House File 2044 - Introduced




                                 HOUSE FILE       
                                 BY  KAUFMANN

                                      A BILL FOR

  1 An Act relating to the maintenance and administration of
  2    epinephrine in schools and certain service providers
  3    regulated by the department of human services.
  4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
    TLSB 5147YH (3) 85
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PAG LIN



  1  1    Section 1.  NEW SECTION.  217.37  Epinephrine auto=injector
  1  2 supply.
  1  3    1.  For purposes of this section, unless the context
  1  4 otherwise requires:
  1  5    a.  "Epinephrine auto=injector" means the same as provided
  1  6 in section 280.16.
  1  7    b.  "Personnel authorized to administer epinephrine" means an
  1  8 employee of a provider trained and authorized to administer an
  1  9 epinephrine auto=injector.
  1 10    c.  "Physician" means the same as provided in section 280.16.
  1 11    d.  "Provider" means a person who is a service provider who
  1 12 is registered, approved, licensed, or regulated in accordance
  1 13 with rules adopted by the department of human services or who
  1 14 is reimbursed in whole or in part with funding administered by
  1 15 the department. "Provider" includes but is not limited to a
  1 16 child care provider, a family or group foster care provider,
  1 17 a shelter care provider, a hospital, a mental health or
  1 18 substance=related disorder service provider, an institutional
  1 19 or home and community=based services waiver provider or other
  1 20 health care provider that receives Medicaid funding, a regional
  1 21 mental health and disability service system, or a state
  1 22 institution administered by the department.
  1 23    2.  Notwithstanding any other provision of law to the
  1 24 contrary, a physician may prescribe epinephrine auto=injectors
  1 25 in the name of a provider to be maintained for use as provided
  1 26 in this section.
  1 27    3.  A provider may obtain a prescription for epinephrine
  1 28 auto=injectors and maintain a supply of such auto=injectors
  1 29 in a secure location at each location where an individual
  1 30 receives, treatment, care, or supervision from the provider
  1 31 for use as provided in this section. A provider who obtains
  1 32 such a prescription shall replace epinephrine auto=injectors
  1 33 in the supply upon use or expiration. Personnel authorized to
  1 34 administer epinephrine may possess and administer epinephrine
  1 35 auto=injectors from the supply as provided in this section.
  2  1    4.  Personnel authorized to administer epinephrine may
  2  2 provide or administer an epinephrine auto=injector from the
  2  3 provider's supply to an individual under the treatment, care,
  2  4 or supervision of the provider if such personnel reasonably and
  2  5 in good faith believe the individual is having an anaphylactic
  2  6 reaction.
  2  7    5.  Any personnel authorized to administer epinephrine
  2  8 who provide, administer, or assist in the administration
  2  9 of an epinephrine auto=injector to an individual receiving
  2 10 treatment, care, or supervision from the provider who such
  2 11 personnel reasonably and in good faith believe to be having an
  2 12 anaphylactic reaction; a provider employing the personnel; the
  2 13 owner or operator of the provider; or the prescriber of the
  2 14 epinephrine auto=injector, shall incur no liability, except for
  2 15 gross negligence, as a result of any injury arising from the
  2 16 provision, administration, or assistance in the administration
  2 17 of an epinephrine auto=injector as provided in this section.
  2 18    6.  The department of human services, the board of medicine,
  2 19 and the board of pharmacy shall adopt rules to implement and
  2 20 administer this section, including but not limited to standards
  2 21 and procedures for the prescription, distribution, storage,
  2 22 replacement, and administration of epinephrine auto=injectors,
  2 23 and for training and authorization to be required for personnel
  2 24 authorized to administer epinephrine.
  2 25    Sec. 2.  Section 280.16, Code 2014, is amended to read as
  2 26 follows:
  2 27    280.16  Self=administration of asthma or other airway
  2 28 constricting disease medication certain medications.
  2 29    1.  Definitions.  For purposes of this section:
  2 30    a.  "Epinephrine auto=injector" means a medical device for
  2 31 immediate self=administration of a measured dose of epinephrine
  2 32 by a person at risk of anaphylaxis.
  2 33    a.  b.  "Medication" means a drug that meets the definition
  2 34 provided in section 126.2, subsection 8, has an individual
  2 35 prescription label, is prescribed by a physician for a
  3  1 student, and pertains to the student's asthma or other airway
  3  2 constricting disease.
