECTION 4. The heading to Section 38.211, Education Code, is amended to read as follows: Sec. 38.211. PRESCRIPTION OF EPINEPHRINE AUTO-INJECTORS AND ASTHMA MEDICINE. SECTION 5. Sections 38.211(a), (b), (c), (e), and (f), Education Code, are amended to read as follows: (a) A physician or person who has been delegated prescriptive authority under Chapter 157, Occupations Code, may prescribe epinephrine auto-injectors or asthma medicine in the name of a school district, open-enrollment charter school, or private school. (b) A physician or other person who prescribes epinephrine auto-injectors or asthma medicine 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 auto-injector to a person reasonably believed to be experiencing anaphylaxis; or (2) asthma medicine to a person reasonably believed to be experiencing a symptom of asthma and who has provided written notification and permission as required by Section 38.208(b-1). (c) The standing order under Subsection (b) is not required to be patient-specific, and the epinephrine auto-injector or asthma medicine 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) the quantity of epinephrine auto-injectors or asthma medicine to be obtained and maintained under the order; and (4) the date of issue. (f) A pharmacist may dispense an epinephrine auto-injector or asthma medicine 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 6. Section 38.212, Education Code, is amended to read as follows: Sec. 38.212. NOTICE TO PARENTS. If a school district, open-enrollment charter school, or private school implements a policy under this subchapter [for the maintenance, administration, and disposal of epinephrine auto-injectors], the district or school shall provide written notice to a parent or guardian of each student enrolled in the district or school. Notice required under this section must be provided before a [the] policy is implemented by the district or school and before the start of each school year. SECTION 7. 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 auto-injectors or asthma medicine; (2) supervising or delegating the administration of an epinephrine auto-injector or asthma medicine; (3) possessing, maintaining, storing, or disposing of an epinephrine auto-injector or asthma medicine; (4) prescribing an epinephrine auto-injector or asthma medicine; (5) dispensing: (A) an epinephrine auto-injector; or (B) asthma medicine, provided that permission has been granted as provided by Section 38.208(b-1); (6) administering, or assisting in administering, an epinephrine auto-injector or 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 8. 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, 2019.