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2023 - 2024 LEGISLATURE
2023 ASSEMBLY BILL 914
January 4, 2024 - Introduced by Representatives SNYDER, BEHNKE, BALDEH,
GUNDRUM, MURPHY, O'CONNOR, OHNSTAD, ORTIZ-VELEZ, PALMERI, ROZAR,
SINICKI, SPIROS, STUBBS, SUBECK, TITTL and VANDERMEER, cosponsored by
Senators JAMES, L. JOHNSON, LARSON and TAYLOR. Referred to Committee on
Health, Aging and Long-Term Care.
***AUTHORS SUBJECT TO CHANGE***
AN ACT to amend 450.11 (1); and to create 118.2915 and 448.03 (2) (qm) of the
statutes; relating to: the supply and use of short-acting bronchodilators on
school premises or at a school-sponsored event.
Analysis by the Legislative Reference Bureau
This bill allows the governing body of a public, private, or tribal school to adopt
a plan for the management of pupils who have asthma. The plan must be approved
by a physician, an advanced practice nurse prescriber, or a physician assistant.
Under the bill, physicians, advanced practice nurse prescribers, and physician
assistants may provide prescriptions and standing orders for short-acting
bronchodilators or components to schools that adopt a plan. The governing body of
a school that adopts a plan and has a valid prescription or standing order may accept
donated short-acting bronchodilators or components if they are unopened and
unexpired and meet certain other requirements.
The governing body of a school that adopts a plan may authorize a school nurse,
or designated school personnel who have received training specified in the school's
plan, to do any of the following on school premises or at a school-sponsored activity:
1. Provide a short-acting bronchodilator to a pupil to self-administer in
accordance with a prescription specific to the pupil that is on file.
2. Administer a short-acting bronchodilator to a pupil in accordance with a
prescription specific to the pupil that is on file.
3. Administer a short-acting bronchodilator to a pupil or other person who the
school nurse or designated personnel believes is experiencing respiratory distress,
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regardless of whether the pupil or other person has a prescription for a short-acting
bronchodilator.
The bill grants immunity from civil liability for injuries resulting from the
administration or self-administration of a short-acting bronchodilator 1) to a school
and designated school personnel; 2) to a physician, an advanced practice nurse
prescriber, or a physician assistant who provides a prescription or standing order to
a school for a short-acting bronchodilator; and 3) to a physician, an advanced
practice nurse prescriber, a physician assistant, or a pharmacist who dispenses a
short-acting bronchodilator to a school.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
SECTION 1. 118.2915 of the statutes is created to read:
118.2915 Asthma in schools; use of short-acting bronchodilators. (1)
DEFINITIONS. In this section:
(a) “Advanced practice nurse prescriber” means an advanced practice nurse
who is certified under s. 441.16.
(b) “Asthma" means a chronic inflammatory disease of the airways,
characterized by airway obstruction, which is at least partially reversible and which
manifests as increased bronchial responsiveness to a variety of stimuli.
(c) “Designated school personnel” means employees, agents, or volunteers of a
school, designated by the governing body of the school, who have completed the
training specified in the plan adopted by the governing body of the school under sub.
(2) (a).
(d) “Pharmacist” has the meaning given in s. 450.01 (15).
(e) “Physician” means a person licensed to practice medicine and surgery under
ch. 448.
(f) “Physician assistant” means a person licensed under s. 448.974.
(g) “School" means a public, private, or tribal school.
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(h) “Self-administer” means to administer a short-acting bronchodilator to
one's own body.
(i) “Short-acting bronchodilator” means any beta-2 agonist, such as albuterol,
used for the quick relief of asthma symptoms. “Short-acting bronchodilator”
includes an orally inhaled medication that contains a premeasured single dose of
albuterol or albuterol sulfate delivered by a nebulizer or by a pressurized
metered-dose inhaler.
(2) SCHOOL PLAN. (a) The governing body of a school may adopt a plan for the
management of pupils attending the school who have asthma. If the governing body
of a school adopts a plan under this paragraph, it shall specify in the plan the training
necessary to perform the activities under sub. (4). The governing body of a school
may not adopt a plan under this paragraph unless the plan has been approved by a
physician, an advanced practice nurse prescriber, or a physician assistant.
(b) The governing body of a school that has adopted a plan under par. (a) shall
make the plan available on the governing body's website or the website of each school
under its jurisdiction or, if such a website does not exist, give a copy of the plan to any
person upon request.
(3) PRESCRIPTIONS AND SUPPLY. (a) A physician, an advanced practice nurse
prescriber, or a physician assistant may provide a prescription or standing order for
a short-acting bronchodilator or components in the name of a school that has
adopted a plan under sub. (2) (a) to be maintained by the school for use under sub.
