H 209 — An act relating to intranasal epinephrine in schools

BILL AS PASSED BY THE HOUSE H.209 Page 1 of 511 H.209 AnIntroduced act relating to intranasal epinephrine in schools It is hereby enacted by theRepresentative GeneralGoldman Assembly of theRockingham StateReferred ofto Vermont:Committee on Date:

Subject:

Health;

education;

intranasal epinephrine;

prescribing and dispensing authority;

schools Statement of purpose of bill as introduced:

This bill proposes to allow a health care professional to prescribe and issue standing orders for the use of intranasal epinephrine in schools.

It proposes to allow a school to maintain a stock supply of intranasal epinephrine.

The bill further proposes to allow a school administrator to authorize school nurses or other designated personnel to administer or have a student self-administer intranasal epinephrine in accordance with a student’s plan of action for managing the student’s life- threatening allergy.

An act relating to intranasal epinephrine in schools It is hereby enacted by the General Assembly of the State of Vermont:

§§ 1388 1388 is amended to read:

STOCK SUPPLY AND EMERGENCY ADMINISTRATION OF EPINEPHRINE AUTO-INJECTORS BILL AS PASSED BY THE HOUSE H.209 Page 2 of 11 (a) As used in this section:

(1) “Designated personnel” means a school employee, agent, or volunteer who has been authorized by the school administrator to provide and administer epinephrine auto-injectors and intranasal epinephrine under this section and who has completed the training required by State Board policy.

(2) “Epinephrine auto-injector” means a single-use device that delivers a premeasured dose of epinephrine.

(3) “Health care professional” means a physician licensed pursuant to 26 V.S.A.

chapter 23 or 33, an advanced practice registered nurse licensed to prescribe drugs and medical devices pursuant to 26 V.S.A.

chapter 28, or a physician assistant licensed to prescribe drugs and medical devices pursuant to 26 V.S.A.

chapter 31.

(4) “Intranasal epinephrine” means a nasal spray delivering a dose a epinephrine.

(5) “School” means a public or approved independent school and extends to school grounds, school-sponsored activities, school-provided transportation, and school-related programs.

(5)(6) “School administrator” means a school’s principal or headmaster.

(b)(1) A health care professional may prescribe an epinephrine auto- injector or intranasal epinephrine, or both, in a school’s name, which may be maintained by the school for use as described in subsection (d) of this section.

BILL AS PASSED BY THE HOUSE H.209 Page 3 of 11 The health care professional shall issue to the school a standing order for the use of an epinephrine auto-injector prescribed under this section, including protocols for:

(A) assessing whether an individual is experiencing a potentially life- threatening allergic reaction;

(B) administering an epinephrine auto-injector and intranasal epinephrine to an individual experiencing a potentially life-threatening allergic reaction;

(C) caring for an individual after administering an epinephrine auto- injector to him or her or intranasal epinephrine, including contacting emergency services personnel and documenting the incident;

and (D) disposing of used or expired epinephrine auto-injectors and intranasal epinephrine.

(2) A pharmacist licensed pursuant to 26 V.S.A.

chapter 36 or a health care professional may dispense prescribed epinephrine auto-injectors prescribed or intranasal epinephrine, or both, to a school.

(c) A school may maintain a stock supply of epinephrine auto-injectors or intranasal epinephrine, or both.

A school may enter into arrangements with epinephrine auto-injector manufacturers or suppliers of epinephrine auto- injectors or intranasal epinephrine, or both, to acquire epinephrine auto- injectors these products for free or at reduced or fair market prices.

BILL AS PASSED BY THE HOUSE H.209 Page 4 of 11 (d) The school administrator may authorize a school nurse or designated personnel, or both, to:

(1) provide an epinephrine auto-injector or intranasal epinephrine to a student for self-administration according to a plan of action for managing the student’s life-threatening allergy maintained in the student’s school health records pursuant to section 1387 of this title;

(2) administer a prescribed epinephrine auto-injector or intranasal epinephrine to a student according to a plan of action maintained in the student’s school health records;

and (3) administer an epinephrine auto-injector or intranasal epinephrine, in accordance with the protocol issued under subsection (b) of this section, to a student or other individual at a school if the nurse or designated personnel believe in good faith that the student or individual is experiencing anaphylaxis, regardless of whether the student or individual has a prescription for an epinephrine auto-injector or intranasal epinephrine.

(e) Designated personnel, a school, and a health care professional prescribing an epinephrine auto-injector or intranasal epinephrine, or both, to a school shall be immune from any civil or criminal liability arising from the administration or self-administration of an epinephrine auto-injector or intranasal epinephrine under this section, unless the person’s conduct constituted intentional misconduct.

Providing or administering an epinephrine BILL AS PASSED BY THE HOUSE H.209 Page 5 of 11 auto-injector or intranasal epinephrine under this section does not constitute the practice of medicine.

(f) On or before January 1, 2014, the The State Board, in consultation with the Department of Health, shall adopt policies for managing students with life- threatening allergies and other individuals with life-threatening allergies who may be present at a school.

The policies shall: