Texas 2023 - 88th Regular

Texas House Bill HB920 Compare Versions

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1	1	88R2945 AMF-F
2	2	By: Klick H.B. No. 920
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the use of medication designated for treatment of
8	8	respiratory distress on public and private school campuses.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. The heading to Subchapter E, Chapter 38,
11	11	Education Code, is amended to read as follows:
12	12	SUBCHAPTER E. MAINTENANCE AND ADMINISTRATION OF EPINEPHRINE
13	13	AUTO-INJECTORS AND MEDICATION FOR RESPIRATORY DISTRESS [ASTHMA
14	14	MEDICINE]
15	15	SECTION 2. Section 38.201, Education Code, is amended by
16	16	adding Subdivision (3-a) to read as follows:
17	17	(3-a) "Medication for respiratory distress" means
18	18	albuterol, levalbuterol, or another medication designated by the
19	19	executive commissioner of the Health and Human Services Commission
20	20	for treatment of respiratory distress under Section 38.208(c).
21	21	SECTION 3. Section 38.202(a), Education Code, is amended to
22	22	read as follows:
23	23	(a) The commissioner of state health services shall
24	24	establish an advisory committee to examine and review the
25	25	administration, on a campus of a school district, an
26	26	open-enrollment charter school, a private school, or an institution
27	27	of higher education, of:
28	28	(1) epinephrine auto-injectors to a person
29	29	experiencing an anaphylactic reaction; and
30	30	(2) medication for respiratory distress to a person
31	31	experiencing respiratory distress [on a campus of a school
32	32	district, an open-enrollment charter school, a private school, or
33	33	an institution of higher education].
34	34	SECTION 4. Section 38.207, Education Code, is amended to
35	35	read as follows:
36	36	Sec. 38.207. ADVISORY COMMITTEE: DUTIES. The advisory
37	37	committee shall advise the commissioner of state health services
38	38	on:
39	39	(1) the storage and maintenance of epinephrine
40	40	auto-injectors and medication for respiratory distress on school
41	41	campuses and campuses of institutions of higher education;
42	42	(2) the training of school personnel and school
43	43	volunteers, and of personnel and volunteers at institutions of
44	44	higher education, in the administration of an epinephrine
45	45	auto-injector;
46	46	(2-a) the training of school personnel and school
47	47	volunteers, and of personnel and volunteers at institutions of
48	48	higher education, in the administration of a medication for
49	49	respiratory distress; and
50	50	(3) a plan for:
51	51	(A) one or more school personnel members or
52	52	school volunteers trained in the administration of an epinephrine
53	53	auto-injector to be on each school campus; [and]
54	54	(B) one or more school personnel members or
55	55	school volunteers trained in the administration of medication for
56	56	respiratory distress to be on each school campus;
57	57	(C) one or more personnel members or volunteers
58	58	of an institution of higher education trained in the administration
59	59	of an epinephrine auto-injector to be on each campus of an
60	60	institution of higher education; and
61	61	(D) one or more personnel members or volunteers
62	62	of an institution of higher education trained in the administration
63	63	of medication for respiratory distress to be on each campus of an
64	64	institution of higher education.
65	65	SECTION 5. The heading to Section 38.208, Education Code,
66	66	is amended to read as follows:
67	67	Sec. 38.208. MAINTENANCE AND ADMINISTRATION OF EPINEPHRINE
68	68	AUTO-INJECTORS AND MEDICATION FOR RESPIRATORY DISTRESS [ASTHMA
69	69	MEDICINE].
70	70	SECTION 6. Section 38.208, Education Code, is amended by
71	71	amending Subsections (a-1), (b-1), (c), (e), and (f) and adding
72	72	Subsections (b-2), (b-3), (d-1), and (e-1) to read as follows:
73	73	(a-1) Each school district, open-enrollment charter school,
74	74	and private school may adopt and implement a policy regarding the
75	75	maintenance, administration, and disposal of medication for
76	76	respiratory distress [authorizing a school nurse to maintain and
77	77	administer asthma medicine] at each campus in the district or
78	78	school.
