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.