85R11251 SRS-D     By: Howard H.B. No. 3851       A BILL TO BE ENTITLED   AN ACT   relating to policies and training regarding the use of epinephrine   auto-injectors by public institutions of higher education;   providing immunity.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Section 38.202, Education Code, is amended by   amending Subsections (a) and (b) and adding Subsection (e) to read   as follows:          (a)  The commissioner of state health services shall   establish an advisory committee to examine and review the   administration of epinephrine auto-injectors to a person   experiencing an anaphylactic reaction on a campus of a school   district, [or] an open-enrollment charter school, or an institution   of higher education.          (b)  The advisory committee shall be composed of members   appointed by the commissioner of state health services.  In making   appointments, the commissioner shall ensure that:                (1)  a majority of the members are physicians with   expertise in treating anaphylaxis, including physicians who   specialize in the fields of pediatrics, allergies, asthma, and   immunology; [and]                (2)  at least one member is a registered nurse employed   by a school district or open-enrollment charter school as a school   nurse; and                (3)  at least one member is an employee of an   institution of higher education.          (e)  In this section, "institution of higher education" has   the meaning assigned by Section 61.003.          SECTION 2.  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   auto-injectors on school campuses and campuses of institutions of   higher education;                (2)  the training of [school] personnel and [school]   volunteers at schools and institutions of higher education in the   administration of an epinephrine auto-injector; and                (3)  a plan for one or more [school] personnel members   or [school] volunteers of a school or an institution of higher   education trained in the administration of an epinephrine   auto-injector to be on each [school] campus of a school or an   institution of higher education.          SECTION 3.  Chapter 51, Education Code, is amended by adding   Subchapter Y-1 to read as follows:   SUBCHAPTER Y-1.  MAINTENANCE AND ADMINISTRATION OF EPINEPHRINE   AUTO-INJECTORS          Sec. 51.881.  DEFINITIONS.  In this subchapter:                (1)  "Advisory committee" means the committee   established under Section 38.202.                (2)  "Anaphylaxis" means a sudden, severe, and   potentially life-threatening allergic reaction that occurs when a   person is exposed to an allergen.                (3)  "Epinephrine auto-injector" means a disposable   medical drug delivery device that contains a premeasured single   dose of epinephrine that is intended to be used to treat   anaphylaxis.                (4)  "Institution of higher education" has the meaning   assigned by Section 61.003.                (5)  "Personnel" means employees of an institution of   higher education.                (6)  "Physician" means a person who holds a license to   practice medicine in this state.          Sec. 51.882.  MAINTENANCE AND ADMINISTRATION OF EPINEPHRINE   AUTO-INJECTORS.  (a)  Each institution of higher education may   adopt and implement a policy regarding the maintenance,   administration, and disposal of epinephrine auto-injectors on the   institution's campus.          (b)  If a policy is adopted under Subsection (a), the policy:                (1)  must provide that personnel who are authorized and   trained may administer an epinephrine auto-injector to a person who   is reasonably believed to be experiencing anaphylaxis on the   institution's campus; and                (2)  may provide that personnel who are authorized and   trained may administer an epinephrine auto-injector to a person who   is reasonably believed to be experiencing anaphylaxis at an   off-campus event sponsored by the institution of higher education.          (c)  The commissioner of state health services, in   consultation with the Texas Higher Education Coordinating Board,   and with advice from the advisory committee, shall adopt rules   regarding the administration of an epinephrine auto-injector on the   campus  of an institution of higher education subject to a policy   adopted under Subsection (a).  The rules must establish:                (1)  the number of epinephrine auto-injectors   available at each campus;                (2)  the process for each institution of higher   education to check the inventory of epinephrine auto-injectors at   regular intervals for expiration and replacement; and                (3)  the amount of training required for personnel to   administer an epinephrine auto-injector.          (d)  Each institution of higher education that adopts a   policy under Subsection (a) must require that the institution's   campuses have personnel authorized and trained to administer an   epinephrine auto-injector present.          (e)  The supply of epinephrine auto-injectors at a campus   must be stored in a secure location and be easily accessible to   personnel authorized and trained to administer an epinephrine   auto-injector.          Sec. 51.883.  REPORT ON ADMINISTERING EPINEPHRINE   AUTO-INJECTOR.  (a)  Not later than the 10th business day after the   date a personnel member administers an epinephrine auto-injector in   accordance with a policy adopted under Section 51.882(a), the   institution of higher education shall report the information   required under Subsection (b) to:                (1)  the Texas Higher Education Coordinating Board;                (2)  the physician who prescribed the epinephrine   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 auto-injector;                (2)  whether the person who received the administration   of the epinephrine auto-injector was a student, a personnel member,   or a visitor;                (3)  the physical location where the epinephrine   auto-injector was administered;                (4)  the number of doses of epinephrine auto-injector   administered;                (5)  the title of the person who administered the   epinephrine auto-injector; and                (6)  any other information required by the Texas Higher   Education Coordinating Board.          Sec. 51.884.  TRAINING. (a)  Each institution of higher   education that adopts a policy under Section 51.882(a) is   responsible for training personnel in the administration of an   epinephrine auto-injector.          (b)  Training required under this section must:                (1)  include information on:                      (A)  recognizing the signs and symptoms of   anaphylaxis;                      (B)  administering an epinephrine auto-injector;                      (C)  implementing emergency procedures, if   necessary, after administering an epinephrine auto-injector; and                      (D)  properly disposing of used or expired   epinephrine auto-injectors; and                (2)  be provided in a formal training session or   through online education and be completed annually.          (c)  Each institution of higher education that adopts a   policy under Section 51.882(a) shall maintain records on the   training required under this section.          Sec. 51.885.  PRESCRIPTION OF EPINEPHRINE AUTO-INJECTORS.     (a)  A physician may prescribe epinephrine auto-injectors in the   name of an institution of higher education that adopts a policy   under Section 51.882(a).  The physician shall provide the   institution with a standing order for the administration of an   epinephrine auto-injector to a person reasonably believed to be   experiencing anaphylaxis.          (b)  The standing order under Subsection (a) is not required   to be patient-specific, and the epinephrine auto-injector may be   administered to a person without an established physician-patient   relationship.          (c)  Notwithstanding any other provisions of law,   supervision or delegation by a physician is considered adequate if   the physician:                (1)  periodically reviews the order; and                (2)  is available through direct telecommunication as   needed for consultation, assistance, and direction.          (d)  An order issued under this section must contain:                (1)  the name and signature of the prescribing   physician;                (2)  the name of the institution of higher education to   which the order is issued;                (3)  the quantity of epinephrine auto-injectors to be   obtained and maintained under the order; and                (4)  the date of issue.          (e)  A pharmacist may dispense an epinephrine auto-injector   to an institution of higher education without requiring the name or   any other identifying information relating to the user.          Sec. 51.886.  GIFTS, GRANTS, AND DONATIONS. An institution   of higher education may accept gifts, grants, donations, and   federal funds to implement this subchapter.          Sec. 51.887.  RULES. Except as otherwise provided by this   subchapter, the Texas Higher Education Coordinating Board and the   commissioner of state health services shall jointly adopt rules   necessary to implement this subchapter.          Sec. 51.888.  IMMUNITY FROM LIABILITY. (a)  Except in a case   of reckless conduct or intentional, wilful, or wanton misconduct, a   person is immune from civil or criminal liability or disciplinary   action for any conduct permitted or required under this subchapter,   including:                (1)  issuing an order for epinephrine auto-injectors;                (2)  supervising or delegating the administration of an   epinephrine auto-injector;                (3)  possessing an epinephrine auto-injector;                (4)  prescribing an epinephrine auto-injector;                (5)  dispensing an epinephrine auto-injector;                (6)  administering, or assisting in administering, an   epinephrine auto-injector;                (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.          (b)  The immunity provided by Subsection (a) is in addition   to other immunity or limitations of liability provided by law.          (c)  Notwithstanding any other law, this subchapter does not   create a cause of action or liability against personnel for the use   of an epinephrine auto-injector as provided by this subchapter.          SECTION 4.  This Act applies beginning with the 2017 fall   semester.          SECTION 5.  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, 2017.