79	79	(b-1) If a policy is adopted under Subsection (a-1), the
80	80	policy must provide that school personnel and school volunteers who
81	81	are authorized and trained [the school nurse] may administer
82	82	medication for respiratory distress [prescription asthma medicine]
83	83	to a person reasonably believed to be experiencing respiratory
84	84	distress on [student only if the school nurse has written
85	85	notification from a parent or guardian of the student that the
86	86	student has been diagnosed as having asthma and stating that the
87	87	school nurse may administer prescription asthma medicine to the
88	88	student. A school nurse may administer the prescription asthma
89	89	medicine only at] a school campus, or at a school-sponsored or
90	90	school-related activity on or off school property.
91	91	(b-2) If medication for respiratory distress is
92	92	administered to a student whose parent or guardian has not provided
93	93	notification to the school that the student has been diagnosed with
94	94	asthma, the school must refer the student to the student's primary
95	95	care provider on the day the medication for respiratory distress is
96	96	administered and inform the student's parent or guardian regarding
97	97	the referral. The referral must include:
98	98	(1) the symptoms of respiratory distress observed;
99	99	(2) the name of the medication for respiratory
100	100	distress administered to the student; and
101	101	(3) any patient care instructions given to the
102	102	student.
103	103	(b-3) If a student who has received medication for
104	104	respiratory distress does not have a primary care provider or the
105	105	parent or guardian of the student has not engaged a primary care
106	106	provider for the student, the student's parent or guardian must
107	107	receive information to assist the parent or guardian in selecting a
108	108	primary care provider for the student.
109	109	(c) The executive commissioner of the Health and Human
110	110	Services Commission, in consultation with the commissioner of
111	111	education, and with advice from the advisory committee as
112	112	appropriate, shall adopt rules regarding the maintenance,
113	113	administration, and disposal of an epinephrine auto-injector at a
114	114	school campus subject to a policy adopted under Subsection (a) and
115	115	the maintenance, [and] administration, and disposal of medication
116	116	for respiratory distress [asthma medicine] at a school campus
117	117	subject to a policy adopted under Subsection (a-1). The rules must
118	118	establish:
119	119	(1) the number of epinephrine auto-injectors
120	120	available at each campus;
121	121	(2) the amount of medication for respiratory distress
122	122	[prescription asthma medicine] available at each campus;
123	123	(3) the process for each school district,
124	124	open-enrollment charter school, and private school to check the
125	125	inventory of epinephrine auto-injectors and medication for
126	126	respiratory distress [asthma medicine] at regular intervals for
127	127	expiration and replacement; [and]
128	128	(4) the amount of training required for school
129	129	personnel and school volunteers to administer:
130	130	(A) an epinephrine auto-injector; or
131	131	(B) medication for respiratory distress; and
132	132	(5) the types of medication that may be administered
133	133	under Subsection (b-1) to persons experiencing respiratory
134	134	distress, based on a review of the best available medical evidence.
135	135	(d-1) Each school district, open-enrollment charter school,
136	136	and private school that adopts a policy under Subsection (a-1) must
137	137	require that each campus have one or more school personnel or school
138	138	volunteers authorized and trained to administer medication for
139	139	respiratory distress present during regular school hours.
140	140	(e) The supply of epinephrine auto-injectors at each campus
141	141	must be stored in a secure location and be easily accessible to
142	142	school personnel and school volunteers authorized and trained to
143	143	administer an epinephrine auto-injector. [The supply of asthma
144	144	medicine at each campus must be stored in a secure location and be
145	145	easily accessible to the school nurse.]
146	146	(e-1) The supply of medication for respiratory distress at
147	147	each campus must be stored in a secure location and be easily
148	148	accessible to authorized school personnel and school volunteers.