(4).
(b) The governing body of a school that has a valid prescription under par. (a)
may accept as a donation a short-acting bronchodilator or components if the donated
short-acting bronchodilator or components are new , unexpired,
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manufacturer-sealed, not subject to recall, unadulterated, and in compliance with
regulations promulgated by the federal food and drug administration.
(c) The governing body of a school that has adopted a plan under sub. (2) (a) may
obtain a prescription or standing order for a short-acting bronchodilator or
components and may acquire and maintain, in accordance with the manufacturer's
instructions, a supply of short-acting bronchodilators and components.
(4) USE OF BRONCHODILATORS. The governing body of a school that has adopted
a plan under sub. (2) (a) may authorize a school nurse or designated school personnel
to do any of the following on school premises or at a school-sponsored activity:
(a) Provide a short-acting bronchodilator to a pupil to self-administer the
short-acting bronchodilator in accordance with a prescription specific to the pupil
that is on file with the school.
(b) Administer a short-acting bronchodilator to a pupil in accordance with a
prescription specific to the pupil that is on file with the school.
(c) In accordance with a prescription or standing order from a physician, an
advanced practice nurse prescriber, or a physician assistant, administer a
short-acting bronchodilator to a pupil or other person who the school nurse or
designated school personnel believes in good faith is experiencing respiratory
distress, regardless of whether the pupil or other person has a prescription for a
short-acting bronchodilator.
(5) INDEPENDENT AUTHORITY. (a) The authority to self-administer a
short-acting bronchodilator under sub. (4) (a) is independent of the authorized
possession and use of a metered-dose inhaler or dry-powder inhaler under s. 118.291
(1r).
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(b) The authority to administer a short-acting bronchodilator under sub. (4)
(b) and (c) is independent of the authority to administer a metered-dose inhaler or
dry-powder inhaler under s. 118.29 (2) (a) 2.
(6) IMMUNITY FROM CIVIL LIABILITY; EXEMPTION FROM PRACTICE OF MEDICINE. (a)
None of the following are liable for any injury that results from the administration
or self-administration of a short-acting bronchodilator under this section,
regardless of whether authorization was given by the pupil's parent or guardian or
by the pupil's physician, physician assistant, or advanced practice nurse prescriber,
unless the injury is the result of an act or omission that constitutes gross negligence
or willful or wanton misconduct:
1. A school, its school nurse, and its designated school personnel.
2. A physician, advanced practice nurse prescriber, or physician assistant who
provides a prescription or standing order for a short-acting bronchodilator or
components to a school under sub. (3) (a).
3. A physician, advanced practice nurse prescriber, physician assistant, or
pharmacist who dispenses a short-acting bronchodilator or components to a school
in accordance with a prescription or standing order under sub. (3) (a).
(b) The immunity from liability provided under this subsection is in addition
to and not in lieu of that provided under s. 895.48.
(7) HEALTH CARE PROFESSIONALS. Nothing in this section prohibits a health care
professional, as defined in s. 118.29 (1) (c), from acting within the scope of practice
of the health care professional's license, certificate, permit, or registration.
SECTION 2. 448.03 (2) (qm) of the statutes is created to read:
448.03 (2) (qm) The administration of a short-acting bronchodilator in
accordance with s. 118.2915.
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SECTION 3 ASSEMBLY BILL 914
SECTION 3. 450.11 (1) of the statutes is amended to read:
450.11 (1) DISPENSING. Except as provided in sub. (1i) (b) 2., no person may
dispense any prescribed drug or device except upon the prescription order of a
practitioner. All prescription orders shall, except as provided in sub. (1a), specify the
date of issue, the name and address of the practitioner, the name and quantity of the
drug product or device prescribed, directions for the use of the drug product or device,
the symptom or purpose for which the drug is being prescribed if required under sub.
(4) (a) 8., and, if the order is written by the practitioner, the signature of the
practitioner. Except as provided in ss. 118.2915 (3) (a), 118.2925 (3), 255.07 (2),
441.18 (2) (a) 1., 448.035 (2), 448.037 (2) (a) 1., 448.9725 (2), and 448.9727 (2) (a) 1.
and except for standing orders issued under s. 441.18 (2) (a) 2., 448.037 (2) (a) 2., or
448.9727 (2) (a) 2., all prescription orders shall also specify the name and address of
the patient. A prescription order issued under s. 118.2915 (3) (a) or 118.2925 (3) shall
specify the name and address of the school. A prescription order issued under s.
255.07 (2) shall specify the name and address of the authorized entity or authorized
individual. Any oral prescription order shall be immediately reduced to writing by
the pharmacist and filed according to sub. (2).
(END)
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