Texas 2023 - 88th Regular

Texas Senate Bill SB294 Compare Versions

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1	1	S.B. No. 294
2	2
3	3
4	4	AN ACT
5	5	relating to the use of epinephrine auto-injectors and medication
6	6	designated for treatment of respiratory distress on public and
7	7	private school campuses.
8	8	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	9	SECTION 1. The heading to Subchapter E, Chapter 38,
10	10	Education Code, is amended to read as follows:
11	11	SUBCHAPTER E. MAINTENANCE AND ADMINISTRATION OF EPINEPHRINE
12	12	AUTO-INJECTORS AND MEDICATION FOR RESPIRATORY DISTRESS [ASTHMA
13	13	MEDICINE]
14	14	SECTION 2. Section 38.201, Education Code, is amended by
15	15	adding Subdivision (3-a) to read as follows:
16	16	(3-a) "Medication for respiratory distress" means
17	17	albuterol, levalbuterol, or another medication designated by the
18	18	executive commissioner of the Health and Human Services Commission
19	19	for treatment of respiratory distress under Section 38.208(c).
20	20	SECTION 3. Section 38.202(a), Education Code, is amended to
21	21	read as follows:
22	22	(a) The commissioner of state health services shall
23	23	establish an advisory committee to examine and review the
24	24	administration, on a campus of a school district, an
25	25	open-enrollment charter school, a private school, or an institution
26	26	of higher education, of:
27	27	(1) epinephrine auto-injectors to a person
28	28	experiencing an anaphylactic reaction; and
29	29	(2) medication for respiratory distress to a person
30	30	experiencing respiratory distress [on a campus of a school
31	31	district, an open-enrollment charter school, a private school, or
32	32	an institution of higher education].
33	33	SECTION 4. Section 38.207, Education Code, is amended to
34	34	read as follows:
35	35	Sec. 38.207. ADVISORY COMMITTEE: DUTIES. The advisory
36	36	committee shall advise the commissioner of state health services
37	37	on:
38	38	(1) the storage and maintenance of epinephrine
39	39	auto-injectors and medication for respiratory distress on school
40	40	campuses and campuses of institutions of higher education;
41	41	(2) the training of school personnel and school
42	42	volunteers, and of personnel and volunteers at institutions of
43	43	higher education, in the administration of an epinephrine
44	44	auto-injector;
45	45	(3) the training of school personnel and school
46	46	volunteers, and of personnel and volunteers at institutions of
47	47	higher education, in the administration of a medication for
48	48	respiratory distress; and
49	49	(4) [(3)] a plan for:
50	50	(A) one or more school personnel members or
51	51	school volunteers trained in the administration of an epinephrine
52	52	auto-injector to be on each school campus; [and]
53	53	(B) one or more school personnel members or
54	54	school volunteers trained in the administration of medication for
55	55	respiratory distress to be on each school campus;
56	56	(C) one or more personnel members or volunteers
57	57	of an institution of higher education trained in the administration
58	58	of an epinephrine auto-injector to be on each campus of an
59	59	institution of higher education; and
60	60	(D) one or more personnel members or volunteers
61	61	of an institution of higher education trained in the administration
62	62	of medication for respiratory distress to be on each campus of an
63	63	institution of higher education.
64	64	SECTION 5. The heading to Section 38.208, Education Code,
65	65	is amended to read as follows:
66	66	Sec. 38.208. MAINTENANCE AND ADMINISTRATION OF EPINEPHRINE
67	67	AUTO-INJECTORS AND MEDICATION FOR RESPIRATORY DISTRESS [ASTHMA
68	68	MEDICINE].
69	69	SECTION 6. Section 38.208, Education Code, is amended by
70	70	amending Subsections (a-1), (b-1), (c), (e), and (f) and adding
71	71	Subsections (b-2), (b-3), (d-1), (d-2), and (e-1) to read as
72	72	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	(d-2) A school personnel member or school volunteer may not
141	141	be subject to any penalty or disciplinary action for refusing to
142	142	administer or receive training to administer epinephrine
143	143	auto-injectors or medication for respiratory distress, as
144	144	applicable, in accordance with a policy adopted under Subsection
145	145	(a) or (a-1).
146	146	(e) The supply of epinephrine auto-injectors at each campus
147	147	must be stored in a secure location and be easily accessible to
148	148	school personnel and school volunteers authorized and trained to
149	149	administer an epinephrine auto-injector. [The supply of asthma
150	150	medicine at each campus must be stored in a secure location and be
151	151	easily accessible to the school nurse.]
152	152	(e-1) The supply of medication for respiratory distress at
153	153	each campus must be stored in a secure location and be easily
154	154	accessible to authorized school personnel and school volunteers.