149	149	(f) The policy described by Subsection (a-1) may not require
150	150	a school district, open-enrollment charter school, or private
151	151	school to purchase medication for respiratory distress
152	152	[prescription asthma medicine] or require any other expenditure
153	153	related to the maintenance or administration of medication for
154	154	respiratory distress [asthma medicine] that would result in a
155	155	negative fiscal impact on the district or school.
156	156	SECTION 7. Subchapter E, Chapter 38, Education Code, is
157	157	amended by adding Section 38.2091 to read as follows:
158	158	Sec. 38.2091. REPORT ON ADMINISTERING MEDICATION FOR
159	159	RESPIRATORY DISTRESS. (a) Not later than the 10th business day
160	160	after the date a school personnel member or school volunteer
161	161	administers medication for respiratory distress to a person
162	162	experiencing respiratory distress in accordance with a policy
163	163	adopted under Section 38.208(a-1), the school shall report the
164	164	information required under Subsection (b) to:
165	165	(1) the school district, the charter holder if the
166	166	school is an open-enrollment charter school, or the governing body
167	167	of the school if the school is a private school;
168	168	(2) the physician or other person who prescribed the
169	169	medication for respiratory distress; and
170	170	(3) the commissioner of state health services.
171	171	(b) The report required under this section must include:
172	172	(1) the age of the person who received the
173	173	administration of the medication for respiratory distress;
174	174	(2) whether the person who received the administration
175	175	of the medication for respiratory distress was a student, a school
176	176	personnel member or school volunteer, or a visitor;
177	177	(3) the dosage of the medication for respiratory
178	178	distress administered;
179	179	(4) the title of the person who administered the
180	180	medication for respiratory distress; and
181	181	(5) any other information required by the commissioner
182	182	of education.
183	183	SECTION 8. Section 38.210, Education Code, is amended by
184	184	amending Subsections (a) and (b) and adding Subsection (a-1) to
185	185	read as follows:
186	186	(a) Each school district, open-enrollment charter school,
187	187	and private school that adopts a policy under Section 38.208(a) is
188	188	responsible for training school personnel and school volunteers in
189	189	the administration of an epinephrine auto-injector. The training
190	190	must include information on:
191	191	(1) recognizing the signs and symptoms of anaphylaxis;
192	192	(2) administering an epinephrine auto-injector;
193	193	(3) implementing emergency procedures, if necessary,
194	194	after administering an epinephrine auto-injector; and
195	195	(4) properly disposing of used or expired epinephrine
196	196	auto-injectors.
197	197	(a-1) Each school district, open-enrollment charter school,
198	198	and private school that adopts a policy under Section 38.208(a-1)
199	199	is responsible for training school personnel and school volunteers
200	200	in the administration of medication for respiratory distress. The
201	201	training must include information on:
202	202	(1) recognizing the signs and symptoms of respiratory
203	203	distress;
204	204	(2) administering medication for respiratory
205	205	distress;
206	206	(3) implementing emergency procedures, if necessary,
207	207	after administering medication for respiratory distress; and
208	208	(4) proper sanitization, reuse, and disposal of
209	209	medication for respiratory distress.
210	210	(b) Training required under this section must be provided:
211	211	(1) [include information on:
212	212	[(A) recognizing the signs and symptoms of
213	213	anaphylaxis;
214	214	[(B) administering an epinephrine auto-injector;
215	215	[(C) implementing emergency procedures, if
216	216	necessary, after administering an epinephrine auto-injector; and
217	217	[(D) properly disposing of used or expired
218	218	epinephrine auto-injectors;
219	219	[(2) be provided] in a formal training session or
220	220	through online education; and
221	221	(2) [(3) be provided] in accordance with the policy
222	222	adopted under Section 21.4515.
223	223	SECTION 9. The heading to Section 38.211, Education Code,
224	224	is amended to read as follows:
225	225	Sec. 38.211. PRESCRIPTION OF EPINEPHRINE AUTO-INJECTORS
226	226	AND MEDICATION FOR RESPIRATORY DISTRESS [ASTHMA MEDICINE].
