HF 2469 (LSB 5885YH (2) 84)

HOUSE FILE 2469

BY  T. OLSON

A BILL FOR

An Act concerning the administration of epinephrine in public and nonpublic schools, and including effective date and applicability provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  Section 280.16, Code 2011, is amended to read as follows:
   280.16  Self-administration of asthma or other airway constricting disease medication, or epinephrine auto-injectors.
   1.  Definitions.  For purposes of this section:
   a.  “Epinephrine auto-injector” means a medical device for immediate self-administration of a measured dose of epinephrine by a person at risk of anaphylaxis.
   a.

b.  “Medication” means a drug that meets the definition provided in section 126.2, subsection 8, has an individual prescription label, is prescribed by a physician for a student, and pertains to the student’s asthma or other airway constricting disease.
   b.

c.  “Physician” means a person licensed under chapter 148, or a physician’s assistant, advanced registered nurse practitioner, or other person licensed or registered to distribute or dispense a prescription drug or device in the course of professional practice in this state in accordance with section 147.107, or a person licensed by another state in a health field in which, under Iowa law, licensees in this state may legally prescribe drugs.
   c.

d.  “Self-administration” means a student’s discretionary use of medication prescribed by a physician for the student.
   2.  The board of directors of a school district and the authorities in charge of an accredited nonpublic school shall permit the self-administration of medication by a student with asthma or other airway constricting disease
 
or the use of an epinephrine auto-injector by a student if the following conditions are met:
   a.  The student’s parent or guardian provides to the school written authorization for the self-administration of medication
 
or for the use of an epinephrine auto-injector.
   b.  The student’s parent or guardian provides to the school a written statement from the student’s physician containing the following information:

   (1)  The name and purpose of the medication
 
or epinephrine auto-injector.
   (2)  The prescribed dosage.
   (3)  The times at which or the special circumstances under which the medication
 
or epinephrine auto-injector is to be administered.
   c.  The parent or guardian and the school meet the requirements of subsection 3
 
5.
   3.  The board of directors of a school district and the authorities in charge of a nonpublic school may authorize the provision of an epinephrine auto-injector that meets a student’s prescription on file to the student or to any personnel legally authorized to administer an epinephrine auto-injector to the student.
   4.  The board of directors of a school district and the authorities in charge of a nonpublic school may authorize a school nurse to do any of the following:
   a.  Provide an epinephrine auto-injector that meets a student’s prescription on file to the student or any personnel legally authorized to administer an epinephrine auto-injector to the student.
   b.  Administer an epinephrine auto-injector that meets the student’s prescription on file to any student for whom the use of epinephrine auto-injector is legally authorized.
   c.  Administer an epinephrine auto-injector to any student whom the school nurse reasonably and in good faith professionally believes is having an anaphylactic reaction.
   3.
  5.  a.  The school district or accredited nonpublic school shall notify the parent or guardian of the student, in writing, that the school district or accredited nonpublic school and its employees are to incur no liability, except for gross negligence, as a result of any injury arising from self-administration of medication by the student
 
or use of an epinephrine auto-injector pursuant to the provisions of this section. The parent or guardian of the student shall sign a statement acknowledging that the school district or nonpublic school is to incur no liability, except for gross negligence, as a result of self-administration of medication by the student
 
or use of an epinephrine auto-injector. A school district or accredited nonpublic school and its employees acting reasonably and in good faith shall incur no liability for any improper use of medication
 
or an epinephrine auto-injector as defined in this section or for supervising, monitoring, or interfering with a student’s self-administration of medication
 
or use of an epinephrine auto-injector as defined in this section.
   b.  If a school nurse administers an epinephrine auto-injector to a student whom the school nurse reasonably and in good faith professionally believes is having an anaphylactic reaction, notwithstanding the lack of notice to the parent or guardian of the student or the absence of the parent’s or guardian’s signed statement acknowledging no liability, the school district or nonpublic school and its employees shall not be liable, except for negligence, as a result of any injury arising from the use of an epinephrine auto-injector, regardless of whether authorization was given by the student’s parent or guardian for such administration.
   4.

6.  The permission for self-administration of medication
 
or use of an epinephrine auto-injector is effective for the school year for which it is granted and shall be renewed each subsequent school year upon fulfillment of the requirements of this section. However, the parent or guardian shall immediately notify the school of any changes in the conditions listed under subsection 2.
   5.

