89R5992 RAL-F     By: Cortez H.B. No. 2283       A BILL TO BE ENTITLED   AN ACT   relating to the use of an epinephrine delivery device by certain   entities.          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 delivery devices [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   DELIVERY DEVICES [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 delivery device" means a medical   delivery device approved by the United States Food and Drug   Administration that delivers a dose of epinephrine intended for use   to treat anaphylaxis, including:                      (A)  an epinephrine auto-injector; and                      (B)  an epinephrine nasal spray.                (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 delivery devices [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   delivery devices [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 delivery   device [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   delivery device [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 delivery device [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   DELIVERY DEVICES [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 delivery   devices [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 delivery device [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 delivery device [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 delivery device   [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 number of epinephrine delivery devices   [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 delivery devices [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 delivery device   [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 delivery device [auto-injector] present during 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 delivery   devices [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 delivery devices   [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 delivery device   [auto-injector].          SECTION 8.  Section 38.209, Education Code, is amended to   read as follows:          Sec. 38.209.  REPORT ON ADMINISTERING EPINEPHRINE DELIVERY   DEVICE [AUTO-INJECTOR]. (a) Not later than the 10th business day   after the date a school personnel member or school volunteer   administers an epinephrine delivery device [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 delivery device [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 delivery device [auto-injector];                (2)  whether the person who received the administration   of the epinephrine delivery device [auto-injector] was a student, a   school personnel member or school volunteer, or a visitor;                (3)  the physical location where the epinephrine   delivery device [auto-injector] was administered;                (4)  the number of doses of epinephrine delivery device   [auto-injector] administered;                (5)  the title of the person who administered the   epinephrine delivery device [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 delivery device   [auto-injector]. The training must include information on:                (1)  recognizing the signs and symptoms of anaphylaxis;                (2)  administering an epinephrine delivery device   [auto-injector];                (3)  implementing emergency procedures, if necessary,   after administering an epinephrine delivery device   [auto-injector]; and                (4)  properly disposing of used or expired epinephrine   delivery devices [auto-injectors].          SECTION 10.  The heading to Section 38.211, Education Code,   is amended to read as follows:          Sec. 38.211.  PRESCRIPTION OF EPINEPHRINE DELIVERY DEVICES   [AUTO-INJECTORS] AND MEDICATION FOR RESPIRATORY DISTRESS.          SECTION 11.  Sections 38.211(a), (b), (c), (e), and (f),   Education Code, are amended to read as follows:          (a)  A physician or person who has been delegated   prescriptive authority under Chapter 157, Occupations Code, may   prescribe epinephrine delivery devices [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   delivery devices [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 delivery device [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.          (c)  The standing order under Subsection (b) is not required   to be patient-specific, and the epinephrine delivery device   [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 delivery devices [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 delivery   device [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 delivery devices   [auto-injectors] or medication for respiratory distress;                (2)  supervising or delegating the administration of an   epinephrine delivery device [auto-injector] or medication for   respiratory distress;                (3)  possessing, maintaining, storing, or disposing of   an epinephrine delivery device [auto-injector] or medication for   respiratory distress;                (4)  prescribing an epinephrine delivery device   [auto-injector] or medication for respiratory distress;                (5)  dispensing:                      (A)  an epinephrine delivery device   [auto-injector]; or                      (B)  medication for respiratory distress;                (6)  administering, or assisting in administering, an   epinephrine delivery device [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.  