  3  3    b.  c.  "Physician" means a person licensed under chapter
  3  4 148, or a physician's assistant, advanced registered nurse
  3  5 practitioner, or other person licensed or registered to
  3  6 distribute or dispense a prescription drug or device in the
  3  7 course of professional practice in this state in accordance
  3  8 with section 147.107, or a person licensed by another state
  3  9 in a health field in which, under Iowa law, licensees in this
  3 10 state may legally prescribe drugs.
  3 11    c.  d.  "Self=administration" means a student's discretionary
  3 12 use of medication prescribed by a physician for the student.
  3 13    2.  The board of directors of a school district and the
  3 14 authorities in charge of an accredited nonpublic school shall
  3 15 permit the self=administration of medication by a student
  3 16 with asthma or other airway constricting disease or the use
  3 17 of an epinephrine auto=injector by a student if the following
  3 18 conditions are met:
  3 19    a.  The student's parent or guardian provides to the school
  3 20 written authorization for the self=administration of medication
  3 21 or for the use of an epinephrine auto=injector.
  3 22    b.  The student's parent or guardian provides to the school
  3 23 a written statement from the student's physician containing the
  3 24 following information:
  3 25    (1)  The name and purpose of the medication or epinephrine
  3 26 auto=injector.
  3 27    (2)  The prescribed dosage.
  3 28    (3)  The times at which or the special circumstances under
  3 29 which the medication or epinephrine auto=injector is to be
  3 30 administered.
  3 31    c.  The parent or guardian and the school meet the
  3 32 requirements of subsection 3.
  3 33    3.  The school district or accredited nonpublic school
  3 34 shall notify the parent or guardian of the student, in
  3 35 writing, that the school district or accredited nonpublic
  4  1 school and its employees are to incur no liability, except
  4  2 for gross negligence, as a result of any injury arising from
  4  3 self=administration of medication or use of an epinephrine
  4  4 auto=injector by the student. The parent or guardian of the
  4  5 student shall sign a statement acknowledging that the school
  4  6 district or nonpublic school is to incur no liability, except
  4  7 for gross negligence, as a result of self=administration of
  4  8 medication or use of an epinephrine auto=injector by the
  4  9 student. A school district or accredited nonpublic school
  4 10 and its employees acting reasonably and in good faith shall
  4 11 incur no liability for any improper use of medication or an
  4 12 epinephrine auto=injector as defined in this section or for
  4 13 supervising, monitoring, or interfering with a student's
  4 14 self=administration of medication or use of an epinephrine
  4 15 auto=injector as defined in this section.
  4 16    4.  The permission for self=administration of medication
  4 17 or use of an epinephrine auto=injector is effective for the
  4 18 school year for which it is granted and shall be renewed each
  4 19 subsequent school year upon fulfillment of the requirements
  4 20 of this section. However, the parent or guardian shall
  4 21 immediately notify the school of any changes in the conditions
  4 22 listed under subsection 2.
  4 23    5.  Provided that the requirements of this section are
  4 24 fulfilled, a student with asthma or other airway constricting
  4 25 disease may possess and use the student's medication and a
  4 26 student with a written statement from a physician on file
  4 27 pursuant to subsection 2, paragraph "a" may use an epinephrine
  4 28 auto=injector while in school, at school=sponsored activities,
  4 29 under the supervision of school personnel, and before or after
  4 30 normal school activities, such as while in before=school or
  4 31 after=school care on school=operated property. If the student
  4 32 misuses this privilege, the privilege may be withdrawn.  A
  4 33 school district or nonpublic school shall notify a student's
  4 34 parent or guardian before withdrawing the privilege to use an
  4 35 epinephrine auto=injector.
  5  1    6.  Information provided to the school under subsection 2
  5  2 shall be kept on file in the office of the school nurse or, in
  5  3 the absence of a school nurse, the school's administrator.
  5  4    7.  The Iowa braille and sight saving school, the state
  5  5 school for the deaf, and the institutions under the control of
  5  6 the department of human services as provided in section 218.1
  5  7 are exempt from the provisions of this section.
  5  8    Sec. 3.  NEW SECTION.  280.16A  Epinephrine auto=injector
  5  9 supply.