227	227	SECTION 10. Sections 38.211(a), (b), (c), (e), and (f),
228	228	Education Code, are amended to read as follows:
229	229	(a) A physician or person who has been delegated
230	230	prescriptive authority under Chapter 157, Occupations Code, may
231	231	prescribe epinephrine auto-injectors or medication for respiratory
232	232	distress [asthma medicine] in the name of a school district,
233	233	open-enrollment charter school, or private school.
234	234	(b) A physician or other person who prescribes epinephrine
235	235	auto-injectors or medication for respiratory distress [asthma
236	236	medicine] under Subsection (a) shall provide the school district,
237	237	open-enrollment charter school, or private school with a standing
238	238	order for the administration of, as applicable:
239	239	(1) an epinephrine auto-injector to a person
240	240	reasonably believed to be experiencing anaphylaxis; or
241	241	(2) medication for respiratory distress [asthma
242	242	medicine] to a person reasonably believed to be experiencing
243	243	respiratory distress [a symptom of asthma and who has provided
244	244	written notification and permission as required by Section
245	245	38.208(b-1)].
246	246	(c) The standing order under Subsection (b) is not required
247	247	to be patient-specific, and the epinephrine auto-injector or
248	248	medication for respiratory distress [asthma medicine] may be
249	249	administered to a person without a previously established
250	250	physician-patient relationship.
251	251	(e) An order issued under this section must contain:
252	252	(1) the name and signature of the prescribing
253	253	physician or other person;
254	254	(2) the name of the school district, open-enrollment
255	255	charter school, or private school to which the order is issued;
256	256	(3) as applicable, the quantity of epinephrine
257	257	auto-injectors or the quantity and types of medications for
258	258	respiratory distress [asthma medicine] to be obtained and
259	259	maintained under the order; and
260	260	(4) the date of issue.
261	261	(f) A pharmacist may dispense an epinephrine auto-injector
262	262	or medication for respiratory distress [asthma medicine] to a
263	263	school district, open-enrollment charter school, or private school
264	264	without requiring the name or any other identifying information
265	265	relating to the user.
266	266	SECTION 11. Section 38.215(a), Education Code, is amended
267	267	to read as follows:
268	268	(a) A person who in good faith takes, or fails to take, any
269	269	action under this subchapter is immune from civil or criminal
270	270	liability or disciplinary action resulting from that action or
271	271	failure to act, including:
272	272	(1) issuing an order for epinephrine auto-injectors or
273	273	medication for respiratory distress [asthma medicine];
274	274	(2) supervising or delegating the administration of an
275	275	epinephrine auto-injector or medication for respiratory distress
276	276	[asthma medicine];
277	277	(3) possessing, maintaining, storing, or disposing of
278	278	an epinephrine auto-injector or medication for respiratory
279	279	distress [asthma medicine];
280	280	(4) prescribing an epinephrine auto-injector or
281	281	medication for respiratory distress [asthma medicine];
282	282	(5) dispensing:
283	283	(A) an epinephrine auto-injector; or
284	284	(B) medication for respiratory distress [asthma
285	285	medicine, provided that permission has been granted as provided by
286	286	Section 38.208(b-1)];
287	287	(6) administering, or assisting in administering, an
288	288	epinephrine auto-injector or medication for respiratory distress
289	289	[asthma medicine, provided that permission has been granted as
290	290	provided by Section 38.208(b-1)];
291	291	(7) providing, or assisting in providing, training,
292	292	consultation, or advice in the development, adoption, or
293	293	implementation of policies, guidelines, rules, or plans; or
294	294	(8) undertaking any other act permitted or required
295	295	under this subchapter.
296	296	SECTION 12. This Act takes effect immediately if it
297	297	receives a vote of two-thirds of all the members elected to each
298	298	house, as provided by Section 39, Article III, Texas Constitution.
299	299	If this Act does not receive the vote necessary for immediate
300	300	effect, this Act takes effect September 1, 2023.