The heading to Subchapter Y-1, Chapter 51,   Education Code, is amended to read as follows:   SUBCHAPTER Y-1. MAINTENANCE, STORAGE, ADMINISTRATION, AND   DISPOSAL OF EPINEPHRINE DELIVERY DEVICES [AUTO-INJECTORS]          SECTION 14.  Section 51.881, Education Code, is amended by   adding Subdivision (4-a) to read as follows:                (4-a)  "Epinephrine delivery device" means a medical   delivery device approved by the United States Food and Drug   Administration that delivers a dose of epinephrine intended for use   to treat anaphylaxis, including:                      (A)  an epinephrine auto-injector; and                      (B)  an epinephrine nasal spray.          SECTION 15.  The heading to Section 51.882, Education Code,   is amended to read as follows:          Sec. 51.882.  MAINTENANCE, STORAGE, ADMINISTRATION, AND   DISPOSAL OF EPINEPHRINE DELIVERY DEVICES [AUTO-INJECTORS].          SECTION 16.  Sections 51.882(a), (b), (c), (d), and (e),   Education Code, are amended to read as follows:          (a)  Each institution of higher education may adopt and   implement a policy regarding the maintenance, storage,   administration, and disposal of epinephrine delivery devices   [auto-injectors] on the institution's campus.          (b)  If a policy is adopted under Subsection (a), the policy:                (1)  must provide that personnel or volunteers who are   authorized and trained may administer an epinephrine delivery   device [auto-injector] to a person who is reasonably believed to be   experiencing anaphylaxis on the institution's campus; and                (2)  may provide that personnel or volunteers who are   authorized and trained may administer an epinephrine delivery   device [auto-injector] to a person who is reasonably believed to be   experiencing anaphylaxis at an off-campus event or while in transit   to or from an off-campus event sponsored by the institution of   higher education.          (c)  The executive commissioner of the Health and Human   Services Commission [state health services] with advice from the   advisory committee shall adopt rules regarding the maintenance,   storage, administration, and disposal of an epinephrine delivery   device [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 delivery devices   [auto-injectors] available at each campus;                (2)  the process for each institution of higher   education to check the inventory of epinephrine delivery devices   [auto-injectors] at regular intervals for expiration and   replacement; and                (3)  the amount of training required for personnel or   volunteers to administer an epinephrine delivery device   [auto-injector].          (d)  Each institution of higher education that adopts a   policy under Subsection (a):                (1)  must require that the institution's campuses have   personnel or volunteers authorized and trained to administer an   epinephrine delivery device [auto-injector] present; and                (2)  shall include the policy in the institution's   student handbook or similar publication and publish the policy on   the institution's Internet website.          (e)  The supply of epinephrine delivery devices   [auto-injectors] at a campus must be stored in a secure location and   be easily accessible to personnel or volunteers authorized and   trained to administer an epinephrine delivery device   [auto-injector].          SECTION 17.  Section 51.883, Education Code, is amended to   read as follows:          Sec. 51.883.  REPORT ON ADMINISTERING EPINEPHRINE DELIVERY   DEVICE [AUTO-INJECTOR].  (a) Not later than the 10th business day   after the date a personnel member or volunteer administers an   epinephrine delivery device [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 physician who prescribed the epinephrine   delivery device [auto-injector]; and                (2)  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 delivery device [auto-injector];                (2)  whether the person who received the administration   of the epinephrine delivery device [auto-injector] was a student, a   personnel member, or a visitor;                (3)  the physical location where the epinephrine   delivery device [auto-injector] was administered;                (4)  the number of doses of epinephrine delivery device   [auto-injector] administered;                (5)  the title of the person who administered the   epinephrine delivery device [auto-injector]; and                (6)  any other information required by the commissioner   of state health services.          SECTION 18.  Sections 51.884(a) and (b), Education Code, are   amended to read as follows:          (a)  Each institution of higher education that adopts a   policy under Section 51.882(a) is responsible for training   personnel or volunteers in the administration of an epinephrine   delivery device [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 delivery device   [auto-injector];                      (C)  implementing emergency procedures, if   necessary, after administering an epinephrine delivery device   [auto-injector]; and                      (D)  properly disposing of used or expired   epinephrine delivery devices [auto-injectors]; and                (2)  be provided in a formal training session or   through online education and be completed annually.          SECTION 19.  The heading to Section 51.885, Education Code,   is amended to read as follows:          Sec. 51.885.  PRESCRIPTION OF EPINEPHRINE DELIVERY DEVICES   [AUTO-INJECTORS].          SECTION 20.  