  5 10    1.  For purposes of this section, unless the context
  5 11 otherwise requires:
  5 12    a.  "Epinephrine auto=injector" means the same as provided
  5 13 in section 280.16.
  5 14    b.  "Personnel authorized to administer epinephrine" means a
  5 15 school nurse or other employee of a school district trained and
  5 16 authorized to administer an epinephrine auto=injector.
  5 17    c.  "Physician" means the same as provided in section 280.16.
  5 18    2.  Notwithstanding any other provision of law to the
  5 19 contrary, a physician may prescribe epinephrine auto=injectors
  5 20 in the name of a school district to be maintained for use as
  5 21 provided in this section.
  5 22    3.  The board of directors in charge of each school district
  5 23 shall obtain a prescription for epinephrine auto=injectors and
  5 24 maintain a supply of such auto=injectors in a secure location
  5 25 at each school for use as provided in this section. The board
  5 26 shall replace epinephrine auto=injectors in the supply upon use
  5 27 or expiration. Personnel authorized to administer epinephrine
  5 28 may possess and administer epinephrine auto=injectors from the
  5 29 supply as provided in this section.
  5 30    4.  Personnel authorized to administer epinephrine may
  5 31 provide or administer an epinephrine auto=injector from
  5 32 the school district's supply to a student if such personnel
  5 33 reasonably and in good faith believe the student is having an
  5 34 anaphylactic reaction.
  5 35    5.  Any personnel authorized to administer epinephrine
  6  1 who provide, administer, or assist in the administration
  6  2 of an epinephrine auto=injector to a student who such
  6  3 personnel reasonably and in good faith believe to be having
  6  4 an anaphylactic reaction; a school district employing the
  6  5 personnel; the board of directors in charge of the school
  6  6 district; or the prescriber of the epinephrine auto=injector,
  6  7 shall incur no liability, except for gross negligence,
  6  8 as a result of any injury arising from the provision,
  6  9 administration, or assistance in the administration of an
  6 10 epinephrine auto=injector as provided in this section.
  6 11    6.  The department of education, the board of medicine,
  6 12 and the board of pharmacy shall adopt rules to implement and
  6 13 administer this section, including but not limited to standards
  6 14 and procedures for the prescription, distribution, storage,
  6 15 replacement, and administration of epinephrine auto=injectors,
  6 16 and for training and authorization to be required for personnel
  6 17 authorized to administer epinephrine.
  6 18    Sec. 4.  POLICIES ON ANAPHYLAXIS IN A SCHOOL SETTING.  The
  6 19 department of education shall develop, in collaboration
  6 20 with the board of medicine and education and health care
  6 21 stakeholders, policies for the recognition and treatment
  6 22 of anaphylaxis in a school setting. The director of the
  6 23 department shall submit a report to the general assembly by
  6 24 January 1, 2015, recommending any legislation necessary to
  6 25 improve recognition and treatment of anaphylaxis in a school
  6 26 setting.
  6 27    Sec. 5.  IMPLEMENTATION OF ACT.  Section 25B.2, subsection
  6 28 3, shall not apply to this Act.
  6 29                           EXPLANATION
  6 30 The inclusion of this explanation does not constitute agreement with
  6 31 the explanation's substance by the members of the general assembly.
  6 32    This bill requires the board of directors in charge of each
  6 33 school district to maintain in a secure location at each school
  6 34 a supply of epinephrine auto=injectors for use as provided in
  6 35 the bill. The bill requires the board to replace epinephrine
  7  1 auto=injectors in the supply upon use or expiration. The bill
  7  2 requires the board to obtain a prescription for epinephrine
  7  3 auto=injectors for use as provided in the bill. The bill
  7  4 permits personnel authorized to administer epinephrine to
  7  5 possess and administer epinephrine auto=injectors from the
  7  6 supply as provided in the bill. The bill permits a physician
  7  7 to prescribe epinephrine auto=injectors in the name of a school
  7  8 district to be maintained for use as provided in the bill,
  7  9 notwithstanding any other provision of law to the contrary.
  7 10    The bill permits personnel authorized to administer
  7 11 epinephrine to provide or administer an epinephrine
  7 12 auto=injector from a school district's supply to a student if
  7 13 such personnel reasonably and in good faith believe the student
  7 14 is having an anaphylactic reaction.
