Texas 2025 - 89th Regular

Texas House Bill HB2283 Compare Versions

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1	1	89R5992 RAL-F
2	2	By: Cortez H.B. No. 2283
3	3
4	4
5	5
6	6
7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to the use of an epinephrine delivery device by certain
10	10	entities.
11	11	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	12	SECTION 1. Section 38.0151(f), Education Code, is amended
13	13	to read as follows:
14	14	(f) A school district or open-enrollment charter school
15	15	that provides for the maintenance, administration, and disposal of
16	16	epinephrine delivery devices [auto-injectors] under Subchapter E
17	17	is not required to comply with this section.
18	18	SECTION 2. The heading to Subchapter E, Chapter 38,
19	19	Education Code, is amended to read as follows:
20	20	SUBCHAPTER E. MAINTENANCE AND ADMINISTRATION OF EPINEPHRINE
21	21	DELIVERY DEVICES [AUTO-INJECTORS] AND MEDICATION FOR RESPIRATORY
22	22	DISTRESS
23	23	SECTION 3. Section 38.201, Education Code, is amended by
24	24	amending Subdivision (3-a) and adding Subdivision (3-b) to read as
25	25	follows:
26	26	(3-a) "Epinephrine delivery device" means a medical
27	27	delivery device approved by the United States Food and Drug
28	28	Administration that delivers a dose of epinephrine intended for use
29	29	to treat anaphylaxis, including:
30	30	(A) an epinephrine auto-injector; and
31	31	(B) an epinephrine nasal spray.
32	32	(3-b) "Medication for respiratory distress" means
33	33	albuterol, levalbuterol, or another medication designated by the
34	34	executive commissioner of the Health and Human Services Commission
35	35	for treatment of respiratory distress under Section 38.208(c).
36	36	SECTION 4. Section 38.202(a), Education Code, is amended to
37	37	read as follows:
38	38	(a) The commissioner of state health services shall
39	39	establish an advisory committee to examine and review the
40	40	administration, on a campus of a school district, an
41	41	open-enrollment charter school, a private school, or an institution
42	42	of higher education, of:
43	43	(1) epinephrine delivery devices [auto-injectors] to
44	44	a person experiencing an anaphylactic reaction; and
45	45	(2) medication for respiratory distress to a person
46	46	experiencing respiratory distress.
47	47	SECTION 5. Section 38.207, Education Code, is amended to
48	48	read as follows:
49	49	Sec. 38.207. ADVISORY COMMITTEE: DUTIES. The advisory
50	50	committee shall advise the commissioner of state health services
51	51	on:
52	52	(1) the storage and maintenance of epinephrine
53	53	delivery devices [auto-injectors] and medication for respiratory
54	54	distress on school campuses and campuses of institutions of higher
55	55	education;
56	56	(2) the training of school personnel and school
57	57	volunteers, and of personnel and volunteers at institutions of
58	58	higher education, in the administration of an epinephrine delivery
59	59	device [auto-injector];
60	60	(3) the training of school personnel and school
61	61	volunteers, and of personnel and volunteers at institutions of
62	62	higher education, in the administration of a medication for
63	63	respiratory distress; and
64	64	(4) a plan for:
65	65	(A) one or more school personnel members or
66	66	school volunteers trained in the administration of an epinephrine
67	67	delivery device [auto-injector] to be on each school campus;
68	68	(B) one or more school personnel members or
69	69	school volunteers trained in the administration of medication for
70	70	respiratory distress to be on each school campus;
71	71	(C) one or more personnel members or volunteers
72	72	of an institution of higher education trained in the administration
73	73	of an epinephrine delivery device [auto-injector] to be on each
74	74	campus of an institution of higher education; and
75	75	(D) one or more personnel members or volunteers
76	76	of an institution of higher education trained in the administration
77	77	of medication for respiratory distress to be on each campus of an
78	78	institution of higher education.
79	79	SECTION 6. The heading to Section 38.208, Education Code,
80	80	is amended to read as follows:
81	81	Sec. 38.208. MAINTENANCE AND ADMINISTRATION OF EPINEPHRINE
82	82	DELIVERY DEVICES [AUTO-INJECTORS] AND MEDICATION FOR RESPIRATORY
83	83	DISTRESS.
84	84	SECTION 7. Sections 38.208(a), (b), (c), (d), (d-2), and
85	85	(e), Education Code, are amended to read as follows:
86	86	(a) Each school district, open-enrollment charter school,
87	87	and private school may adopt and implement a policy regarding the
88	88	maintenance, administration, and disposal of epinephrine delivery
89	89	devices [auto-injectors] at each campus in the district or school.
90	90	(b) If a policy is adopted under Subsection (a), the policy:
91	91	(1) must provide that school personnel and school
92	92	volunteers who are authorized and trained may administer an
93	93	epinephrine delivery device [auto-injector] to a person who is
94	94	reasonably believed to be experiencing anaphylaxis on a school
95	95	campus; and
96	96	(2) may provide that school personnel and school
97	97	volunteers who are authorized and trained may administer an
98	98	epinephrine delivery device [auto-injector] to a person who is
99	99	reasonably believed to be experiencing anaphylaxis at an off-campus
100	100	school event or while in transit to or from a school event.
101	101	(c) The executive commissioner of the Health and Human
102	102	Services Commission, in consultation with the commissioner of
103	103	education, and with advice from the advisory committee as
104	104	appropriate, shall adopt rules regarding the maintenance,
105	105	administration, and disposal of an epinephrine delivery device
106	106	[auto-injector] at a school campus subject to a policy adopted
107	107	under Subsection (a) and the maintenance, administration, and
108	108	disposal of medication for respiratory distress at a school campus
109	109	subject to a policy adopted under Subsection (a-1). The rules must
110	110	establish:
111	111	(1) the number of epinephrine delivery devices
112	112	[auto-injectors] available at each campus;
113	113	(2) the amount of medication for respiratory distress
114	114	available at each campus;
115	115	(3) the process for each school district,
116	116	open-enrollment charter school, and private school to check the
117	117	inventory of epinephrine delivery devices [auto-injectors] and
118	118	medication for respiratory distress at regular intervals for
119	119	expiration and replacement;
120	120	(4) the amount of training required for school
121	121	personnel and school volunteers to administer:
122	122	(A) an epinephrine delivery device
123	123	[auto-injector]; or
124	124	(B) medication for respiratory distress; and
125	125	(5) the types of medication that may be administered
126	126	under Subsection (b-1) to persons experiencing respiratory
127	127	distress, based on a review of the best available medical evidence.