Sections 51.885(a), (b), (d), and (e),   Education Code, are amended to read as follows:          (a)  A physician may prescribe epinephrine delivery devices   [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 delivery device [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 delivery device   [auto-injector] may be administered to a person without an   established physician-patient relationship.          (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 delivery devices   [auto-injectors] to be obtained and maintained under the order; and                (4)  the date of issue.          (e)  A pharmacist may dispense an epinephrine delivery   device [auto-injector] to an institution of higher education   without requiring the name or any other identifying information   relating to the user.          SECTION 21.  Section 51.888(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 act or failure   to act, including:                (1)  issuing an order for epinephrine delivery devices   [auto-injectors];                (2)  supervising or delegating the administration of an   epinephrine delivery device [auto-injector];                (3)  possessing an epinephrine delivery device   [auto-injector];                (4)  maintaining an epinephrine delivery device   [auto-injector];                (5)  storing an epinephrine delivery device   [auto-injector];                (6)  disposing of an epinephrine delivery device   [auto-injector];                (7)  prescribing an epinephrine delivery device   [auto-injector];                (8)  dispensing an epinephrine delivery device   [auto-injector];                (9)  administering, or assisting in administering, an   epinephrine delivery device [auto-injector];                (10)  providing, or assisting in providing, training,   consultation, or advice in the development, adoption, or   implementation of policies, guidelines, rules, or plans; or                (11)  undertaking any other act permitted or required   under this subchapter.          SECTION 22.  Section 773.003, Health and Safety Code, is   amended by amending Subdivision (15-a) and adding Subdivisions   (15-b) and (15-c) to read as follows:                (15-a)  "Epinephrine auto-injector" means a disposable   medical drug delivery device that contains a premeasured single   dose of epinephrine intended for use to treat anaphylaxis.                (15-b)  "Epinephrine delivery device" means a medical   delivery device approved by the United States Food and Drug   Administration that delivers a dose of epinephrine intended for use   to treat anaphylaxis, including:                      (A)  an epinephrine auto-injector; and                      (B)  an epinephrine nasal spray.                (15-c) "Executive commissioner" means the executive   commissioner of the Health and Human Services Commission.          SECTION 23.  Sections 773.014(a), (b), (c), (c-1), (d), (e),   (f), and (g), Health and Safety Code, are amended to read as   follows:          (a)  An emergency medical services provider and a first   responder organization may acquire and possess epinephrine   delivery [auto-injector] devices in accordance with this section.   Emergency medical services personnel may carry and administer   epinephrine delivery [auto-injector] devices in accordance with   this section.          (b)  The executive commissioner shall adopt rules designed   to protect the public health and safety to implement this section.   The rules must provide that emergency medical services personnel   may administer an epinephrine delivery [auto-injector] device to   another only if the person has successfully completed a training   course, approved by the department, in the use of the device that is   consistent with the national standard training curriculum for   emergency medical technicians.          (c)  An emergency medical services provider or first   responder organization may acquire, possess, maintain, and dispose   of epinephrine delivery [auto-injector] devices, and emergency   medical services personnel may carry, maintain, administer, and   dispose of epinephrine delivery [auto-injector] devices, only in   accordance with:                (1)  rules adopted under this section; and                (2)  a delegated practice agreement that provides for   medical supervision by a licensed physician who either:                      (A)  acts as a medical director for an emergency   medical services system or a licensed hospital; or                      (B)  has knowledge and experience in the delivery   of emergency care.          (c-1)  A licensed physician acting as a medical director for   an emergency medical services system may restrict the use and   administration of epinephrine delivery [auto-injector] devices to   certain emergency medical services personnel of the system through:                (1)  the delegated practice agreement; or                (2)  the adoption of policies governing the use of the   epinephrine delivery devices by personnel within the system.          (d)  Emergency medical services personnel who administer   epinephrine delivery [auto-injector] devices to others shall   immediately report the use to the physician supervising the   activities of the emergency medical services personnel.          (e)  The administration of an epinephrine delivery   [auto-injector] device to another under this section is considered   to be the administration of emergency care for the purposes of any   statute relating to liability for the provision of emergency care.   