  7 15    The bill provides immunity from legal liability, except for
  7 16 gross negligence, to any personnel authorized to administer
  7 17 epinephrine who provide, administer, or assist in the
  7 18 administration of an epinephrine auto=injector to a student
  7 19 who such personnel reasonably and in good faith believe to be
  7 20 having an anaphylactic reaction; a school district employing
  7 21 the personnel; the board of directors in charge of the school
  7 22 district; or the prescriber of the epinephrine auto=injector,
  7 23 for any injury arising from the provision, administration,
  7 24 or assistance in the administration of an epinephrine
  7 25 auto=injector as provided in the bill.
  7 26    The bill defines "epinephrine auto=injector" as a medical
  7 27 device for immediate self=administration of a measured dose
  7 28 of epinephrine by a person at risk of anaphylaxis. The bill
  7 29 defines "personnel authorized to administer epinephrine" as an
  7 30 employee trained and authorized to administer an epinephrine
  7 31 auto=injector.
  7 32    The bill permits a person who is a service provider who is
  7 33 registered, approved, licensed, or regulated in accordance
  7 34 with rules adopted by the department of human services or who
  7 35 is reimbursed in whole or in part with funding administered
  8  1 by the department to maintain a supply of epinephrine
  8  2 auto=injectors in the same fashion, with the same duties,
  8  3 powers, and immunities relating to maintaining a supply of
  8  4 epinephrine auto=injectors and administering the auto=injectors
  8  5 applying if the provider chooses to do so.  The bill specifies
  8  6 that "provider" includes but is not limited to a child care
  8  7 provider, a family or group foster care provider, a shelter
  8  8 care provider, a hospital, a mental health or substance=related
  8  9 disorder service provider, an institutional or home and
  8 10 community=based services waiver provider or other health care
  8 11 provider that receives Medicaid funding, a regional mental
  8 12 health and disability service system, or a state institution
  8 13 administered by the department.
  8 14    The bill requires the department of education, the
  8 15 department of human services, the board of medicine, and the
  8 16 board of pharmacy to adopt rules to implement and administer
  8 17 the bill, including but not limited to standards and procedures
  8 18 for the prescription, distribution, storage, replacement, and
  8 19 administration of epinephrine auto=injectors, and for training
  8 20 and authorization to be required for personnel authorized to
  8 21 administer epinephrine auto=injectors.
  8 22    The bill also adds epinephrine auto=injectors to Code
  8 23 section 280.16, which permits self=administration of medication
  8 24 in public and nonpublic schools by students with asthma.
  8 25    The bill requires school districts and nonpublic schools
  8 26 to  allow the use of an epinephrine auto=injector by a student
  8 27 with a written statement from a physician on file if the school
  8 28 receives written authorization and certain medical information
  8 29 from the student's parent or guardian.
  8 30    The bill permits a student with a written statement
  8 31 from a physician on file to possess and use an epinephrine
  8 32 auto=injector while in school, at school=sponsored activities,
  8 33 under the supervision of school personnel, and before or after
  8 34 normal school activities, such as while in before=school or
  8 35 after=school care on school=operated property. The bill
  9  1 requires a school district or nonpublic school to notify a
  9  2 student's parent or guardian before withdrawing the privilege
  9  3 to use an epinephrine auto=injector.
  9  4    The bill adds epinephrine auto=injectors to the provisions
  9  5 of Code section 280.16 granting immunity from legal liability
  9  6 to school employees, except for gross negligence, for injuries
  9  7 resulting from the self=administration of medication. Code
  9  8 section 280.16 requires a student's parent or guardian to
  9  9 receive notice of such immunity.
  9 10    The bill requires the director of the department of
  9 11 education to develop, in collaboration with the board of
  9 12 medicine and education and health care stakeholders, policies
  9 13 for the recognition and treatment of anaphylaxis in a school
  9 14 setting. The bill requires the director to submit a report
  9 15 to the general assembly by January 1, 2015, recommending any
  9 16 legislation necessary to improve recognition and treatment of
  9 17 anaphylaxis in a school setting.
  9 18    The bill may include a state mandate as defined in Code
  9 19 section 25B.3.  The bill makes inapplicable Code section 25B.2,
  9 20 subsection 3, which would relieve a political subdivision from
  9 21 complying with a state mandate if funding for the cost of
  9 22 the state mandate is not provided or specified.  Therefore,
  9 23 political subdivisions are required to comply with any state
  9 24 mandate included in the bill.
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