128	128	(d) Each school district, open-enrollment charter school,
129	129	and private school that adopts a policy under Subsection (a) must
130	130	require that each campus have one or more school personnel members
131	131	or school volunteers authorized and trained to administer an
132	132	epinephrine delivery device [auto-injector] present during all
133	133	hours the campus is open.
134	134	(d-2) A school personnel member or school volunteer may not
135	135	be subject to any penalty or disciplinary action for refusing to
136	136	administer or receive training to administer epinephrine delivery
137	137	devices [auto-injectors] or medication for respiratory distress,
138	138	as applicable, in accordance with a policy adopted under Subsection
139	139	(a) or (a-1).
140	140	(e) The supply of epinephrine delivery devices
141	141	[auto-injectors] at each campus must be stored in a secure location
142	142	and be easily accessible to school personnel and school volunteers
143	143	authorized and trained to administer an epinephrine delivery device
144	144	[auto-injector].
145	145	SECTION 8. Section 38.209, Education Code, is amended to
146	146	read as follows:
147	147	Sec. 38.209. REPORT ON ADMINISTERING EPINEPHRINE DELIVERY
148	148	DEVICE [AUTO-INJECTOR]. (a) Not later than the 10th business day
149	149	after the date a school personnel member or school volunteer
150	150	administers an epinephrine delivery device [auto-injector] in
151	151	accordance with a policy adopted under Section 38.208(a), the
152	152	school shall report the information required under Subsection (b)
153	153	to:
154	154	(1) the school district, the charter holder if the
155	155	school is an open-enrollment charter school, or the governing body
156	156	of the school if the school is a private school;
157	157	(2) the physician or other person who prescribed the
158	158	epinephrine delivery device [auto-injector]; and
159	159	(3) the commissioner of state health services.
160	160	(b) The report required under this section must include the
161	161	following information:
162	162	(1) the age of the person who received the
163	163	administration of the epinephrine delivery device [auto-injector];
164	164	(2) whether the person who received the administration
165	165	of the epinephrine delivery device [auto-injector] was a student, a
166	166	school personnel member or school volunteer, or a visitor;
167	167	(3) the physical location where the epinephrine
168	168	delivery device [auto-injector] was administered;
169	169	(4) the number of doses of epinephrine delivery device
170	170	[auto-injector] administered;
171	171	(5) the title of the person who administered the
172	172	epinephrine delivery device [auto-injector]; and
173	173	(6) any other information required by the commissioner
174	174	of education.
175	175	SECTION 9. Section 38.210(a), Education Code, is amended to
176	176	read as follows:
177	177	(a) Each school district, open-enrollment charter school,
178	178	and private school that adopts a policy under Section 38.208(a) is
179	179	responsible for training school personnel and school volunteers in
180	180	the administration of an epinephrine delivery device
181	181	[auto-injector]. The training must include information on:
182	182	(1) recognizing the signs and symptoms of anaphylaxis;
183	183	(2) administering an epinephrine delivery device
184	184	[auto-injector];
185	185	(3) implementing emergency procedures, if necessary,
186	186	after administering an epinephrine delivery device
187	187	[auto-injector]; and
188	188	(4) properly disposing of used or expired epinephrine
189	189	delivery devices [auto-injectors].
190	190	SECTION 10. The heading to Section 38.211, Education Code,
191	191	is amended to read as follows:
192	192	Sec. 38.211. PRESCRIPTION OF EPINEPHRINE DELIVERY DEVICES
193	193	[AUTO-INJECTORS] AND MEDICATION FOR RESPIRATORY DISTRESS.
194	194	SECTION 11. Sections 38.211(a), (b), (c), (e), and (f),
195	195	Education Code, are amended to read as follows:
196	196	(a) A physician or person who has been delegated
197	197	prescriptive authority under Chapter 157, Occupations Code, may
198	198	prescribe epinephrine delivery devices [auto-injectors] or
199	199	medication for respiratory distress in the name of a school
200	200	district, open-enrollment charter school, or private school.
201	201	(b) A physician or other person who prescribes epinephrine
202	202	delivery devices [auto-injectors] or medication for respiratory
203	203	distress under Subsection (a) shall provide the school district,
204	204	open-enrollment charter school, or private school with a standing
205	205	order for the administration of, as applicable:
206	206	(1) an epinephrine delivery device [auto-injector] to
207	207	a person reasonably believed to be experiencing anaphylaxis; or
208	208	(2) medication for respiratory distress to a person
209	209	reasonably believed to be experiencing respiratory distress.
210	210	(c) The standing order under Subsection (b) is not required
211	211	to be patient-specific, and the epinephrine delivery device
212	212	[auto-injector] or medication for respiratory distress may be
213	213	administered to a person without a previously established
214	214	physician-patient relationship.
215	215	(e) An order issued under this section must contain:
216	216	(1) the name and signature of the prescribing
217	217	physician or other person;
218	218	(2) the name of the school district, open-enrollment
219	219	charter school, or private school to which the order is issued;
220	220	(3) as applicable, the quantity and types of
221	221	epinephrine delivery devices [auto-injectors] or the quantity and
222	222	types of medications for respiratory distress to be obtained and
223	223	maintained under the order; and
224	224	(4) the date of issue.
225	225	(f) A pharmacist may dispense an epinephrine delivery
226	226	device [auto-injector] or medication for respiratory distress to a
227	227	school district, open-enrollment charter school, or private school
228	228	without requiring the name or any other identifying information
229	229	relating to the user.