The administration of an epinephrine delivery [auto-injector]   device to another in accordance with the requirements of this   section does not constitute the unlawful practice of any health   care profession.          (f)  A person otherwise authorized to sell or provide an   epinephrine delivery [auto-injector] device to another may sell or   provide the epinephrine delivery devices to an emergency medical   services provider or a first responder organization authorized to   acquire and possess the epinephrine delivery devices under this   section.          (g)  This section does not prevent emergency medical   services personnel who are also licensed health care professionals   under another health care licensing law and who are authorized to   acquire, possess, and administer an epinephrine delivery   [auto-injector] device under the other health care licensing law   from acting under the other law.          SECTION 24.  Sections 773.0145(a), (c), (d), (e), (f), (g),   (h), (i), (k), (l), (m), (o), (p), (q), and (r), Health and Safety   Code, are amended to read as follows:          (a)  This section applies to:                (1)  an amusement park, as defined by Section 46.03,   Penal Code;                (2)  a child-care facility, as defined by Section   42.002, Human Resources Code;                (3)  a day camp or youth camp, as defined by Section   141.002;                (4)  a private or independent institution of higher   education, as defined by Section 61.003, Education Code;                (5)  a restaurant, as defined by Section 17.821,   Business & Commerce Code;                (6)  a sports venue, as defined by Section 504.151,   Local Government Code;                (7)  a youth center, as defined by Section 481.134; or                (8)  subject to Subsection (b), any other entity that   the executive commissioner by rule designates as an entity that   would benefit from the possession and administration of epinephrine   delivery devices [auto-injectors].          (c)  An entity described by Subsection (a) may adopt a policy   regarding the maintenance, administration, and disposal of   epinephrine delivery devices [auto-injectors].          (d)  A policy adopted under Subsection (c) must provide that   only an entity employee or volunteer who is authorized and trained   may administer an epinephrine delivery device [auto-injector] to a   person who is reasonably believed to be experiencing anaphylaxis on   the premises of the entity.          (e)  The executive commissioner shall adopt rules regarding   the maintenance, administration, and disposal of an epinephrine   delivery device [auto-injector] by an entity subject to a policy   adopted under Subsection (c). The rules must establish:                (1)  the number of epinephrine delivery devices   [auto-injectors] and the dosages of the epinephrine delivery   devices [auto-injectors] available at each entity;                (2)  the process for each entity to verify the   inventory of epinephrine delivery devices [auto-injectors] at   regular intervals for expiration and replacement; and                (3)  the amount of training required for an entity   employee or volunteer to administer an epinephrine delivery device   [auto-injector].          (f)  Each entity that adopts a policy under Subsection (c)   must have at least one entity employee or volunteer authorized and   trained to administer an epinephrine delivery device   [auto-injector] present during all hours the entity is open to the   public or to the population that the entity serves, as applicable.          (g)  The supply of epinephrine delivery devices   [auto-injectors] at each entity must:                (1)  be stored in accordance with the manufacturer's   instructions in a secure location; and                (2)  be easily accessible to an entity employee or   volunteer authorized and trained to administer an epinephrine   delivery device [auto-injector].          (h)  Each entity that adopts a policy under Subsection (c) is   responsible for training the entity's employees and volunteers in   the administration of an epinephrine delivery device   [auto-injector].          (i)  Employee and volunteer training under this section   must:                (1)  include information on:                      (A)  the signs and symptoms of anaphylaxis;                      (B)  the recommended dosages for an adult and a   child;                      (C)  the administration of an epinephrine   delivery device [auto-injector];                      (D)  the implementation of emergency procedures,   if necessary, after administering an epinephrine delivery device   [auto-injector]; and                      (E)  the proper disposal of used or expired   epinephrine delivery devices [auto-injectors]; and                (2)  be completed annually in a formal training session   or through online education.          (k)  A physician or person who has been delegated   prescriptive authority under Chapter 157, Occupations Code, may   prescribe epinephrine delivery devices [auto-injectors] in the   name of an entity.          (l)  A physician or other person who prescribes epinephrine   delivery devices [auto-injectors] under Subsection (k) shall   provide the entity with a standing order for the administration of   an epinephrine delivery device [auto-injector] to a person   reasonably believed to be experiencing anaphylaxis.          (m)  The standing order under Subsection (l) is not required   to be patient-specific, and the epinephrine delivery device   [auto-injector] may be administered to a person without a   previously established physician-patient relationship.          (o)  For purposes of Subsection (n)(2), a person who has been   delegated prescriptive authority under Chapter 157, Occupations   Code, is not engaged in the unauthorized practice of telemedicine   or acting outside the person's scope of practice by consulting a   physician as provided by that subdivision when prescribing an   epinephrine delivery device [auto-injector] in accordance with   this section.          (p)  An order issued under this section must contain:                (1)  the name and signature of the prescriber;                (2)  the name of the entity to which the order is   issued;                (3)  the quantity of epinephrine delivery devices   [auto-injectors] to be obtained and maintained under the order; and                (4)  the date of issue.          (q)  A pharmacist may dispense an epinephrine delivery   device [auto-injector] to an entity without requiring the name or   any other identifying information relating to the user.          (r)  A person who in good faith takes, or fails to take, any   action under this section 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 delivery devices   [auto-injectors];                (2)  supervising or delegating the administration of an   epinephrine delivery device [auto-injector];                (3)  possessing, maintaining, storing, or disposing of   an epinephrine delivery device [auto-injector];                (4)  prescribing an epinephrine delivery device   [auto-injector];                (5)  dispensing an epinephrine delivery device   [auto-injector];                (6)  administering, or assisting in administering, an   epinephrine delivery device [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 section.          SECTION 25.  Section 773.050(g), Health and Safety Code, is   amended to read as follows:          (g)  Rules adopting minimum standards under this section   shall require:                (1)  an emergency medical services vehicle to be   equipped with an epinephrine delivery [auto-injector] device [or   similar device] to treat anaphylaxis; and                (2)  emergency medical services personnel to complete   continuing education training in the administration of anaphylaxis   treatment.          SECTION 26.  The heading to Section 42.067, Human Resources   Code, is amended to read as follows:          Sec. 42.067.  EPINEPHRINE DELIVERY DEVICES   [AUTO-INJECTORS]; IMMUNITY FROM LIABILITY.          SECTION 27.  Section 42.067(a), Human Resources Code, is   amended by adding Subdivision (2-a) to read as follows:                (2-a)  "Epinephrine delivery device" means a medical   delivery device approved by the United States Food and Drug   Administration that delivers a dose of epinephrine intended for use   to treat anaphylaxis, including:                      (A)  an epinephrine auto-injector; and                      (B)  an epinephrine nasal spray.          SECTION 28.  Sections 42.067(b), (c), (d), (f), (g), (h),   (i), (k), (l), (n), and (q), Human Resources Code, are amended to   read as follows:          (b)  A physician, or a person who has been delegated   prescriptive authority under Chapter 157, Occupations Code, may   prescribe epinephrine delivery devices [auto-injectors] in the   name of a day-care center.          (c)  A physician or other person who prescribes epinephrine   delivery devices [auto-injectors] under Subsection (b) shall   provide the day-care center with a standing order for the   administration of an epinephrine delivery device [auto-injector]   to a person reasonably believed to be experiencing anaphylaxis.          (d)  A standing order under Subsection (c) is not required to   be patient-specific.  An epinephrine delivery device   [auto-injector] may be administered under this section to a person   without a previously established physician-patient relationship.          (f)  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 day-care center to which the order   is issued;                (3)  the quantity of epinephrine delivery devices   [auto-injectors] to be obtained and maintained under the order; and                (4)  the date the order was issued.          (g)  A pharmacist may dispense an epinephrine delivery   device [auto-injector] to a day-care center without requiring the   name of or any other identifying information relating to the user.          (h)  A day-care center shall store an epinephrine delivery   device [auto-injector] in a secure location that is easily   accessible to employees or volunteers of the day-care center   authorized and trained to administer an epinephrine delivery device   [auto-injector].          (i)  Each day-care center is responsible for training   employees in the administration of an epinephrine delivery device   [auto-injector]. The training must:                (1)  include information on:                      (A)  recognizing the signs and symptoms of   anaphylaxis;                      (B)  administering an epinephrine delivery device   [auto-injector];                      (C)  the recommended dosages for adults and   children by age and weight, if applicable, and the dosages   available at the center;                      (D)  implementing emergency procedures, if   necessary, after administering an epinephrine delivery device   [auto-injector]; and                      (E)  the proper disposal of used or expired   epinephrine delivery devices [auto-injectors]; and                (2)  be completed annually in a formal training session   or through online education.          (k)  Not later than the 10th business day after the date a   day-care center employee administers an epinephrine delivery   device [auto-injector] in accordance with this section, the   day-care center shall report the following information to the   persons listed in Subsection (l):                (1)  the age of the person who received the   administration of the epinephrine delivery device [auto-injector];                (2)  whether the person who received the administration   of the epinephrine delivery device [auto-injector] was:                      (A)  a child enrolled in the day-care center;                      (B)  a day-care center employee or volunteer; or                      (C)  a visitor to the day-care center;                (3)  the physical location where the epinephrine   delivery device [auto-injector] was administered;                (4)  the number of doses of epinephrine delivery device   [auto-injector] administered;                (5)  the title of the employee who administered the   epinephrine delivery device [auto-injector]; and                (6)  any other information required by the executive   commissioner.          (l)  The information required by Subsection (k) shall be   reported to:                (1)  the owner of the day-care center;                (2)  the physician or other person who prescribed the   epinephrine delivery device [auto-injector];                (3)  the commission; and                (4)  the Department of State Health Services.          (n)  A person who in good faith takes, or fails to take,   action relating to the prescription of an epinephrine delivery   device [auto-injector] to a day-care center or the administration   of an epinephrine delivery device [auto-injector] in a day-care   center 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 delivery devices   [auto-injectors];                (2)  supervising or delegating the administration of an   epinephrine delivery device [auto-injector];                (3)  possessing, maintaining, storing, or disposing of   an epinephrine delivery device [auto-injector];                (4)  prescribing an epinephrine delivery device   [auto-injector];                (5)  dispensing an epinephrine delivery device   [auto-injector];                (6)  administering, or assisting in administering, an   epinephrine delivery device [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 section.          (q)  If a day-care center obtains epinephrine delivery   devices [auto-injectors] for use as authorized by this section, the   day-care center shall notify each parent of a child enrolled in the   center of the center's policy and procedures relating to the   administration of the epinephrine delivery devices   [auto-injectors].          SECTION 29.  Section 562.057, Occupations Code, is amended   to read as follows:          Sec. 562.057.  ADMINISTRATION OF EPINEPHRINE. (a) A   pharmacist may administer epinephrine through an epinephrine   delivery [auto-injector] device in accordance with this section.          (b)  The board shall adopt rules designed to protect the   public health and safety to implement this section. The rules must   provide that a pharmacist may administer epinephrine through an   epinephrine delivery [auto-injector] device to a patient in an   emergency situation.          (c)  A pharmacist may maintain, administer, and dispose of   epinephrine delivery [auto-injector] devices only in accordance   with rules adopted by the board under this section.          (d)  A pharmacist who administers epinephrine through an   epinephrine delivery [auto-injector] device to a patient shall   report the use to the patient's primary care physician, as   identified by the patient, if the patient has a primary care   physician.          (e)  A pharmacist who in good faith administers epinephrine   through an epinephrine delivery [auto-injector] device in   accordance with the requirements of this section is not liable for   civil damages for an act performed in the administration unless the   act is wilfully or wantonly negligent. A pharmacist may not receive   remuneration for the administration of epinephrine through an   epinephrine delivery [auto-injector] device but may seek   reimbursement for the cost of the epinephrine delivery   [auto-injector] device.          (f)  The administration of epinephrine through an   epinephrine delivery [auto-injector] device to a patient in   accordance with the requirements of this section does not   constitute the unlawful practice of any health care profession.          (g)  In this section:                (1)  "Epinephrine auto-injector" means a disposable   medical drug delivery device that contains a premeasured single   dose of epinephrine intended for use to treat anaphylaxis.                (2)  "Epinephrine delivery device" means a medical   delivery device approved by the United States Food and Drug   Administration that delivers a dose of epinephrine intended for use   to treat anaphylaxis, including:                      (A)  an epinephrine auto-injector; and                      (B)  an epinephrine nasal spray.          SECTION 30.  