H.F. 29 Section 1. Section 280.16, Code 2013, is amended to read as 1 follows: 2 280.16 Self-administration of asthma or other airway 3 constricting disease medication , or epinephrine auto-injectors . 4 1. Definitions. For purposes of this section : 5 a. “Epinephrine auto-injector” means a medical device for 6 immediate self-administration of a measured dose of epinephrine 7 by a person at risk of anaphylaxis. 8 a. b. “Medication” means a drug that meets the definition 9 provided in section 126.2, subsection 8 , has an individual 10 prescription label, is prescribed by a physician for a 11 student, and pertains to the student’s asthma or other airway 12 constricting disease. 13 b. c. “Physician” means a person licensed under chapter 14 148 , or a physician’s assistant, advanced registered nurse 15 practitioner, or other person licensed or registered to 16 distribute or dispense a prescription drug or device in the 17 course of professional practice in this state in accordance 18 with section 147.107 , or a person licensed by another state 19 in a health field in which, under Iowa law, licensees in this 20 state may legally prescribe drugs. 21 c. d. “Self-administration” means a student’s discretionary 22 use of medication prescribed by a physician for the student. 23 2. The board of directors of a school district and the 24 authorities in charge of an accredited nonpublic school shall 25 permit the self-administration of medication by a student 26 with asthma or other airway constricting disease or the use 27 of an epinephrine auto-injector by a student if the following 28 conditions are met: 29 a. The student’s parent or guardian provides to the school 30 written authorization for the self-administration of medication 31 or for the use of an epinephrine auto-injector . 32 b. The student’s parent or guardian provides to the school 33 a written statement from the student’s physician containing the 34 following information: 35 -1- LSB 1463HH (3) 85 je/nh 1/ 6

H.F. 29 (1) The name and purpose of the medication or epinephrine 1 auto-injector . 2 (2) The prescribed dosage. 3 (3) The times at which or the special circumstances under 4 which the medication or epinephrine auto-injector is to be 5 administered. 6 c. The parent or guardian and the school meet the 7 requirements of subsection 3 5 . 8 3. The board of directors of a school district and the 9 authorities in charge of a nonpublic school may authorize 10 the provision of an epinephrine auto-injector that meets 11 a student’s prescription on file to the student or to any 12 personnel legally authorized to administer an epinephrine 13 auto-injector to the student. 14 4. The board of directors of a school district and the 15 authorities in charge of a nonpublic school may authorize a 16 school nurse to do any of the following: 17 a. Provide an epinephrine auto-injector that meets a 18 student’s prescription on file to the student or any personnel 19 legally authorized to administer an epinephrine auto-injector 20 to the student. 21 b. Administer an epinephrine auto-injector that meets the 22 student’s prescription on file to any student for whom the use 23 of epinephrine auto-injector is legally authorized. 24 c. Administer an epinephrine auto-injector to any 25 student whom the school nurse reasonably and in good faith 26 professionally believes is having an anaphylactic reaction. 27 3. 5. a. The school district or accredited nonpublic 28 school shall notify the parent or guardian of the student, 29 in writing, that the school district or accredited nonpublic 30 school and its employees are to incur no liability, except 31 for gross negligence, as a result of any injury arising from 32 self-administration of medication by the student or use of an 33 epinephrine auto-injector pursuant to the provisions of this 34 section . The parent or guardian of the student shall sign a 35 -2- LSB 1463HH (3) 85 je/nh 2/ 6

H.F. 29 statement acknowledging that the school district or nonpublic 1 school is to incur no liability, except for gross negligence, 2 as a result of self-administration of medication by the student 3 or use of an epinephrine auto-injector . A school district or 4 accredited nonpublic school and its employees acting reasonably 5 and in good faith shall incur no liability for any improper 6 use of medication or an epinephrine auto-injector as defined 7 in this section or for supervising, monitoring, or interfering 8 with a student’s self-administration of medication or use of an 9 epinephrine auto-injector as defined in this section . 10 b. If a school nurse administers an epinephrine 11 auto-injector to a student whom the school nurse reasonably and 12 in good faith professionally believes is having an anaphylactic 13 reaction, notwithstanding the lack of notice to the parent 14 or guardian of the student or the absence of the parent’s or 15 guardian’s signed statement acknowledging no liability, the 16 school district or nonpublic school and its employees shall 17 not be liable, except for negligence, as a result of any 18 injury arising from the use of an epinephrine auto-injector, 19 regardless of whether authorization was given by the student’s 20 parent or guardian for such administration. 21 4. 6. The permission for self-administration of medication 22 or use of an epinephrine auto-injector is effective for the 23 school year for which it is granted and shall be renewed each 24 subsequent school year upon fulfillment of the requirements 25 of this section . However, the parent or guardian shall 26 immediately notify the school of any changes in the conditions 27 listed under subsection 2 . 28 5. 7. Provided that the requirements of this section are 29 fulfilled, a student with asthma or other airway constricting 30 disease may possess and use the student’s medication and a 31 student with a prescription on file may use an epinephrine 32 auto-injector while in school, at school-sponsored activities, 33 under the supervision of school personnel, and before or after 34 normal school activities, such as while in before-school or 35 -3- LSB 1463HH (3) 85 je/nh 3/ 6