155	155	(f) The policy described by Subsection (a-1) may not require
156	156	a school district, open-enrollment charter school, or private
157	157	school to purchase medication for respiratory distress
158	158	[prescription asthma medicine] or require any other expenditure
159	159	related to the maintenance or administration of medication for
160	160	respiratory distress [asthma medicine] that would result in a
161	161	negative fiscal impact on the district or school.
162	162	SECTION 7. Subchapter E, Chapter 38, Education Code, is
163	163	amended by adding Section 38.2091 to read as follows:
164	164	Sec. 38.2091. REPORT ON ADMINISTERING MEDICATION FOR
165	165	RESPIRATORY DISTRESS. (a) Not later than the 10th business day
166	166	after the date a school personnel member or school volunteer
167	167	administers medication for respiratory distress to a person
168	168	experiencing respiratory distress in accordance with a policy
169	169	adopted under Section 38.208(a-1), the school shall report the
170	170	information required under Subsection (b) to:
171	171	(1) the school district, the charter holder if the
172	172	school is an open-enrollment charter school, or the governing body
173	173	of the school if the school is a private school;
174	174	(2) the physician or other person who prescribed the
175	175	medication for respiratory distress; and
176	176	(3) the commissioner of state health services.
177	177	(b) The report required under this section must include:
178	178	(1) the age of the person who received the
179	179	administration of the medication for respiratory distress;
180	180	(2) whether the person who received the administration
181	181	of the medication for respiratory distress was a student, a school
182	182	personnel member or school volunteer, or a visitor;
183	183	(3) the dosage of the medication for respiratory
184	184	distress administered;
185	185	(4) the title of the person who administered the
186	186	medication for respiratory distress; and
187	187	(5) any other information required by the commissioner
188	188	of education.
189	189	SECTION 8. Section 38.210, Education Code, is amended by
190	190	amending Subsections (a) and (b) and adding Subsection (a-1) to
191	191	read as follows:
192	192	(a) Each school district, open-enrollment charter school,
193	193	and private school that adopts a policy under Section 38.208(a) is
194	194	responsible for training school personnel and school volunteers in
195	195	the administration of an epinephrine auto-injector. The training
196	196	must include information on:
197	197	(1) recognizing the signs and symptoms of anaphylaxis;
198	198	(2) administering an epinephrine auto-injector;
199	199	(3) implementing emergency procedures, if necessary,
200	200	after administering an epinephrine auto-injector; and
201	201	(4) properly disposing of used or expired epinephrine
202	202	auto-injectors.
203	203	(a-1) Each school district, open-enrollment charter school,
204	204	and private school that adopts a policy under Section 38.208(a-1)
205	205	is responsible for training school personnel and school volunteers
206	206	in the administration of medication for respiratory distress. The
207	207	training must include information on:
208	208	(1) recognizing the signs and symptoms of respiratory
209	209	distress;
210	210	(2) administering medication for respiratory
211	211	distress;
212	212	(3) implementing emergency procedures, if necessary,
213	213	after administering medication for respiratory distress; and
214	214	(4) proper sanitization, reuse, and disposal of
215	215	medication for respiratory distress.
216	216	(b) Training required under this section must be provided:
217	217	(1) [include information on:
218	218	[(A) recognizing the signs and symptoms of
219	219	anaphylaxis;
220	220	[(B) administering an epinephrine auto-injector;
221	221	[(C) implementing emergency procedures, if
222	222	necessary, after administering an epinephrine auto-injector; and
223	223	[(D) properly disposing of used or expired
224	224	epinephrine auto-injectors;
225	225	[(2) be provided] in a formal training session or
226	226	through online education; and
227	227	(2) [(3) be provided] in accordance with the policy
228	228	adopted under Section 21.4515.
229	229	SECTION 9. The heading to Section 38.211, Education Code,
230	230	is amended to read as follows:
231	231	Sec. 38.211. PRESCRIPTION OF EPINEPHRINE AUTO-INJECTORS
232	232	AND MEDICATION FOR RESPIRATORY DISTRESS [ASTHMA MEDICINE].
233	233	SECTION 10. Sections 38.211(a), (b), (c), (e), and (f),
234	234	Education Code, are amended to read as follows:
235	235	(a) A physician or person who has been delegated
236	236	prescriptive authority under Chapter 157, Occupations Code, may
237	237	prescribe epinephrine auto-injectors or medication for respiratory
238	238	distress [asthma medicine] in the name of a school district,
239	239	open-enrollment charter school, or private school.