Section 1701.701, Occupations Code, is amended   by adding Subdivision (2-a) to read as follows:                (2-a)  "Epinephrine delivery device" means a medical   delivery device approved by the United States Food and Drug   Administration that delivers a dose of epinephrine intended for use   to treat anaphylaxis, including:                      (A)  an epinephrine auto-injector; and                      (B)  an epinephrine nasal spray.          SECTION 31.  Section 1701.702, Occupations Code, is amended   to read as follows:          Sec. 1701.702.  ADMINISTRATION OF EPINEPHRINE. (a) A law   enforcement agency may acquire and possess epinephrine delivery   devices [auto-injectors] and a peace officer may possess and   administer an epinephrine delivery device [auto-injector] in   accordance with this subchapter.          (b)  A peace officer may possess and administer an   epinephrine delivery device [auto-injector] only if the peace   officer has successfully completed training in the use of the   device in a course approved by the commission.          (c)  The commission, in consultation with the Department of   State Health Services, shall approve a training course on the   administration of an epinephrine delivery device [auto-injector].          SECTION 32.  Sections 1701.703(a), (b), (c), (e), and (f),   Occupations Code, are amended to read as follows:          (a)  A physician, or a person who has been delegated   prescriptive authority under Chapter 157, Occupations Code, may   prescribe epinephrine delivery devices [auto-injectors] in the   name of a law enforcement agency.          (b)  A physician or other person who prescribes epinephrine   delivery devices [auto-injectors] under Subsection (a) shall   provide the law enforcement agency with a standing order for the   administration of an epinephrine delivery device [auto-injector]   to a person reasonably believed to be experiencing anaphylaxis.          (c)  A standing order under Subsection (b) is not required to   be patient-specific. An epinephrine delivery device   [auto-injector] may be administered under this subchapter 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 law enforcement agency to which the   order is issued;                (3)  the quantity of epinephrine delivery devices   [auto-injectors] to be obtained and maintained under the order; and                (4)  the date the order was issued.          (f)  A pharmacist may dispense an epinephrine delivery   device [auto-injector] to a law enforcement agency without   requiring the name of or any other identifying information relating   to the user.          SECTION 33.  Section 1701.704, Occupations Code, is amended   to read as follows:          Sec. 1701.704.  MAINTENANCE AND ADMINISTRATION OF   EPINEPHRINE DELIVERY DEVICES [AUTO-INJECTORS]. A law enforcement   agency that acquires and possesses epinephrine delivery devices   [auto-injectors] under this subchapter shall adopt and implement a   policy regarding the maintenance, administration, and disposal of   the epinephrine delivery devices [auto-injectors]. The policy   must:                (1)  establish a process for the agency to check the   inventory of epinephrine delivery devices [auto-injectors] at   regular intervals for expiration and replacement; and                (2)  require that the epinephrine delivery devices   [auto-injectors] be stored in a secure location.          SECTION 34.  Section 1701.705, Occupations Code, is amended   to read as follows:          Sec. 1701.705.  NOTIFICATION OF ADMINISTRATION OF   EPINEPHRINE DELIVERY DEVICE [AUTO-INJECTOR].  After an officer   administers an epinephrine delivery device [auto-injector] under   this subchapter, the law enforcement agency shall notify the   physician or other person who prescribed the epinephrine delivery   device [auto-injector] of:                (1)  the age of the person to whom the epinephrine   delivery device [auto-injector] was administered; and                (2)  the number of epinephrine delivery device   [auto-injector] doses administered to the person.          SECTION 35.  Section 1701.707, Occupations Code, is amended   to read as follows:          Sec. 1701.707.  NOT PRACTICE OF HEALTH CARE. The   administration by a peace officer of an epinephrine delivery device   [auto-injector] to a person in accordance with the requirements of   this subchapter or commission rules does not constitute the   unlawful practice of any health care profession.          SECTION 36.  Section 1701.708(a), Occupations Code, is   amended to read as follows:          (a)  A person who in good faith takes, or fails to take,   action relating to the prescription of an epinephrine delivery   device [auto-injector] to a law enforcement agency or the   administration of an epinephrine delivery device [auto-injector]   by a peace officer 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 delivery devices   [auto-injectors];                (2)  supervising or delegating the administration of an   epinephrine delivery device [auto-injector];                (3)  possessing, maintaining, storing, or disposing of   an epinephrine delivery device [auto-injector];                (4)  prescribing an epinephrine delivery device   [auto-injector];                (5)  dispensing an epinephrine delivery device   [auto-injector];                (6)  administering, or assisting in administering, an   epinephrine delivery device [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.          SECTION 37.  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.