HB 2365 — Establishes provisions relating to allergy prevention and responses in child care facilities

SECOND REGULAR SESSION HOUSE COMMITTEE SUBSTITUTE FOR HOUSE BILL NO.NOS.

23652365, 2490 & 2249 103RD GENERAL ASSEMBLY INTRODUCED5652H.03C BYJOSEPH REPRESENTATIVEENGLER, SCHULTE.Chief Clerk AN ACT To repeal section 196.990, RSMo, and to enact in lieu thereof two new sections relating to allergies in child care facilities.

5652H.01I JOSEPH ENGLER, Chief Clerk AN ACT To repeal section 196.990, RSMo, and to enact in lieu thereof two new sections relating to allergies in child care facilities.

(1) "Administer", the direct application of an epinephrine [auto-injector] delivery devicesystem to the body of an individual;

(3) "Epinephrine [auto-injector] delivery device",system", a single-use device[device] system used for the [automatic injection] delivery of a premeasured dose of epinephrine into the human body;

(5) "Provide", the supply of one or more epinephrine [auto-injectors] delivery devicessystems to an individual;

(6) "Self-administration", a person's discretionary use of an epinephrine [auto- injector] delivery device.system.

A physician may prescribe epinephrine [auto-injectors] delivery devicessystems in the name of an authorized entity for use in accordance with this section, and pharmacists, EXPLANATION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is intended to be omitted from the law.

HBHCS 2365HBs 2365, 2490 & 2249 2 physicians, and other persons authorized to dispense prescription medications may dispense epinephrine [auto-injectors] delivery devicessystems under a prescription issued in the name of an authorized entity.

An authorized entity may acquire and stock a supply of epinephrine [auto- injectors] delivery devicessystems under a prescription issued in accordance with this section.

Such epinephrine [auto-injectors] delivery devicessystems shall be stored in a location readily accessible in an emergency and in accordance with the epinephrine [auto-injector's] delivery device'ssystem's instructions for use and any additional requirements established by the department of health and senior services by rule.

An authorized entity shall designate employees or agents who have completed the training required under this section to be responsible for the storage, maintenance, and general oversight of epinephrine [auto-injectors] delivery devicessystems acquired by the authorized entity.

An authorized entity that acquires a supply of epinephrine [auto-injectors] delivery devicessystems under a prescription issued in accordance with this section shall ensure that:

(1) Expected epinephrine [auto-injector] delivery devicesystem users receive training in recognizing symptoms of severe allergic reactions including anaphylaxis and the use of epinephrine [auto-injectors] delivery devicessystems from a nationally recognized organization experienced in training laypersons in emergency health treatment or another entity or person approved by the department of health and senior services;

(2) All epinephrine [auto-injectors] delivery devicessystems are maintained and stored according to the epinephrine [auto-injector's] delivery device'ssystem's instructions for use;

(3) Any person who provides or administers an epinephrine [auto-injector] delivery devicesystem to an individual who the person believes in good faith is experiencing anaphylaxis activates the emergency medical services system as soon as possible;

and (4) A proper review of all situations in which an epinephrine [auto-injector] delivery devicesystem is used to render emergency care is conducted.

Any authorized entity that acquires a supply of epinephrine [auto-injectors] delivery devicessystems under a prescription issued in accordance with this section shall notify the emergency communications district or the ambulance dispatch center of the primary provider of emergency medical services where the epinephrine [auto-injectors] delivery devicessystems are to be located within the entity's facility.

No person shall provide or administer an epinephrine [auto-injector] delivery devicesystem to any individual who is under eighteen years of age without the verbal consent of a parent or guardian who is present at the time when provision or administration of the epinephrine [auto-injector] delivery devicesystem is needed.

Provided, however, that a person may provide or administer an epinephrine [auto-injector] delivery devicesystem to such an individual without the consent of a parent or guardian if the parent or guardian is not physically present HBHCS 2365HBs 2365, 2490 & 2249 3 and the person reasonably believes the individual shall be in imminent danger without the provision or administration of the epinephrine [auto-injector] delivery device.system.

The following persons and entities shall not be liable for any injuries or related damages that result from the administration or self-administration of an epinephrine [auto- injector] delivery devicesystem in accordance with this section that may constitute ordinary negligence:

(1) An authorized entity that possesses and makes available epinephrine [auto- injectors] delivery devicessystems and its employees, agents, and other trained persons;

(2) Any person who uses an epinephrine [auto-injector] delivery devicesystem made available under this section;

(3) A physician that prescribes epinephrine [auto-injectors] delivery devicessystems to an authorized entity;

The administration of an epinephrine [auto- injector] delivery devicesystem in accordance with this section shall not be considered the practice of medicine.

An authorized entity located in this state shall not be liable for any injuries or related damages that result from the provision or administration of an epinephrine [auto-injector] delivery devicesystem by its employees or agents outside of this state if the entity or its employee or agent is not liable for such injuries or related damages under the laws of the state in which such provision or administration occurred.

No trained person who is in compliance with this section and who in good faith and exercising reasonable care fails to administer an epinephrine [auto-injector] delivery devicesystem shall be liable for such failure.

All basic life support ambulances and stretcher vans operated in the state shall be equipped with epinephrine [auto-injectors] delivery devicessystems and be staffed by at least one individual trained in the use of epinephrine [auto-injectors] delivery devices.systems.

(1) Before July 1, 2028, each licensed child care provider shall adopt a policy on allergy prevention and response with priority given to addressing potentially deadly HBHCS 2365HBs 2365, 2490 & 2249 4 food-borne allergies.