HB 2428 — Studying students' life-threatening allergic reactions.

H-4396.2SUBSTITUTEH-3388.1HOUSE HOUSE BILL 2428State of Washington66th Legislature2020 Regular SessionByHouseSessionByRepresentatives Education (originally sponsored by Representatives Duerr, Walen, Springer, Santos, Ramel, Shewmake, Doglio, Kilduff, Paul, and Pollet)READPolletRead FIRSTfirst TIMEtime 02/05/20.AN01/14/20.Referred to Committee on Education.AN ACT Relating to students' life-threatening allergic reactions;

creatingadding a new section;section to chapter 28A.630 RCW;

(1)(a)A Bynew Decembersection 1,is 2020,added andto inchapter compliance28A.630 with RCW 43.01.036, the office of the superintendent of public instruction and the department of health must collaborate to submitread toas thefollows:(1)(a) appropriateThe committeesEpiPen ofwork thegroup legislatureis aestablished report of findings related to statewidemake implementationrecommendations ofon RCWimproving 28A.210.383, authorizing prescriptions for, and use of, school supplies of epinephrine autoinjectors.(b) In preparing the report,prevention the office of the superintendent of public instruction and the department of health must:(i) Analyze information about the schools that maintain a supply of epinephrine autoinjectors under RCW 28A.210.383;(ii) Examine the barriers and challenges licensed health professionals with the authority to prescribe epinephrine autoinjectors experience in prescribing this medication under a standing order;(iii) Review whether and to what extent the requirement under RCW 28A.210.320 that a student with a life-threatening allergic reaction present a medication or treatment order addressing the medical services that may be required to be performed at the school reduces the need for and use of a school supply of epinephrine autoinjectors;(iv) Determine the number of unused epinephrine autoinjectors discarded by schools, and returned to students' families, at the end of the 2020-21 school year;(v) Complete an inventory of the number and categories of school district staff provided with training on identifying and responding to life-threatening allergiesallergic betweenreactions Septemberin 1,schools 2017,serving andkindergarten Septemberthrough 1,twelfth 2020;grade students.

and(vi)One Investigategoal any other implementation issues raised by school nurses, students who have life-threatening allergic reactions, and students' families during meetings held by the office of the superintendentwork ofgroup publicis instructionto forrecommend thepolicies purposethat ofwill solicitingreduce feedback on these issues.(2) When collecting and analyzing information as required under subsection (1) of this section, the officewaste of theepinephrine superintendentautoinjectors of public instruction and the departmentcosts of healthpurchasing mustthis collectmedication informationfor fromschools multiple sources, and disaggregatestudents' informationfamilies. during analysis, such that information can be separated by school geography, student enrollment, school socioeconomic status, and other student demographics.(3) This section expires August 31, 2021.--- END ---

Another goal of the work group is to analyze data collected by the office of the superintendent of public instruction in order to make data-informed decisions.(b) The office of the superintendent of public instruction must convene and staff the work group, and must consult the department of health and the health care authority as applicable.(2)(a) The work group must consist of the following members:(i) A school board director recommended by the Washington state school directors' association;(ii) A school superintendent recommended by a Washington association of school administrators;(iii) A school principal recommended by a Washington association of school principals;(iv) A school nurse who works full time at one or two schools recommended by a Washington association of school nurses;(v) A school nurse who is part of the school nurse corps program recommended by a Washington association of school nurses;(vi) A school employee who has agreed to the use of epinephrine autoinjectors as a specific part of their job description recommended by a Washington association of school employees;(vii) A representative of the nursing care quality assurance commission with expertise in standards of nursing practice and the principals of delegation in a school setting recommended by the commission;(viii) A parent of a student with a life-threatening allergy recommended by a nonprofit organization representing people with asthma and allergies for over fifty years;(ix) A student with a life-threatening allergy recommended by a Washington association of parents, teachers, and students;(x) A school health services expert selected by the superintendent of public instruction;(xi) A pediatric physician certified by the American board of allergy and immunology recommended by a Washington association of physicians;(xii) A pharmacist with experience dispensing epinephrine autoinjectors to schools under a standing order recommended by a Washington association of pharmacists;

and(xiii) An attorney with experience representing school districts recommended by a Washington association of school attorneys.(b) To the extent possible, the members of the work group must be racially and ethnically diverse and must represent urban, suburban, and rural locations across the state.(c) The work group must elect cochairs from the members described in this subsection (2), one from the education sector and the other from the health sector.(3) The office of the superintendent of public instruction must survey public schools to collect the following data for the 2020-21 school year:(a) For students with life-threatening allergic reactions, the number of medication orders, individual health care plans, and emergency care plans;

and whether a prescription for an epinephrine autoinjector is on file;(b) The approximate number of epinephrine autoinjectors maintained by schools disaggregated by source;(c) The number of epinephrine autoinjectors administered to and by students, disaggregated by:

(i) The source of the medication;

(ii) the category of person who administered the medication;

(iii) whether the student does or does not have a prescription for an epinephrine autoinjector on file;

and (iv) the location of medication administration;(d) The number and types of school personnel designated and trained to administer epinephrine autoinjectors as described in RCW 28A.210.383;

and(e) The number of letters of refusal to use epinephrine autoinjectors filed compared to the total number of school employees.(4) At a minimum, the work group must:(a) Analyze the survey data collected as required under subsection (3) of this section;(b) Review federal and state laws and state guidelines related to nursing care, children with life-threatening conditions, students with asthma and anaphylaxis, epinephrine autoinjectors in schools, and other relevant laws and guidelines;(c) Discuss topics for which recommendations are required under subsection (5) of this section.(5) By December 15, 2021, and in compliance with RCW 43.01.036, the office of the superintendent of public instruction must report to the appropriate committees of the legislature with a summary of the survey results, the work group's activities, and the work group's recommendations for state agencies and the legislature to improve the prevention and treatment of students' life-threatening allergic reactions in schools serving kindergarten through twelfth grade students.

If members of the work group do not agree with the content of the majority report, there may be a minority report included as an addendum to the majority report.

At a minimum, the work group must make recommendations on the following topics:(a) Required periodic data collection and analysis related to students' life-threatening allergic reactions, such as the data described in subsection (3) of this section;(b) Whether selling epinephrine autoinjectors singly would reduce epinephrine autoinjector waste without compromising student health and safety;(c) Whether the families of students with life-threatening allergic reactions should be required to provide epinephrine autoinjectors to a school that maintains a school stock of epinephrine autoinjectors and, if not, the minimum number of epinephrine autoinjectors per student that a school should maintain as school stock;(d) Whether to allow or require the administration of over-the-counter allergy medication to treat students' symptoms of allergic reactions, and under what circumstances;(e) Other ways to reduce the waste of epinephrine autoinjectors and the costs of purchasing this medication for schools and students' families, while maintaining students' safety and without increasing schools' liability;

and(f) Whether to allow designated trained school employees to administer epinephrine autoinjectors to students without prescriptions for epinephrine autoinjectors who are demonstrating the symptoms of anaphylaxis when a school nurse is not in the vicinity and, if so, policies and procedures to do this safely.(6) This section expires June 30, 2022.--- END ---