Bill Text: NH SB25 | 2016 | Regular Session | Amended
Bill Title: Relative to the administration of epinephrine.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Passed) 2016-05-04 - Signed by the Governor on 05/03/2016; Chapter 0039; Effective 07/02/2016 [SB25 Detail]
Download: New_Hampshire-2016-SB25-Amended.html
SB 25-FN - AS AMENDED BY THE SENATE
01/06/2016 2411s
2015 SESSION
15-0621
04/09
SENATE BILL 25-FN
AN ACT relative to the administration of epinephrine.
SPONSORS: Sen. D'Allesandro, Dist 20
COMMITTEE: Education
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AMENDED ANALYSIS
This bill establishes procedures for the administration of epinephrine by certain authorized entities. The bill also provides immunity to school personnel relating to a pupil's administration of epinephrine and requires that designated school personnel participate in an anaphylaxis training program.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
15-0621
01/06/2016 2411s 04/09
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Fifteen
AN ACT relative to the administration of epinephrine.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Subdivision; Administration of Epinephrine. Amend RSA 126-A by inserting after section 68 the following new subdivision:
Administration of Epinephrine
126-A:69 Definitions.
I. “Administer” means the direct application of an epinephrine auto-injector to the body of an individual.
II. “Authorized entity” means any entity or organization in which allergens capable of causing anaphylaxis may be present, including recreation camps and day care facilities. Authorized entity shall not include an elementary or secondary school or a postsecondary educational institution eligible to establish policies and guidelines for the emergency administration of epinephrine under RSA 200-N.
III. “Epinephrine auto-injector” means a single-use device used for the automatic injection of a premeasured dose of epinephrine into the human body.
IV. “Health care practitioner” means a person who is lawfully entitled to prescribe, administer, dispense, or distribute controlled drugs.
V. “Provide” means to furnish one or more epinephrine auto-injectors to an individual.
126-A:70 Administration of Epinephrine.
I. A health care practitioner may prescribe epinephrine auto-injectors in the name of an authorized entity for use in accordance with this subdivision, and pharmacists and health care practitioners may dispense epinephrine auto-injectors pursuant to a prescription issued in the name of an authorized entity.
II. An authorized entity may acquire and maintain a supply of epinephrine auto-injectors pursuant to a prescription issued in accordance with this subdivision. Such epinephrine auto-injectors shall be stored in a location readily accessible in an emergency and in accordance with the instructions for use, and any additional requirements that may be established by the department of health and human services. An authorized entity shall designate employees or agents who have completed the training required by paragraph IV to be responsible for the storage, maintenance, control, and general oversight of epinephrine auto-injectors acquired by the authorized entity.
III. An employee or agent of an authorized entity, or other individual, who has completed the training required by paragraph IV may use epinephrine auto-injectors prescribed pursuant to this section to:
(a) Provide an epinephrine auto-injector to any individual who the employee agent or other individual believes in good faith is experiencing anaphylaxis, or the parent, guardian, or caregiver of such individual, for immediate administration, regardless of whether the individual has a prescription for an epinephrine auto-injector or has previously been diagnosed with an allergy.
(b) Administer an epinephrine auto-injector to any individual who the employee, agent, or other individual believes in good faith is experiencing anaphylaxis, regardless of whether the individual has a prescription for an epinephrine auto-injector or has previously been diagnosed with an allergy.
IV.(a) An employee, agent, or other individual described in paragraph III shall complete an anaphylaxis training program at least every 2 years, following completion of the initial anaphylaxis training program. Such training shall be conducted by a nationally-recognized organization experienced in training unlicensed persons in emergency health care treatment or an entity or individual approved by the department of health and human services. Training may be conducted online or in person and, at a minimum, shall cover:
(1) How to recognize signs and symptoms of severe allergic reactions, including anaphylaxis;
(2) Standards and procedures for the storage and administration of an epinephrine auto-injector; and
(3) Emergency follow-up procedures.
(b) The entity or individual that conducts the training shall issue a certificate, on a form developed or approved by the department of health and human services, to each person who successfully completes the anaphylaxis training program.
V. No authorized entity that possesses and makes available epinephrine auto-injectors and its employees, agents, and other individuals, or health care practitioner that prescribes or dispenses epinephrine auto-injectors to an authorized entity, or pharmacist or health care practitioner that dispenses epinephrine auto-injectors to an authorized entity, or individual or entity that conducts the training described in paragraph IV, shall be liable for any injuries or related damages that result from any act or omission pursuant to this section, unless such injury or damage is the result of willful or wanton misconduct. The administration of an epinephrine auto-injector in accordance with this section shall not be considered to be the practice of medicine or any other profession that otherwise requires licensure. This section shall not be construed to eliminate, limit, or reduce any other immunity or defense that may be available under state law. An 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 outside of this state if the entity would not have been liable for such injuries or related damages had the provision or administration occurred within this state, or is not liable for such injuries or related damages under the law of the state in which such provision or administration occurred.
VI. An authorized entity that possesses and makes available epinephrine auto-injectors shall submit to the department of health and human services, on a form developed by the department of health and human services, a report of each incident on the authorized entity’s premises that involves the administration of an epinephrine auto injector pursuant to paragraph III. The department of health and human services shall annually publish a report on the department’s website that summarizes and analyzes all reports submitted to it under this section.
2 New Section; Pupil Use of Epinephrine Auto-Injectors; Training. Amend RSA 200 by inserting after section 44 the following new section:
200:44-a Anaphylaxis Training Required.