230	230	SECTION 12. Section 38.215(a), Education Code, is amended
231	231	to read as follows:
232	232	(a) A person who in good faith takes, or fails to take, any
233	233	action under this subchapter is immune from civil or criminal
234	234	liability or disciplinary action resulting from that action or
235	235	failure to act, including:
236	236	(1) issuing an order for epinephrine delivery devices
237	237	[auto-injectors] or medication for respiratory distress;
238	238	(2) supervising or delegating the administration of an
239	239	epinephrine delivery device [auto-injector] or medication for
240	240	respiratory distress;
241	241	(3) possessing, maintaining, storing, or disposing of
242	242	an epinephrine delivery device [auto-injector] or medication for
243	243	respiratory distress;
244	244	(4) prescribing an epinephrine delivery device
245	245	[auto-injector] or medication for respiratory distress;
246	246	(5) dispensing:
247	247	(A) an epinephrine delivery device
248	248	[auto-injector]; or
249	249	(B) medication for respiratory distress;
250	250	(6) administering, or assisting in administering, an
251	251	epinephrine delivery device [auto-injector] or medication for
252	252	respiratory distress;
253	253	(7) providing, or assisting in providing, training,
254	254	consultation, or advice in the development, adoption, or
255	255	implementation of policies, guidelines, rules, or plans; or
256	256	(8) undertaking any other act permitted or required
257	257	under this subchapter.
258	258	SECTION 13. The heading to Subchapter Y-1, Chapter 51,
259	259	Education Code, is amended to read as follows:
260	260	SUBCHAPTER Y-1. MAINTENANCE, STORAGE, ADMINISTRATION, AND
261	261	DISPOSAL OF EPINEPHRINE DELIVERY DEVICES [AUTO-INJECTORS]
262	262	SECTION 14. Section 51.881, Education Code, is amended by
263	263	adding Subdivision (4-a) to read as follows:
264	264	(4-a) "Epinephrine delivery device" means a medical
265	265	delivery device approved by the United States Food and Drug
266	266	Administration that delivers a dose of epinephrine intended for use
267	267	to treat anaphylaxis, including:
268	268	(A) an epinephrine auto-injector; and
269	269	(B) an epinephrine nasal spray.
270	270	SECTION 15. The heading to Section 51.882, Education Code,
271	271	is amended to read as follows:
272	272	Sec. 51.882. MAINTENANCE, STORAGE, ADMINISTRATION, AND
273	273	DISPOSAL OF EPINEPHRINE DELIVERY DEVICES [AUTO-INJECTORS].
274	274	SECTION 16. Sections 51.882(a), (b), (c), (d), and (e),
275	275	Education Code, are amended to read as follows:
276	276	(a) Each institution of higher education may adopt and
277	277	implement a policy regarding the maintenance, storage,
278	278	administration, and disposal of epinephrine delivery devices
279	279	[auto-injectors] on the institution's campus.
280	280	(b) If a policy is adopted under Subsection (a), the policy:
281	281	(1) must provide that personnel or volunteers who are
282	282	authorized and trained may administer an epinephrine delivery
283	283	device [auto-injector] to a person who is reasonably believed to be
284	284	experiencing anaphylaxis on the institution's campus; and
285	285	(2) may provide that personnel or volunteers who are
286	286	authorized and trained may administer an epinephrine delivery
287	287	device [auto-injector] to a person who is reasonably believed to be
288	288	experiencing anaphylaxis at an off-campus event or while in transit
289	289	to or from an off-campus event sponsored by the institution of
290	290	higher education.
291	291	(c) The executive commissioner of the Health and Human
292	292	Services Commission [state health services] with advice from the
293	293	advisory committee shall adopt rules regarding the maintenance,
294	294	storage, administration, and disposal of an epinephrine delivery
295	295	device [auto-injector] on the campus of an institution of higher
296	296	education subject to a policy adopted under Subsection (a). The
297	297	rules must establish:
298	298	(1) the number of epinephrine delivery devices
299	299	[auto-injectors] available at each campus;
300	300	(2) the process for each institution of higher
301	301	education to check the inventory of epinephrine delivery devices
302	302	[auto-injectors] at regular intervals for expiration and
303	303	replacement; and
304	304	(3) the amount of training required for personnel or
305	305	volunteers to administer an epinephrine delivery device
306	306	[auto-injector].
307	307	(d) Each institution of higher education that adopts a
308	308	policy under Subsection (a):
309	309	(1) must require that the institution's campuses have
310	310	personnel or volunteers authorized and trained to administer an
311	311	epinephrine delivery device [auto-injector] present; and
312	312	(2) shall include the policy in the institution's
313	313	student handbook or similar publication and publish the policy on
314	314	the institution's Internet website.
315	315	(e) The supply of epinephrine delivery devices
316	316	[auto-injectors] at a campus must be stored in a secure location and
317	317	be easily accessible to personnel or volunteers authorized and
318	318	trained to administer an epinephrine delivery device
319	319	[auto-injector].
320	320	SECTION 17. Section 51.883, Education Code, is amended to
321	321	read as follows:
322	322	Sec. 51.883. REPORT ON ADMINISTERING EPINEPHRINE DELIVERY
323	323	DEVICE [AUTO-INJECTOR]. (a) Not later than the 10th business day
324	324	after the date a personnel member or volunteer administers an
325	325	epinephrine delivery device [auto-injector] in accordance with a
326	326	policy adopted under Section 51.882(a), the institution of higher
327	327	education shall report the information required under Subsection
328	328	(b) to:
329	329	(1) the physician who prescribed the epinephrine
330	330	delivery device [auto-injector]; and
331	331	(2) the commissioner of state health services.
332	332	(b) The report required under this section must include the
333	333	following information:
334	334	(1) the age of the person who received the
335	335	administration of the epinephrine delivery device [auto-injector];
336	336	(2) whether the person who received the administration
337	337	of the epinephrine delivery device [auto-injector] was a student, a
338	338	personnel member, or a visitor;
339	339	(3) the physical location where the epinephrine
340	340	delivery device [auto-injector] was administered;
341	341	(4) the number of doses of epinephrine delivery device
342	342	[auto-injector] administered;
343	343	(5) the title of the person who administered the
344	344	epinephrine delivery device [auto-injector]; and
345	345	(6) any other information required by the commissioner
346	346	of state health services.
347	347	SECTION 18. Sections 51.884(a) and (b), Education Code, are
348	348	amended to read as follows:
349	349	(a) Each institution of higher education that adopts a
350	350	policy under Section 51.882(a) is responsible for training
351	351	personnel or volunteers in the administration of an epinephrine
352	352	delivery device [auto-injector].
353	353	(b) Training required under this section must:
354	354	(1) include information on:
355	355	(A) recognizing the signs and symptoms of
356	356	anaphylaxis;
357	357	(B) administering an epinephrine delivery device
358	358	[auto-injector];
359	359	(C) implementing emergency procedures, if
360	360	necessary, after administering an epinephrine delivery device
361	361	[auto-injector]; and
362	362	(D) properly disposing of used or expired
363	363	epinephrine delivery devices [auto-injectors]; and
364	364	(2) be provided in a formal training session or
365	365	through online education and be completed annually.
366	366	SECTION 19. The heading to Section 51.885, Education Code,
367	367	is amended to read as follows:
368	368	Sec. 51.885. PRESCRIPTION OF EPINEPHRINE DELIVERY DEVICES
369	369	[AUTO-INJECTORS].
370	370	SECTION 20. Sections 51.885(a), (b), (d), and (e),
371	371	Education Code, are amended to read as follows:
372	372	(a) A physician may prescribe epinephrine delivery devices
373	373	[auto-injectors] in the name of an institution of higher education
374	374	that adopts a policy under Section 51.882(a). The physician shall
375	375	provide the institution with a standing order for the
376	376	administration of an epinephrine delivery device [auto-injector]
377	377	to a person reasonably believed to be experiencing anaphylaxis.
378	378	(b) The standing order under Subsection (a) is not required
379	379	to be patient-specific, and the epinephrine delivery device
380	380	[auto-injector] may be administered to a person without an
381	381	established physician-patient relationship.
382	382	(d) An order issued under this section must contain:
383	383	(1) the name and signature of the prescribing
384	384	physician;
385	385	(2) the name of the institution of higher education to
386	386	which the order is issued;
387	387	(3) the quantity of epinephrine delivery devices
388	388	[auto-injectors] to be obtained and maintained under the order; and
389	389	(4) the date of issue.
390	390	(e) A pharmacist may dispense an epinephrine delivery
391	391	device [auto-injector] to an institution of higher education
392	392	without requiring the name or any other identifying information
393	393	relating to the user.
394	394	SECTION 21. Section 51.888(a), Education Code, is amended
395	395	to read as follows:
396	396	(a) A person who in good faith takes, or fails to take, any
397	397	action under this subchapter is immune from civil or criminal
398	398	liability or disciplinary action resulting from that act or failure
399	399	to act, including:
400	400	(1) issuing an order for epinephrine delivery devices
401	401	[auto-injectors];
402	402	(2) supervising or delegating the administration of an
403	403	epinephrine delivery device [auto-injector];
404	404	(3) possessing an epinephrine delivery device
405	405	[auto-injector];
406	406	(4) maintaining an epinephrine delivery device
407	407	[auto-injector];
408	408	(5) storing an epinephrine delivery device
409	409	[auto-injector];
410	410	(6) disposing of an epinephrine delivery device
411	411	[auto-injector];
412	412	(7) prescribing an epinephrine delivery device
413	413	[auto-injector];
414	414	(8) dispensing an epinephrine delivery device
415	415	[auto-injector];
416	416	(9) administering, or assisting in administering, an
417	417	epinephrine delivery device [auto-injector];
418	418	(10) providing, or assisting in providing, training,
419	419	consultation, or advice in the development, adoption, or
420	420	implementation of policies, guidelines, rules, or plans; or
421	421	(11) undertaking any other act permitted or required
422	422	under this subchapter.
423	423	SECTION 22. Section 773.003, Health and Safety Code, is
424	424	amended by amending Subdivision (15-a) and adding Subdivisions
425	425	(15-b) and (15-c) to read as follows:
426	426	(15-a) "Epinephrine auto-injector" means a disposable
427	427	medical drug delivery device that contains a premeasured single
428	428	dose of epinephrine intended for use to treat anaphylaxis.
429	429	(15-b) "Epinephrine delivery device" means a medical
430	430	delivery device approved by the United States Food and Drug
431	431	Administration that delivers a dose of epinephrine intended for use
432	432	to treat anaphylaxis, including:
433	433	(A) an epinephrine auto-injector; and
434	434	(B) an epinephrine nasal spray.
435	435	(15-c) "Executive commissioner" means the executive
436	436	commissioner of the Health and Human Services Commission.
437	437	SECTION 23. Sections 773.014(a), (b), (c), (c-1), (d), (e),
438	438	(f), and (g), Health and Safety Code, are amended to read as
439	439	follows:
440	440	(a) An emergency medical services provider and a first
441	441	responder organization may acquire and possess epinephrine
442	442	delivery [auto-injector] devices in accordance with this section.
443	443	Emergency medical services personnel may carry and administer
444	444	epinephrine delivery [auto-injector] devices in accordance with
445	445	this section.
446	446	(b) The executive commissioner shall adopt rules designed
447	447	to protect the public health and safety to implement this section.
448	448	The rules must provide that emergency medical services personnel
449	449	may administer an epinephrine delivery [auto-injector] device to
450	450	another only if the person has successfully completed a training
451	451	course, approved by the department, in the use of the device that is
452	452	consistent with the national standard training curriculum for
453	453	emergency medical technicians.