7.  Provided that the requirements of this section are fulfilled, a student with asthma or other airway constricting disease may possess and use the student’s medication
 
and a student with a prescription on file may use an epinephrine auto-injector while in school, at school-sponsored activities, under the supervision of school personnel, and before or after normal school activities, such as while in before-school or after-school care on school-operated property. If the student misuses this privilege, the privilege may be withdrawn.
   8.  Notwithstanding any other provision of law to the contrary, a physician may prescribe pursuant to a standing protocol epinephrine auto-injectors in the name of the school district or nonpublic school to be maintained for use when necessary. A school district or nonpublic school with such a prescription may maintain at a school in a locked, secure location a supply of epinephrine auto-injectors. The school district or nonpublic school supply of epinephrine auto-injectors may be provided to and utilized by any student authorized to self-administer an epinephrine auto-injector by any personnel legally authorized to administer an epinephrine auto-injector to the student, if the epinephrine auto-injector meets the student’s prescription on file. When a student does not have an epinephrine auto-injector or a prescription for an epinephrine auto-injector on file, the school nurse may utilize the school district or nonpublic school supply of epinephrine auto-injectors to respond to anaphylactic reaction under a standing protocol from a physician and the requirements of this section.
   6.

9.  Information provided to the school under subsection 2 shall be kept on file in the office of the school nurse or, in the absence of a school nurse, the school’s administrator.
   7.

10.  The Iowa braille and sight saving school, the state school for the deaf, and the institutions under the control of the department of human services as provided in section 218.1 are exempt from the provisions of this section.
    Sec. 2.  EFFECTIVE UPON ENACTMENT.  This Act, being deemed of immediate importance, takes effect upon enactment.
    Sec. 3.  APPLICABILITY.  This Act shall apply to school years beginning on or after July 1, 2012.
EXPLANATION
   This bill adds epinephrine auto-injectors to Code section 280.16, which permits self-administration of medication in school by students with asthma. The bill defines “epinephrine auto-injector” as a medical device for immediate self-administration of a measured dose of epinephrine by a person at risk of anaphylaxis.
   The bill requires school districts and nonpublic schools to allow the use of an epinephrine auto-injector by a student with a prescription on file if the school receives written authorization and certain medical information from the student’s parent or guardian.
   The bill provides that a school district or nonpublic school may authorize the provision of an epinephrine auto-injector that meets a student’s prescription on file to the student or to any personnel legally authorized to administer an epinephrine auto-injector to the student. The bill provides that a school district or nonpublic school may authorize a school nurse to provide an epinephrine auto-injector to a student or any personnel legally authorized to administer an epinephrine auto-injector to the student; administer an epinephrine auto-injector to any student for whom the use of epinephrine auto-injector is legally authorized; or administer an epinephrine auto-injector to any student whom the school nurse reasonably and in good faith professionally believes is having an anaphylactic reaction.
   The bill adds epinephrine auto-injectors to the provisions of Code section 280.16 granting immunity from legal liability to school employees, except for gross negligence, for injuries resulting from the self-administration of medication. Code section 280.16 requires a student’s parent or guardian to receive notice of such immunity. The bill also grants immunity from legal liability, except for negligence, to a school nurse who administers an epinephrine auto-injector to a student whom the school nurse reasonably and in good faith professionally believes is having an anaphylactic reaction, even if prior notice to the student’s parent or guardian has not been given.
   The bill permits a student with a prescription on file to possess and use an epinephrine auto-injector while in school, at school-sponsored activities, under the supervision of school personnel, and before or after normal school activities, such as while in before-school or after-school care on school-operated property.
   The bill provides that a school district or nonpublic school may maintain at a school in a locked, secure location a supply of epinephrine auto-injectors. The bill provides that a physician may prescribe epinephrine auto-injectors in the name of the school district or nonpublic school to be maintained for use when necessary. The bill provides that the school’s supply of epinephrine auto-injectors may be provided to and utilized by any student authorized to self-administer an epinephrine auto-injector by any personnel legally authorized to administer an epinephrine auto-injector to the student, if the epinephrine auto-injector meets the student’s prescription on file. The bill provides that when a student does not have an epinephrine auto-injector or a prescription for an epinephrine auto-injector on file, the school nurse may utilize the school district or nonpublic school supply of epinephrine auto-injectors to respond to anaphylactic reaction under a standing protocol from a physician and the requirements of the bill.
   The bill takes effect upon enactment and applies to school years beginning on or after July 1, 2012.