240	240	(b) A physician or other person who prescribes epinephrine
241	241	auto-injectors or medication for respiratory distress [asthma
242	242	medicine] under Subsection (a) shall provide the school district,
243	243	open-enrollment charter school, or private school with a standing
244	244	order for the administration of, as applicable:
245	245	(1) an epinephrine auto-injector to a person
246	246	reasonably believed to be experiencing anaphylaxis; or
247	247	(2) medication for respiratory distress [asthma
248	248	medicine] to a person reasonably believed to be experiencing
249	249	respiratory distress [a symptom of asthma and who has provided
250	250	written notification and permission as required by Section
251	251	38.208(b-1)].
252	252	(c) The standing order under Subsection (b) is not required
253	253	to be patient-specific, and the epinephrine auto-injector or
254	254	medication for respiratory distress [asthma medicine] may be
255	255	administered to a person without a previously established
256	256	physician-patient relationship.
257	257	(e) An order issued under this section must contain:
258	258	(1) the name and signature of the prescribing
259	259	physician or other person;
260	260	(2) the name of the school district, open-enrollment
261	261	charter school, or private school to which the order is issued;
262	262	(3) as applicable, the quantity of epinephrine
263	263	auto-injectors or the quantity and types of medications for
264	264	respiratory distress [asthma medicine] to be obtained and
265	265	maintained under the order; and
266	266	(4) the date of issue.
267	267	(f) A pharmacist may dispense an epinephrine auto-injector
268	268	or medication for respiratory distress [asthma medicine] to a
269	269	school district, open-enrollment charter school, or private school
270	270	without requiring the name or any other identifying information
271	271	relating to the user.
272	272	SECTION 11. Section 38.212, Education Code, is amended to
273	273	read as follows:
274	274	Sec. 38.212. NOTICE TO PARENTS. (a) If a school district,
275	275	open-enrollment charter school, or private school implements a
276	276	policy under this subchapter, the district or school shall provide
277	277	written notice of the policy to a parent or guardian of each student
278	278	enrolled in the district or school.
279	279	(b) Notice required under Subsection (a) [this section]
280	280	must be provided before a policy is implemented by the district or
281	281	school under this subchapter and before the start of each school
282	282	year.
283	283	SECTION 12. Section 38.215(a), Education Code, is amended
284	284	to read as follows:
285	285	(a) A person who in good faith takes, or fails to take, any
286	286	action under this subchapter is immune from civil or criminal
287	287	liability or disciplinary action resulting from that action or
288	288	failure to act, including:
289	289	(1) issuing an order for epinephrine auto-injectors or
290	290	medication for respiratory distress [asthma medicine];
291	291	(2) supervising or delegating the administration of an
292	292	epinephrine auto-injector or medication for respiratory distress
293	293	[asthma medicine];
294	294	(3) possessing, maintaining, storing, or disposing of
295	295	an epinephrine auto-injector or medication for respiratory
296	296	distress [asthma medicine];
297	297	(4) prescribing an epinephrine auto-injector or
298	298	medication for respiratory distress [asthma medicine];
299	299	(5) dispensing:
300	300	(A) an epinephrine auto-injector; or
301	301	(B) medication for respiratory distress [asthma
302	302	medicine, provided that permission has been granted as provided by
303	303	Section 38.208(b-1)];
304	304	(6) administering, or assisting in administering, an
305	305	epinephrine auto-injector or medication for respiratory distress
306	306	[asthma medicine, provided that permission has been granted as
307	307	provided by Section 38.208(b-1)];
308	308	(7) providing, or assisting in providing, training,
309	309	consultation, or advice in the development, adoption, or
310	310	implementation of policies, guidelines, rules, or plans; or
311	311	(8) undertaking any other act permitted or required
312	312	under this subchapter.
313	313	SECTION 13. This Act takes effect immediately if it
314	314	receives a vote of two-thirds of all the members elected to each
315	315	house, as provided by Section 39, Article III, Texas Constitution.
316	316	If this Act does not receive the vote necessary for immediate
317	317	effect, this Act takes effect September 1, 2023.
318	318	______________________________ ______________________________
319	319	President of the Senate Speaker of the House
320	320	I hereby certify that S.B. No. 294 passed the Senate on
321	321	April 11, 2023, by the following vote: Yeas 31, Nays 0; and that
322	322	the Senate concurred in House amendment on May 11, 2023, by the
323	323	following vote: Yeas 30, Nays 0.
324	324	______________________________
325	325	Secretary of the Senate
326	326	I hereby certify that S.B. No. 294 passed the House, with
327	327	amendment, on May 6, 2023, by the following vote: Yeas 135,
328	328	Nays 0, two present not voting.
329	329	______________________________
330	330	Chief Clerk of the House
331	331	Approved:
332	332	______________________________
333	333	Date
334	334	______________________________
335	335	Governor