454	454	(c) An emergency medical services provider or first
455	455	responder organization may acquire, possess, maintain, and dispose
456	456	of epinephrine delivery [auto-injector] devices, and emergency
457	457	medical services personnel may carry, maintain, administer, and
458	458	dispose of epinephrine delivery [auto-injector] devices, only in
459	459	accordance with:
460	460	(1) rules adopted under this section; and
461	461	(2) a delegated practice agreement that provides for
462	462	medical supervision by a licensed physician who either:
463	463	(A) acts as a medical director for an emergency
464	464	medical services system or a licensed hospital; or
465	465	(B) has knowledge and experience in the delivery
466	466	of emergency care.
467	467	(c-1) A licensed physician acting as a medical director for
468	468	an emergency medical services system may restrict the use and
469	469	administration of epinephrine delivery [auto-injector] devices to
470	470	certain emergency medical services personnel of the system through:
471	471	(1) the delegated practice agreement; or
472	472	(2) the adoption of policies governing the use of the
473	473	epinephrine delivery devices by personnel within the system.
474	474	(d) Emergency medical services personnel who administer
475	475	epinephrine delivery [auto-injector] devices to others shall
476	476	immediately report the use to the physician supervising the
477	477	activities of the emergency medical services personnel.
478	478	(e) The administration of an epinephrine delivery
479	479	[auto-injector] device to another under this section is considered
480	480	to be the administration of emergency care for the purposes of any
481	481	statute relating to liability for the provision of emergency care.
482	482	The administration of an epinephrine delivery [auto-injector]
483	483	device to another in accordance with the requirements of this
484	484	section does not constitute the unlawful practice of any health
485	485	care profession.
486	486	(f) A person otherwise authorized to sell or provide an
487	487	epinephrine delivery [auto-injector] device to another may sell or
488	488	provide the epinephrine delivery devices to an emergency medical
489	489	services provider or a first responder organization authorized to
490	490	acquire and possess the epinephrine delivery devices under this
491	491	section.
492	492	(g) This section does not prevent emergency medical
493	493	services personnel who are also licensed health care professionals
494	494	under another health care licensing law and who are authorized to
495	495	acquire, possess, and administer an epinephrine delivery
496	496	[auto-injector] device under the other health care licensing law
497	497	from acting under the other law.
498	498	SECTION 24. Sections 773.0145(a), (c), (d), (e), (f), (g),
499	499	(h), (i), (k), (l), (m), (o), (p), (q), and (r), Health and Safety
500	500	Code, are amended to read as follows:
501	501	(a) This section applies to:
502	502	(1) an amusement park, as defined by Section 46.03,
503	503	Penal Code;
504	504	(2) a child-care facility, as defined by Section
505	505	42.002, Human Resources Code;
506	506	(3) a day camp or youth camp, as defined by Section
507	507	141.002;
508	508	(4) a private or independent institution of higher
509	509	education, as defined by Section 61.003, Education Code;
510	510	(5) a restaurant, as defined by Section 17.821,
511	511	Business & Commerce Code;
512	512	(6) a sports venue, as defined by Section 504.151,
513	513	Local Government Code;
514	514	(7) a youth center, as defined by Section 481.134; or
515	515	(8) subject to Subsection (b), any other entity that
516	516	the executive commissioner by rule designates as an entity that
517	517	would benefit from the possession and administration of epinephrine
518	518	delivery devices [auto-injectors].
519	519	(c) An entity described by Subsection (a) may adopt a policy
520	520	regarding the maintenance, administration, and disposal of
521	521	epinephrine delivery devices [auto-injectors].
522	522	(d) A policy adopted under Subsection (c) must provide that
523	523	only an entity employee or volunteer who is authorized and trained
524	524	may administer an epinephrine delivery device [auto-injector] to a
525	525	person who is reasonably believed to be experiencing anaphylaxis on
526	526	the premises of the entity.
527	527	(e) The executive commissioner shall adopt rules regarding
528	528	the maintenance, administration, and disposal of an epinephrine
529	529	delivery device [auto-injector] by an entity subject to a policy
530	530	adopted under Subsection (c). The rules must establish:
531	531	(1) the number of epinephrine delivery devices
532	532	[auto-injectors] and the dosages of the epinephrine delivery
533	533	devices [auto-injectors] available at each entity;
534	534	(2) the process for each entity to verify the
535	535	inventory of epinephrine delivery devices [auto-injectors] at
536	536	regular intervals for expiration and replacement; and
537	537	(3) the amount of training required for an entity
538	538	employee or volunteer to administer an epinephrine delivery device
539	539	[auto-injector].
540	540	(f) Each entity that adopts a policy under Subsection (c)
541	541	must have at least one entity employee or volunteer authorized and
542	542	trained to administer an epinephrine delivery device
543	543	[auto-injector] present during all hours the entity is open to the
544	544	public or to the population that the entity serves, as applicable.
545	545	(g) The supply of epinephrine delivery devices
546	546	[auto-injectors] at each entity must:
547	547	(1) be stored in accordance with the manufacturer's
548	548	instructions in a secure location; and
549	549	(2) be easily accessible to an entity employee or
550	550	volunteer authorized and trained to administer an epinephrine
551	551	delivery device [auto-injector].
552	552	(h) Each entity that adopts a policy under Subsection (c) is
553	553	responsible for training the entity's employees and volunteers in
554	554	the administration of an epinephrine delivery device
555	555	[auto-injector].
556	556	(i) Employee and volunteer training under this section
557	557	must:
558	558	(1) include information on:
559	559	(A) the signs and symptoms of anaphylaxis;
560	560	(B) the recommended dosages for an adult and a
561	561	child;
562	562	(C) the administration of an epinephrine
563	563	delivery device [auto-injector];
564	564	(D) the implementation of emergency procedures,
565	565	if necessary, after administering an epinephrine delivery device
566	566	[auto-injector]; and
567	567	(E) the proper disposal of used or expired
568	568	epinephrine delivery devices [auto-injectors]; and
569	569	(2) be completed annually in a formal training session
570	570	or through online education.