H.F. 29 after-school care on school-operated property. If the student 1 misuses this privilege, the privilege may be withdrawn. 2 8. Notwithstanding any other provision of law to the 3 contrary, a physician may prescribe pursuant to a standing 4 protocol epinephrine auto-injectors in the name of the 5 school district or nonpublic school to be maintained for use 6 when necessary. A school district or nonpublic school with 7 such a prescription may maintain at a school in a locked, 8 secure location a supply of epinephrine auto-injectors. The 9 school district or nonpublic school supply of epinephrine 10 auto-injectors may be provided to and utilized by any student 11 authorized to self-administer an epinephrine auto-injector by 12 any personnel legally authorized to administer an epinephrine 13 auto-injector to the student, if the epinephrine auto-injector 14 meets the student’s prescription on file. When a student does 15 not have an epinephrine auto-injector or a prescription for an 16 epinephrine auto-injector on file, the school nurse may utilize 17 the school district or nonpublic school supply of epinephrine 18 auto-injectors to respond to anaphylactic reaction under a 19 standing protocol from a physician and the requirements of this 20 section. 21 6. 9. Information provided to the school under subsection 2 22 shall be kept on file in the office of the school nurse or, in 23 the absence of a school nurse, the school’s administrator. 24 7. 10. The Iowa braille and sight saving school, the state 25 school for the deaf, and the institutions under the control of 26 the department of human services as provided in section 218.1 27 are exempt from the provisions of this section . 28 Sec. 2. EFFECTIVE UPON ENACTMENT. This Act, being deemed of 29 immediate importance, takes effect upon enactment. 30 Sec. 3. APPLICABILITY. This Act shall apply to school years 31 beginning on or after July 1, 2013. 32 EXPLANATION 33 This bill adds epinephrine auto-injectors to Code section 34 280.16, which permits self-administration of medication 35 -4- LSB 1463HH (3) 85 je/nh 4/ 6

H.F. 29 in school by students with asthma. The bill defines 1 “epinephrine auto-injector” as a medical device for immediate 2 self-administration of a measured dose of epinephrine by a 3 person at risk of anaphylaxis. 4 The bill requires school districts and nonpublic schools 5 to allow the use of an epinephrine auto-injector by a student 6 with a prescription on file if the school receives written 7 authorization and certain medical information from the 8 student’s parent or guardian. 9 The bill provides that a school district or nonpublic school 10 may authorize the provision of an epinephrine auto-injector 11 that meets a student’s prescription on file to the student 12 or to any personnel legally authorized to administer an 13 epinephrine auto-injector to the student. The bill provides 14 that a school district or nonpublic school may authorize a 15 school nurse to provide an epinephrine auto-injector to a 16 student or any personnel legally authorized to administer 17 an epinephrine auto-injector to the student; administer an 18 epinephrine auto-injector to any student for whom the use of 19 epinephrine auto-injector is legally authorized; or administer 20 an epinephrine auto-injector to any student whom the school 21 nurse reasonably and in good faith professionally believes is 22 having an anaphylactic reaction. 23 The bill adds epinephrine auto-injectors to the provisions 24 of Code section 280.16 granting immunity from legal liability 25 to school employees, except for gross negligence, for injuries 26 resulting from the self-administration of medication. Code 27 section 280.16 requires a student’s parent or guardian to 28 receive notice of such immunity. The bill also grants immunity 29 from legal liability, except for negligence, to a school nurse 30 who administers an epinephrine auto-injector to a student whom 31 the school nurse reasonably and in good faith professionally 32 believes is having an anaphylactic reaction, even if prior 33 notice to the student’s parent or guardian has not been given. 34 The bill permits a student with a prescription on file to 35 -5- LSB 1463HH (3) 85 je/nh 5/ 6

H.F. 29 possess and use an epinephrine auto-injector while in school, 1 at school-sponsored activities, under the supervision of school 2 personnel, and before or after normal school activities, 3 such as while in before-school or after-school care on 4 school-operated property. 5 The bill provides that a school district or nonpublic 6 school may maintain at a school in a locked, secure location 7 a supply of epinephrine auto-injectors. The bill provides 8 that a physician may prescribe epinephrine auto-injectors in 9 the name of the school district or nonpublic school to be 10 maintained for use when necessary. The bill provides that the 11 school’s supply of epinephrine auto-injectors may be provided 12 to and utilized by any student authorized to self-administer an 13 epinephrine auto-injector by any personnel legally authorized 14 to administer an epinephrine auto-injector to the student, if 15 the epinephrine auto-injector meets the student’s prescription 16 on file. The bill provides that when a student does not 17 have an epinephrine auto-injector or a prescription for an 18 epinephrine auto-injector on file, the school nurse may utilize 19 the school district or nonpublic school supply of epinephrine 20 auto-injectors to respond to anaphylactic reaction under a 21 standing protocol from a physician and the requirements of the 22 bill. 23 The bill takes effect upon enactment and applies to school 24 years beginning on or after July 1, 2013. 25 -6- LSB 1463HH (3) 85 je/nh 6/ 6