Hinojosa’s bill widening school epinephrine rules

The text as introduced · 2,104 words

89R5240 RAL-F

By: Hinojosa of Hidalgo
S.B. No. 1374

A BILL TO BE ENTITLED

AN ACT

relating to the administration of epinephrine medication by public

and private schools.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Section 38.0151(f), Education Code, is amended

to read as follows:

(f) A school district or open-enrollment charter school

that provides for the maintenance, administration, and disposal of

epinephrine medication [ auto-injectors ] under Subchapter E is not

required to comply with this section.

SECTION 2. The heading to Subchapter E, Chapter 38,

Education Code, is amended to read as follows:

SUBCHAPTER E. MAINTENANCE AND ADMINISTRATION OF EPINEPHRINE

MEDICATION [ AUTO-INJECTORS ] AND MEDICATION FOR RESPIRATORY

DISTRESS

SECTION 3. Section 38.201, Education Code, is amended by

amending Subdivision (3-a) and adding Subdivision (3-b) to read as

follows:

(3-a) "Epinephrine medication" means an epinephrine

auto-injector, an epinephrine nasal spray, or other medication

designated by the executive commissioner of the Health and Human

Services Commission for treatment of anaphylaxis under Section

38.208(c).

(3-b) "Medication for respiratory distress" means

albuterol, levalbuterol, or another medication designated by the

executive commissioner of the Health and Human Services Commission

for treatment of respiratory distress under Section 38.208(c).

SECTION 4. Section 38.202(a), Education Code, is amended to

read as follows:

(a) The commissioner of state health services shall

establish an advisory committee to examine and review the

administration, on a campus of a school district, an

open-enrollment charter school, a private school, or an institution

of higher education, of:

(1) epinephrine medication [ auto-injectors ] to a

person experiencing an anaphylactic reaction; and

(2) medication for respiratory distress to a person

experiencing respiratory distress.

SECTION 5. Section 38.207, Education Code, is amended to

read as follows:

Sec. 38.207. ADVISORY COMMITTEE: DUTIES. The advisory

committee shall advise the commissioner of state health services

on:

(1) the storage and maintenance of epinephrine

medication [ auto-injectors ] and medication for respiratory

distress on school campuses and campuses of institutions of higher

education;

(2) the training of school personnel and school

volunteers, and of personnel and volunteers at institutions of

higher education, in the administration of [ an ] epinephrine

medication [ auto-injector ];

(3) the training of school personnel and school

volunteers, and of personnel and volunteers at institutions of

higher education, in the administration of a medication for

respiratory distress; and

(4) a plan for:

(A) one or more school personnel members or

school volunteers trained in the administration of [ an ] epinephrine

medication [ auto-injector ] to be on each school campus;

(B) one or more school personnel members or

school volunteers trained in the administration of medication for

respiratory distress to be on each school campus;

(C) one or more personnel members or volunteers

of an institution of higher education trained in the administration

of [ an ] epinephrine medication [ auto-injector ] to be on each campus

of an institution of higher education; and

(D) one or more personnel members or volunteers

of an institution of higher education trained in the administration

of medication for respiratory distress to be on each campus of an

institution of higher education.

SECTION 6. The heading to Section 38.208, Education Code,

is amended to read as follows:

Sec. 38.208. MAINTENANCE AND ADMINISTRATION OF EPINEPHRINE

MEDICATION [ AUTO-INJECTORS ] AND MEDICATION FOR RESPIRATORY

DISTRESS.

SECTION 7. Sections 38.208(a), (b), (c), (d), (d-2), and

(e), Education Code, are amended to read as follows:

(a) Each school district, open-enrollment charter school,

and private school may adopt and implement a policy regarding the

maintenance, administration, and disposal of epinephrine

medication [ auto-injectors ] at each campus in the district or

school.

(b) If a policy is adopted under Subsection (a), the policy:

(1) must provide that school personnel and school

volunteers who are authorized and trained may administer [ an ]

epinephrine medication [ auto-injector ] to a person who is

reasonably believed to be experiencing anaphylaxis on a school

campus; and

(2) may provide that school personnel and school

volunteers who are authorized and trained may administer [ an ]

epinephrine medication [ auto-injector ] to a person who is

reasonably believed to be experiencing anaphylaxis at an off-campus

school event or while in transit to or from a school event.