571	571	(k) A physician or person who has been delegated
572	572	prescriptive authority under Chapter 157, Occupations Code, may
573	573	prescribe epinephrine delivery devices [auto-injectors] in the
574	574	name of an entity.
575	575	(l) A physician or other person who prescribes epinephrine
576	576	delivery devices [auto-injectors] under Subsection (k) shall
577	577	provide the entity with a standing order for the administration of
578	578	an epinephrine delivery device [auto-injector] to a person
579	579	reasonably believed to be experiencing anaphylaxis.
580	580	(m) The standing order under Subsection (l) is not required
581	581	to be patient-specific, and the epinephrine delivery device
582	582	[auto-injector] may be administered to a person without a
583	583	previously established physician-patient relationship.
584	584	(o) For purposes of Subsection (n)(2), a person who has been
585	585	delegated prescriptive authority under Chapter 157, Occupations
586	586	Code, is not engaged in the unauthorized practice of telemedicine
587	587	or acting outside the person's scope of practice by consulting a
588	588	physician as provided by that subdivision when prescribing an
589	589	epinephrine delivery device [auto-injector] in accordance with
590	590	this section.
591	591	(p) An order issued under this section must contain:
592	592	(1) the name and signature of the prescriber;
593	593	(2) the name of the entity to which the order is
594	594	issued;
595	595	(3) the quantity of epinephrine delivery devices
596	596	[auto-injectors] to be obtained and maintained under the order; and
597	597	(4) the date of issue.
598	598	(q) A pharmacist may dispense an epinephrine delivery
599	599	device [auto-injector] to an entity without requiring the name or
600	600	any other identifying information relating to the user.
601	601	(r) A person who in good faith takes, or fails to take, any
602	602	action under this section is immune from civil or criminal
603	603	liability or disciplinary action resulting from that action or
604	604	failure to act, including:
605	605	(1) issuing an order for epinephrine delivery devices
606	606	[auto-injectors];
607	607	(2) supervising or delegating the administration of an
608	608	epinephrine delivery device [auto-injector];
609	609	(3) possessing, maintaining, storing, or disposing of
610	610	an epinephrine delivery device [auto-injector];
611	611	(4) prescribing an epinephrine delivery device
612	612	[auto-injector];
613	613	(5) dispensing an epinephrine delivery device
614	614	[auto-injector];
615	615	(6) administering, or assisting in administering, an
616	616	epinephrine delivery device [auto-injector];
617	617	(7) providing, or assisting in providing, training,
618	618	consultation, or advice in the development, adoption, or
619	619	implementation of policies, guidelines, rules, or plans; or
620	620	(8) undertaking any other act permitted or required
621	621	under this section.
622	622	SECTION 25. Section 773.050(g), Health and Safety Code, is
623	623	amended to read as follows:
624	624	(g) Rules adopting minimum standards under this section
625	625	shall require:
626	626	(1) an emergency medical services vehicle to be
627	627	equipped with an epinephrine delivery [auto-injector] device [or
628	628	similar device] to treat anaphylaxis; and
629	629	(2) emergency medical services personnel to complete
630	630	continuing education training in the administration of anaphylaxis
631	631	treatment.
632	632	SECTION 26. The heading to Section 42.067, Human Resources
633	633	Code, is amended to read as follows:
634	634	Sec. 42.067. EPINEPHRINE DELIVERY DEVICES
635	635	[AUTO-INJECTORS]; IMMUNITY FROM LIABILITY.
636	636	SECTION 27. Section 42.067(a), Human Resources Code, is
637	637	amended by adding Subdivision (2-a) to read as follows:
638	638	(2-a) "Epinephrine delivery device" means a medical
639	639	delivery device approved by the United States Food and Drug
640	640	Administration that delivers a dose of epinephrine intended for use
641	641	to treat anaphylaxis, including:
642	642	(A) an epinephrine auto-injector; and
643	643	(B) an epinephrine nasal spray.
644	644	SECTION 28. Sections 42.067(b), (c), (d), (f), (g), (h),
645	645	(i), (k), (l), (n), and (q), Human Resources Code, are amended to
646	646	read as follows:
647	647	(b) A physician, or a person who has been delegated
648	648	prescriptive authority under Chapter 157, Occupations Code, may
649	649	prescribe epinephrine delivery devices [auto-injectors] in the
650	650	name of a day-care center.
651	651	(c) A physician or other person who prescribes epinephrine
652	652	delivery devices [auto-injectors] under Subsection (b) shall
653	653	provide the day-care center with a standing order for the
654	654	administration of an epinephrine delivery device [auto-injector]
655	655	to a person reasonably believed to be experiencing anaphylaxis.
656	656	(d) A standing order under Subsection (c) is not required to
657	657	be patient-specific. An epinephrine delivery device
658	658	[auto-injector] may be administered under this section to a person
659	659	without a previously established physician-patient relationship.
660	660	(f) An order issued under this section must contain:
661	661	(1) the name and signature of the prescribing
662	662	physician or other person;
663	663	(2) the name of the day-care center to which the order
664	664	is issued;
665	665	(3) the quantity of epinephrine delivery devices
666	666	[auto-injectors] to be obtained and maintained under the order; and
667	667	(4) the date the order was issued.
668	668	(g) A pharmacist may dispense an epinephrine delivery
669	669	device [auto-injector] to a day-care center without requiring the
670	670	name of or any other identifying information relating to the user.
671	671	(h) A day-care center shall store an epinephrine delivery
672	672	device [auto-injector] in a secure location that is easily
673	673	accessible to employees or volunteers of the day-care center
674	674	authorized and trained to administer an epinephrine delivery device
675	675	[auto-injector].