I.(a) Designated assistive personnel shall complete an anaphylaxis training program prior to providing or administering an epinephrine auto-injector at least every 2 years following completion of the initial anaphylaxis training program. Such training shall be conducted based on resources provided by the National Association of School Nurses, the Food and Allergy Anaphylaxis Network, or the New Hampshire School Nurses Association. Training shall be conducted online or in person and, at a minimum, shall cover:
(1) Techniques on how to recognize symptoms of severe allergic reactions, including anaphylaxis.
(2) Standards and procedures for the storage and administration of an epinephrine auto-injector.
(3) Emergency follow-up procedures.
(b) The school nurse conducting the anaphylaxis training shall maintain a list of individuals who have successfully completed the anaphylaxis training program.
II. Not later than January 1, 2017, the department of education, in consultation with the New Hampshire School Nurse Association, shall develop and make available to all schools guidelines for the management of students with life-threatening allergies. The guidelines shall include, but not be limited to implementation of the following by a school nurse: education and training for designated unlicensed assistive personnel on the management of students with life-threatening allergies, including training related to the administration of an epinephrine auto-injector; procedures for responding to life-threatening allergic reactions; the development of individualized health care plans and allergy action plans for every student with a known life-threatening allergy; and protocols to prevent exposure to allergens. Not later than September 1, 2017, each school district, under the direction of a school nurse, shall implement a plan based on the guidelines developed pursuant to this section for the management of students with life-threatening allergies enrolled in the schools under its jurisdiction, and make such plan available to the public.
3 Pupil Use of Epinephrine Auto-injectors. Amend RSA 200:45 to read as follows:
200:45 Immunity.
I. No school district, member of a school board, or school district employee shall be liable in a suit for damages as a result of any act or omission related to a pupil’s use of an epinephrine auto-injector pursuant to RSA 200:43, if the provisions of RSA 200:42 have been met, unless the damages were caused by willful or wanton conduct or disregard of the criteria established in that section for the possession and self-administration of an epinephrine auto-injector by a pupil.
II. No school that possesses and makes available epinephrine auto-injectors, member of its school board, school nurse, school district employee, agents or volunteers, no health care practitioner that prescribes epinephrine auto-injectors to a school, and no person that conducts the training described in RSA 200:44-a shall be liable for damages as a result of the administration or self-administration of an epinephrine auto-injector, the failure to administer an epinephrine auto-injector, or any other act or omission related to the possession or use of an epinephrine auto-injector, unless the damages were caused by willful or wanton misconduct.
III. The administration of an epinephrine auto-injector by designated school personnel pursuant to the provisions of this subdivision shall not require licensure.
IV. This section shall not be construed to eliminate, limit, or reduce any other immunity or defense that may be available under state law.
4 Effective Date. This act shall take effect 60 days after its passage.
LBAO
15-0621
Revised 02/18/15
SB 25-FN FISCAL NOTE
AN ACT relative to epinephrine administered in schools.
FISCAL IMPACT:
The Department of Education and Department of Health and Human Services state this bill, as introduced, may increase state and local expenditures by an indeterminable amount in FY 2016 and each year thereafter. There will be no impact on county expenditures or state, county, and local revenue.
METHODOLOGY:
The Department of Education states this bill allows schools and authorized entities to develop policies and maintain a supply of auto-injectable epinephrine for a trained designee to administer to any individual they believe is experiencing anaphylaxis. The Department of Education, in consultation with the Department of Health and Human Services, must develop and make available to all school districts by July 1, 2015 guidelines for the management of students with life-threatening food allergies; procedures for responding to life-threatening allergic reactions; a process for developing allergy action plans for applicable students; and protocols to prevent allergen exposure. Each school district is required to implement a plan based on the aforementioned guidelines for the management of students with life-threatening allergies and make such plan publically available by January 1, 2016. This bill requires school nurses and designated personnel to biannually complete an anaphylaxis training program approved by the Department of Health and Human Services. Upon completion, such individuals may administer epinephrine auto-injectors and not be liable for any injuries or related damages that are not the result of wilful or wanton misconduct. Schools using epinephrine auto-injectors, pursuant to this bill, must submit a report involving each incident of their use to the Department of Education which must annually publish a report summarizing all such incidents. Authorized entities using auto-injectors must submit a report involving each incident of their use to the Department of Health and Human Services which must annually publish a report summarizing all such incidents.
The Department of Education states this bill may increase state and local expenditures by an indeterminable amount. The Department is unable to estimate the costs associated with developing epinephrine use guidelines or the annual reporting requirement. The Department cannot estimate how many schools will acquire and maintain a supply of epinephrine auto-injectors. Participating schools may need to pay for bi-annual anaphylaxis training and epinephrine auto-injectors which cost approximately $200 each and expire after less than two years.
The Department of Health and Human Services states this bill may increase state expenditures by an indeterminable amount. The Department is unable to estimate how much time will be spent developing state guidelines for the use auto-injectable epinephrine or the required annual report. Postsecondary educational institutions, operated by the State, may choose to develop policies for the emergency administration of auto-injectable epinephrine and maintain a supply of epinephrine which could increase expenditures. However, the Department is unable to predict whether any postsecondary education institutions will choose to do so. The Department states this bill will add additional requirements for training and competency for nursing staff. Finally, this bill could result in the Board of Nursing having to conduct an unknown number of investigations and proceedings for any violations of this bill.