(c) The executive commissioner of the Health and Human

Services Commission, in consultation with the commissioner of

education, and with advice from the advisory committee as

appropriate, shall adopt rules regarding the maintenance,

administration, and disposal of [ an ] epinephrine medication

[ auto-injector ] at a school campus subject to a policy adopted

under Subsection (a) and the maintenance, administration, and

disposal of medication for respiratory distress at a school campus

subject to a policy adopted under Subsection (a-1). The rules must

establish:

(1) the amount [ number ] of epinephrine medication

[ auto-injectors ] available at each campus;

(2) the amount of medication for respiratory distress

available at each campus;

(3) the process for each school district,

open-enrollment charter school, and private school to check the

inventory of epinephrine medication [ auto-injectors ] and

medication for respiratory distress at regular intervals for

expiration and replacement;

(4) the amount of training required for school

personnel and school volunteers to administer:

(A) [ an ] epinephrine medication [ auto-injector ];

or

(B) medication for respiratory distress; and

(5) the types of medication that may be administered

under Subsection (b-1) to persons experiencing respiratory

distress, based on a review of the best available medical evidence.

(d) Each school district, open-enrollment charter school,

and private school that adopts a policy under Subsection (a) must

require that each campus have one or more school personnel members

or school volunteers authorized and trained to administer [ an ]

epinephrine medication [ auto-injector ] present during regular

school [ all ] hours [ the campus is open ].

(d-2) A school personnel member or school volunteer may not

be subject to any penalty or disciplinary action for refusing to

administer or receive training to administer epinephrine

medication [ auto-injectors ] or medication for respiratory

distress, as applicable, in accordance with a policy adopted under

Subsection (a) or (a-1).

(e) The supply of epinephrine medication [ auto-injectors ]

at each campus must be stored in a secure location and be easily

accessible to school personnel and school volunteers authorized and

trained to administer [ an ] epinephrine medication [ auto-injector ].

SECTION 8. Section 38.209, Education Code, is amended to

read as follows:

Sec. 38.209. REPORT ON ADMINISTERING EPINEPHRINE

MEDICATION [ AUTO-INJECTOR ]. (a) Not later than the 10th business

day after the date a school personnel member or school volunteer

administers [ an ] epinephrine medication [ auto-injector ] in

accordance with a policy adopted under Section 38.208(a), the

school shall report the information required under Subsection (b)

to:

(1) the school district, the charter holder if the

school is an open-enrollment charter school, or the governing body

of the school if the school is a private school;

(2) the physician or other person who prescribed the

epinephrine medication [ auto-injector ]; and

(3) the commissioner of state health services.

(b) The report required under this section must include the

following information:

(1) the age of the person who received the

administration of the epinephrine medication [ auto-injector ];

(2) whether the person who received the administration

of the epinephrine medication [ auto-injector ] was a student, a

school personnel member or school volunteer, or a visitor;

(3) the physical location where the epinephrine

medication [ auto-injector ] was administered;

(4) the number of doses of epinephrine medication

[ auto-injector ] administered;

(5) the title of the person who administered the

epinephrine medication [ auto-injector ]; and

(6) any other information required by the commissioner

of education.

SECTION 9. Section 38.210(a), Education Code, is amended to

read as follows:

(a) Each school district, open-enrollment charter school,

and private school that adopts a policy under Section 38.208(a) is

responsible for training school personnel and school volunteers in

the administration of [ an ] epinephrine medication [ auto-injector ].

The training must include information on:

(1) recognizing the signs and symptoms of anaphylaxis;

(2) administering [ an ] epinephrine medication

[ auto-injector ];

(3) implementing emergency procedures, if necessary,

after administering [ an ] epinephrine medication [ auto-injector ];

and

(4) properly disposing of used or expired epinephrine

medication [ auto-injectors ].

SECTION 10. The heading to Section 38.211, Education Code,

is amended to read as follows:

Sec. 38.211. PRESCRIPTION OF EPINEPHRINE MEDICATION

[ AUTO-INJECTORS ] AND MEDICATION FOR RESPIRATORY DISTRESS.

SECTION 11. Section 38.211, Education Code, is amended by

amending Subsections (a), (b), (c), (e), and (f) and adding

Subsections (b-1) and (b-2) to read as follows:

(a) A physician or person who has been delegated

prescriptive authority under Chapter 157, Occupations Code, may

prescribe epinephrine medication [ auto-injectors ] or medication

for respiratory distress in the name of a school district,

open-enrollment charter school, or private school.

(b) A physician or other person who prescribes epinephrine

medication [ auto-injectors ] or medication for respiratory distress

under Subsection (a) shall provide the school district,

open-enrollment charter school, or private school with a standing

order for the administration of, as applicable:

(1) [ an ] epinephrine medication [ auto-injector ] to a

person reasonably believed to be experiencing anaphylaxis; or

(2) medication for respiratory distress to a person

reasonably believed to be experiencing respiratory distress.

(b-1) The commissioner of state health services or, if the

commissioner is not a physician, the chief medical executive of the

Department of State Health Services may issue a statewide standing

order prescribing epinephrine medication to a school district,

open-enrollment charter school, or private school.

(b-2) If a standing order has not been issued under

Subsection (b-1) to a school district, open-enrollment charter

school, or private school within 30 days of the beginning of a

school year, a regional director of a public health region

described by Section 121.007, Health and Safety Code, or a health

authority, as defined by Section 121.021, Health and Safety Code,

may issue a standing order prescribing epinephrine medication to a

school district, open-enrollment charter school, or private school

in the director's public health region or health authority's

jurisdiction, as applicable, for that school year.

(c) The standing order under Subsection (b) , (b-1), or (b-2)

is not required to be patient-specific, and the epinephrine

medication [ auto-injector ] or medication for respiratory distress

may be administered to a person without a previously established

physician-patient relationship.

(e) An order issued under this section must contain:

(1) the name and signature of the prescribing

physician or other person;

(2) the name of the school district, open-enrollment

charter school, or private school to which the order is issued;

(3) as applicable, the quantity and types of

epinephrine medication [ auto-injectors ] or the quantity and types

of medications for respiratory distress to be obtained and

maintained under the order; and

(4) the date of issue.

(f) A pharmacist may dispense [ an ] epinephrine medication

[ auto-injector ] or medication for respiratory distress to a school

district, open-enrollment charter school, or private school

without requiring the name or any other identifying information

relating to the user.

SECTION 12. Section 38.215(a), Education Code, is amended

to read as follows:

(a) A person who in good faith takes, or fails to take, any

action under this subchapter is immune from civil or criminal

liability or disciplinary action resulting from that action or

failure to act, including:

(1) issuing an order for epinephrine medication

[ auto-injectors ] or medication for respiratory distress;

(2) supervising or delegating the administration of

[ an ] epinephrine medication [ auto-injector ] or medication for

respiratory distress;

(3) possessing, maintaining, storing, or disposing of

[ an ] epinephrine medication [ auto-injector ] or medication for

respiratory distress;

(4) prescribing [ an ] epinephrine medication

[ auto-injector ] or medication for respiratory distress;

(5) dispensing:

(A) [ an ] epinephrine medication [ auto-injector ];

or

(B) medication for respiratory distress;

(6) administering, or assisting in administering,

[ an ] epinephrine medication [ auto-injector ] or medication for

respiratory distress;

(7) providing, or assisting in providing, training,

consultation, or advice in the development, adoption, or

implementation of policies, guidelines, rules, or plans; or

(8) undertaking any other act permitted or required

under this subchapter.

SECTION 13. This Act takes effect immediately if it

receives a vote of two-thirds of all the members elected to each

house, as provided by Section 39, Article III, Texas Constitution.

If this Act does not receive the vote necessary for immediate

effect, this Act takes effect September 1, 2025.