676	676	(i) Each day-care center is responsible for training
677	677	employees in the administration of an epinephrine delivery device
678	678	[auto-injector]. The training must:
679	679	(1) include information on:
680	680	(A) recognizing the signs and symptoms of
681	681	anaphylaxis;
682	682	(B) administering an epinephrine delivery device
683	683	[auto-injector];
684	684	(C) the recommended dosages for adults and
685	685	children by age and weight, if applicable, and the dosages
686	686	available at the center;
687	687	(D) implementing emergency procedures, if
688	688	necessary, after administering an epinephrine delivery device
689	689	[auto-injector]; and
690	690	(E) the proper disposal of used or expired
691	691	epinephrine delivery devices [auto-injectors]; and
692	692	(2) be completed annually in a formal training session
693	693	or through online education.
694	694	(k) Not later than the 10th business day after the date a
695	695	day-care center employee administers an epinephrine delivery
696	696	device [auto-injector] in accordance with this section, the
697	697	day-care center shall report the following information to the
698	698	persons listed in Subsection (l):
699	699	(1) the age of the person who received the
700	700	administration of the epinephrine delivery device [auto-injector];
701	701	(2) whether the person who received the administration
702	702	of the epinephrine delivery device [auto-injector] was:
703	703	(A) a child enrolled in the day-care center;
704	704	(B) a day-care center employee or volunteer; or
705	705	(C) a visitor to the day-care center;
706	706	(3) the physical location where the epinephrine
707	707	delivery device [auto-injector] was administered;
708	708	(4) the number of doses of epinephrine delivery device
709	709	[auto-injector] administered;
710	710	(5) the title of the employee who administered the
711	711	epinephrine delivery device [auto-injector]; and
712	712	(6) any other information required by the executive
713	713	commissioner.
714	714	(l) The information required by Subsection (k) shall be
715	715	reported to:
716	716	(1) the owner of the day-care center;
717	717	(2) the physician or other person who prescribed the
718	718	epinephrine delivery device [auto-injector];
719	719	(3) the commission; and
720	720	(4) the Department of State Health Services.
721	721	(n) A person who in good faith takes, or fails to take,
722	722	action relating to the prescription of an epinephrine delivery
723	723	device [auto-injector] to a day-care center or the administration
724	724	of an epinephrine delivery device [auto-injector] in a day-care
725	725	center is immune from civil or criminal liability or disciplinary
726	726	action resulting from that action or failure to act, including:
727	727	(1) issuing an order for epinephrine delivery devices
728	728	[auto-injectors];
729	729	(2) supervising or delegating the administration of an
730	730	epinephrine delivery device [auto-injector];
731	731	(3) possessing, maintaining, storing, or disposing of
732	732	an epinephrine delivery device [auto-injector];
733	733	(4) prescribing an epinephrine delivery device
734	734	[auto-injector];
735	735	(5) dispensing an epinephrine delivery device
736	736	[auto-injector];
737	737	(6) administering, or assisting in administering, an
738	738	epinephrine delivery device [auto-injector];
739	739	(7) providing, or assisting in providing, training,
740	740	consultation, or advice in the development, adoption, or
741	741	implementation of policies, guidelines, rules, or plans; or
742	742	(8) undertaking any other act permitted or required
743	743	under this section.
744	744	(q) If a day-care center obtains epinephrine delivery
745	745	devices [auto-injectors] for use as authorized by this section, the
746	746	day-care center shall notify each parent of a child enrolled in the
747	747	center of the center's policy and procedures relating to the
748	748	administration of the epinephrine delivery devices
749	749	[auto-injectors].
750	750	SECTION 29. Section 562.057, Occupations Code, is amended
751	751	to read as follows:
752	752	Sec. 562.057. ADMINISTRATION OF EPINEPHRINE. (a) A
753	753	pharmacist may administer epinephrine through an epinephrine
754	754	delivery [auto-injector] device in accordance with this section.
755	755	(b) The board shall adopt rules designed to protect the
756	756	public health and safety to implement this section. The rules must
757	757	provide that a pharmacist may administer epinephrine through an
758	758	epinephrine delivery [auto-injector] device to a patient in an
759	759	emergency situation.
760	760	(c) A pharmacist may maintain, administer, and dispose of
761	761	epinephrine delivery [auto-injector] devices only in accordance
762	762	with rules adopted by the board under this section.
763	763	(d) A pharmacist who administers epinephrine through an
764	764	epinephrine delivery [auto-injector] device to a patient shall
765	765	report the use to the patient's primary care physician, as
766	766	identified by the patient, if the patient has a primary care
767	767	physician.
768	768	(e) A pharmacist who in good faith administers epinephrine
769	769	through an epinephrine delivery [auto-injector] device in
770	770	accordance with the requirements of this section is not liable for
771	771	civil damages for an act performed in the administration unless the
772	772	act is wilfully or wantonly negligent. A pharmacist may not receive
773	773	remuneration for the administration of epinephrine through an
774	774	epinephrine delivery [auto-injector] device but may seek
775	775	reimbursement for the cost of the epinephrine delivery
776	776	[auto-injector] device.
777	777	(f) The administration of epinephrine through an
778	778	epinephrine delivery [auto-injector] device to a patient in
779	779	accordance with the requirements of this section does not
780	780	constitute the unlawful practice of any health care profession.
781	781	(g) In this section:
782	782	(1) "Epinephrine auto-injector" means a disposable
783	783	medical drug delivery device that contains a premeasured single
784	784	dose of epinephrine intended for use to treat anaphylaxis.
785	785	(2) "Epinephrine delivery device" means a medical
786	786	delivery device approved by the United States Food and Drug
787	787	Administration that delivers a dose of epinephrine intended for use
788	788	to treat anaphylaxis, including:
789	789	(A) an epinephrine auto-injector; and
790	790	(B) an epinephrine nasal spray.
791	791	SECTION 30. Section 1701.701, Occupations Code, is amended
792	792	by adding Subdivision (2-a) to read as follows:
793	793	(2-a) "Epinephrine delivery device" means a medical
794	794	delivery device approved by the United States Food and Drug
795	795	Administration that delivers a dose of epinephrine intended for use
796	796	to treat anaphylaxis, including:
797	797	(A) an epinephrine auto-injector; and
798	798	(B) an epinephrine nasal spray.
799	799	SECTION 31. Section 1701.702, Occupations Code, is amended
800	800	to read as follows:
801	801	Sec. 1701.702. ADMINISTRATION OF EPINEPHRINE. (a) A law
802	802	enforcement agency may acquire and possess epinephrine delivery
803	803	devices [auto-injectors] and a peace officer may possess and
804	804	administer an epinephrine delivery device [auto-injector] in
805	805	accordance with this subchapter.
806	806	(b) A peace officer may possess and administer an
807	807	epinephrine delivery device [auto-injector] only if the peace
808	808	officer has successfully completed training in the use of the
809	809	device in a course approved by the commission.
810	810	(c) The commission, in consultation with the Department of
811	811	State Health Services, shall approve a training course on the
812	812	administration of an epinephrine delivery device [auto-injector].
813	813	SECTION 32. Sections 1701.703(a), (b), (c), (e), and (f),
814	814	Occupations Code, are amended to read as follows:
815	815	(a) A physician, or a person who has been delegated
816	816	prescriptive authority under Chapter 157, Occupations Code, may
817	817	prescribe epinephrine delivery devices [auto-injectors] in the
818	818	name of a law enforcement agency.
819	819	(b) A physician or other person who prescribes epinephrine
820	820	delivery devices [auto-injectors] under Subsection (a) shall
821	821	provide the law enforcement agency with a standing order for the
822	822	administration of an epinephrine delivery device [auto-injector]
823	823	to a person reasonably believed to be experiencing anaphylaxis.
824	824	(c) A standing order under Subsection (b) is not required to
825	825	be patient-specific. An epinephrine delivery device
826	826	[auto-injector] may be administered under this subchapter to a
827	827	person without a previously established physician-patient
828	828	relationship.
829	829	(e) An order issued under this section must contain:
830	830	(1) the name and signature of the prescribing
831	831	physician or other person;
832	832	(2) the name of the law enforcement agency to which the
833	833	order is issued;
834	834	(3) the quantity of epinephrine delivery devices
835	835	[auto-injectors] to be obtained and maintained under the order; and
836	836	(4) the date the order was issued.
837	837	(f) A pharmacist may dispense an epinephrine delivery
838	838	device [auto-injector] to a law enforcement agency without
839	839	requiring the name of or any other identifying information relating
840	840	to the user.
841	841	SECTION 33. Section 1701.704, Occupations Code, is amended
842	842	to read as follows:
843	843	Sec. 1701.704. MAINTENANCE AND ADMINISTRATION OF
844	844	EPINEPHRINE DELIVERY DEVICES [AUTO-INJECTORS]. A law enforcement
845	845	agency that acquires and possesses epinephrine delivery devices
846	846	[auto-injectors] under this subchapter shall adopt and implement a
847	847	policy regarding the maintenance, administration, and disposal of
848	848	the epinephrine delivery devices [auto-injectors]. The policy
849	849	must:
850	850	(1) establish a process for the agency to check the
851	851	inventory of epinephrine delivery devices [auto-injectors] at
852	852	regular intervals for expiration and replacement; and
853	853	(2) require that the epinephrine delivery devices
854	854	[auto-injectors] be stored in a secure location.
855	855	SECTION 34. Section 1701.705, Occupations Code, is amended
856	856	to read as follows:
857	857	Sec. 1701.705. NOTIFICATION OF ADMINISTRATION OF
858	858	EPINEPHRINE DELIVERY DEVICE [AUTO-INJECTOR]. After an officer
859	859	administers an epinephrine delivery device [auto-injector] under
860	860	this subchapter, the law enforcement agency shall notify the
861	861	physician or other person who prescribed the epinephrine delivery
862	862	device [auto-injector] of:
863	863	(1) the age of the person to whom the epinephrine
864	864	delivery device [auto-injector] was administered; and
865	865	(2) the number of epinephrine delivery device
866	866	[auto-injector] doses administered to the person.
867	867	SECTION 35. Section 1701.707, Occupations Code, is amended
868	868	to read as follows:
869	869	Sec. 1701.707. NOT PRACTICE OF HEALTH CARE. The
870	870	administration by a peace officer of an epinephrine delivery device
871	871	[auto-injector] to a person in accordance with the requirements of
872	872	this subchapter or commission rules does not constitute the
873	873	unlawful practice of any health care profession.
874	874	SECTION 36. Section 1701.708(a), Occupations Code, is
875	875	amended to read as follows:
876	876	(a) A person who in good faith takes, or fails to take,
877	877	action relating to the prescription of an epinephrine delivery
878	878	device [auto-injector] to a law enforcement agency or the
879	879	administration of an epinephrine delivery device [auto-injector]
880	880	by a peace officer is immune from civil or criminal liability or
881	881	disciplinary action resulting from that action or failure to act,
882	882	including:
883	883	(1) issuing an order for epinephrine delivery devices
884	884	[auto-injectors];
885	885	(2) supervising or delegating the administration of an
886	886	epinephrine delivery device [auto-injector];
887	887	(3) possessing, maintaining, storing, or disposing of
888	888	an epinephrine delivery device [auto-injector];
889	889	(4) prescribing an epinephrine delivery device
890	890	[auto-injector];
891	891	(5) dispensing an epinephrine delivery device
892	892	[auto-injector];
893	893	(6) administering, or assisting in administering, an
894	894	epinephrine delivery device [auto-injector];
895	895	(7) providing, or assisting in providing, training,
896	896	consultation, or advice in the development, adoption, or
897	897	implementation of policies, guidelines, rules, or plans; or
898	898	(8) undertaking any other act permitted or required
899	899	under this subchapter.
900	900	SECTION 37. This Act takes effect immediately if it
901	901	receives a vote of two-thirds of all the members elected to each
902	902	house, as provided by Section 39, Article III, Texas Constitution.
903	903	If this Act does not receive the vote necessary for immediate
904	904	effect, this Act takes effect September 1, 2025.