House Bill 1287

AN ACT TO CREATE NEW SECTION 41-79-33, MISSISSIPPI CODE OF 1972, TO AUTHORIZE HEALTH CARE PROVIDERS TO PRESCRIBE EPINEPHRINE AUTO-INJECTORS IN THE NAME OF A SCHOOL FOR USE IN ACCORDANCE WITH THIS ACT; TO AUTHORIZE SCHOOLS TO MAINTAIN A STOCK SUPPLY OF EPINEPHRINE AUTO-INJECTORS FOR USE IN ACCORDANCE WITH THIS ACT; TO AUTHORIZE SCHOOL NURSES AND DESIGNATED SCHOOL PERSONNEL TO USE EPINEPHRINE AUTO-INJECTORS PRESCRIBED UNDER THIS ACT TO PROVIDE THEM TO STUDENTS FOR SELF-ADMINISTRATION IN ACCORDANCE WITH A PRESCRIPTION SPECIFIC TO THE STUDENT ON FILE WITH THE SCHOOL, TOADMINISTER AN EPINEPHRINE AUTO-INJECTOR TO A STUDENT IN ACCORDANCE WITH A PRESCRIPTION SPECIFIC TO THE STUDENT ON FILE WITH THE SCHOOL, AND TO ADMINISTER AN EPINEPHRINE AUTO-INJECTOR TO ANY STUDENT OR OTHER INDIVIDUAL WHO THE SCHOOL NURSE OR DESIGNATED SCHOOL PERSONNEL BELIEVES IN GOOD FAITH IS EXPERIENCING ANAPHYLAXIS IN ACCORDANCE WITH A STANDING PROTOCOL FROM AN AUTHORIZED HEALTH CARE PROVIDER; TO AUTHORIZE SCHOOLS TO ENTER INTO ARRANGEMENTS WITH MANUFACTURERS OF EPINEPHRINE AUTO-INJECTORS OR THIRD-PARTY SUPPLIERS OF EPINEPHRINE AUTO-INJECTORS TO OBTAIN EPINEPHRINE AUTO-INJECTORS AT FAIR-MARKET, FREE, OR REDUCED PRICES; TO REQUIRE DESIGNATED SCHOOL PERSONNEL TO COMPLETE AN ANAPHYLAXIS TRAINING PROGRAM BEFORE PROVIDING OR ADMINISTERING AN EPINEPHRINE AUTO-INJECTOR MADE AVAILABLE BY A SCHOOL; TO DIRECT THE STATE DEPARTMENT OF EDUCATION, IN CONSULTATION WITH THE STATE DEPARTMENT OF HEALTH, TO DEVELOP AND MAKE AVAILABLE TO ALL SCHOOLS GUIDELINES FOR THE MANAGEMENT OF STUDENTS WITH LIFE-THREATENING FOOD ALLERGIES; TO REQUIRE THE GOVERNING AUTHORITIES OF SCHOOLS TO IMPLEMENT A PLAN BASED ON THE GUIDELINES DEVELOPED BY THE DEPARTMENT OF EDUCATION FOR THE MANAGEMENT OF STUDENTS WITH LIFE-THREATENING ALLERGIES ENROLLED IN THE SCHOOLS UNDER ITS JURISDICTION, AND TO MAKE THE PLAN AVAILABLE ON THE GOVERNING AUTHORITY'S WEBSITE OR THE WEBSITE OF EACH SCHOOL UNDER THE GOVERNING AUTHORITY'S JURISDICTION; TO AUTHORIZE HEALTH CARE PROVIDERS TO PRESCRIBE EPINEPHRINE AUTO-INJECTORS IN THE NAME OF CERTAIN AUTHORIZED ENTITIES FOR USE IN ACCORDANCE WITH THIS ACT; TO PROVIDE THAT AUTHORIZED ENTITIES MAY ACQUIRE AND MAINTAIN A STOCK SUPPLY OF EPINEPHRINE AUTO-INJECTORS UNDER A PRESCRIPTION ISSUED IN ACCORDANCE WITH THIS ACT; TO REQUIRE THAT THOSE EPINEPHRINE AUTO-INJECTORS BE STORED IN A LOCATION READILY ACCESSIBLE IN AN EMERGENCY AND IN ACCORDANCE WITH THE EPINEPHRINE AUTO-INJECTOR'S INSTRUCTIONS FOR USE AND ANY ADDITIONAL REQUIREMENTS THAT MAY BE ESTABLISHED BY THE STATE DEPARTMENT OF HEALTH; TO REQUIRE AUTHORIZED ENTITIES TO DESIGNATE EMPLOYEES OR AGENTS WHO HAVE COMPLETED THE TRAINING REQUIRED BY THIS SECTION TO BE RESPONSIBLE FOR THE STORAGE, MAINTENANCE, AND GENERAL OVERSIGHT OF EPINEPHRINE AUTO-INJECTORS ACQUIRED BY THE AUTHORIZED ENTITY; TO AUTHORIZE EMPLOYEES AND AGENTS OF AUTHORIZED ENTITIES AND OTHER INDIVIDUALS WHO HAVE COMPLETED THE TRAINING REQUIRED BY THIS ACT TO USE EPINEPHRINE AUTO-INJECTORS PRESCRIBED UNDER THIS ACT TO PROVIDE THEM TO ANY INDIVIDUAL WHO THE EMPLOYEE, AGENT OR OTHER INDIVIDUAL BELIEVES IN GOOD FAITH IS EXPERIENCING ANAPHYLAXIS FOR IMMEDIATE SELF-ADMINISTRATION, AND ADMINISTER AN EPINEPHRINE AUTO-INJECTOR TO ANY INDIVIDUAL WHO THE EMPLOYEE, AGENT OR OTHER INDIVIDUAL BELIEVES IN GOOD FAITH IS EXPERIENCING ANAPHYLAXIS; TO REQUIRE EMPLOYEES, AGENTS AND OTHER INDIVIDUALS TO COMPLETE AN ANAPHYLAXIS TRAINING PROGRAM BEFORE PROVIDING OR ADMINISTERING AN EPINEPHRINE AUTO-INJECTOR MADE AVAILABLE BY AN AUTHORIZED ENTITY; TO PROVIDE THAT AUTHORIZED ENTITIES THAT ACQUIRE AND MAINTAIN A STOCK SUPPLY OF EPINEPHRINE AUTO-INJECTORS UNDER A PRESCRIPTION ISSUED IN ACCORDANCE WITH THIS ACT MAY MAKE THOSE EPINEPHRINE AUTO-INJECTORS AVAILABLE TO INDIVIDUALS OTHER THAN THOSE TRAINED INDIVIDUALS DESCRIBED IN THIS ACT IF THE EPINEPHRINE AUTO-INJECTORS ARE STORED IN A LOCKED, SECURE CONTAINER AND ARE MADE AVAILABLE ONLY UPON REMOTE AUTHORIZATION BY AN AUTHORIZED HEALTH CARE PROVIDER AFTER CONSULTATION WITH THE AUTHORIZED HEALTH CARE PROVIDER BY AUDIO, TELEVIDEO, OR OTHER SIMILAR MEANS OF ELECTRONIC COMMUNICATION; TO PROVIDE IMMUNITY FROM LIABILITY FOR DAMAGES FOR ANY INJURIES THAT RESULT FROM THE ADMINISTRATION OF, SELF-ADMINISTRATION OF, OR FAILURE TO ADMINISTER AN EPINEPHRINE AUTO-INJECTOR THAT MAY CONSTITUTE ORDINARY NEGLIGENCE FOR SCHOOLS THAT POSSESS AND MAKE AVAILABLE EPINEPHRINE AUTO-INJECTORS AND SCHOOL NURSES, EMPLOYEES, AGENTS, AND VOLUNTEERS, AND FOR AUTHORIZED ENTITIES THAT POSSESS AND MAKES AVAILABLE EPINEPHRINE AUTO-INJECTORS AND THEIR EMPLOYEES, AGENTS, AND OTHER TRAINED INDIVIDUALS; AND FOR RELATED PURPOSES.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:

SECTION 1. The following shall be codified as Section 41-79-33, Mississippi Code of 1972:

41-79-33. (1) As used in this section:

(a) "Administer" means the direct application of an epinephrine auto-injector to the body of an individual.

(b) "Authorized entity" means any entity or organization at or in connection with which allergens capable of causing anaphylaxis may be present, including, but not limited to, restaurants, recreation camps, youth sports leagues, amusement parks, and sports arenas.

(c) "Authorized health care provider" means an individual allowed by law to prescribe and administer prescription drugs in the course of the provider's professional practice.

(d) "Designated school personnel" means an employee, agent, or volunteer of a school designated by the governing authority of the school who has completed the training required under this section to provide or administer an epinephrine auto-injector.

(e) "Epinephrine auto-injector" means a single-use device used for the automatic injection of a premeasured dose of epinephrine into the human body.

(f) "Provide" means the supply of one or more epinephrine auto-injectors to an individual.

(g) "School" means any public or nonpublic school and any charter school.

(h) "Self-administration" means a person's discretionary use of an epinephrine auto-injector.

(2) An authorized health care provider may prescribe epinephrine auto-injectors in the name of a school for use in accordance with this section, and pharmacists and authorized health care providers may dispense epinephrine auto-injectors under a prescription issued in the name of a school. A school may maintain a stock supply of epinephrine auto-injectors for use in accordance with this section.

(3) School nurses and designated school personnel may, upon authorization by the governing body of a school, use epinephrine auto-injectors prescribed under this section to:

(a) Provide an epinephrine auto-injector to a student for self-administration in accordance with a prescription specific to the student on file with the school;

(b) Administer an epinephrine auto-injector to a student in accordance with a prescription specific to the student on file with the school; and

(c) Administer an epinephrine auto-injector to any student or other individual, on school premises, at school-sponsored events, or at any other time the student or individual is subject to the school's jurisdiction or supervision, who the school nurse or designated school personnel believes in good faith is experiencing anaphylaxis in accordance with a standing protocol from an authorized health care provider, regardless of whether the student or other individual has a prescription for an epinephrine auto-injector or has previously been diagnosed with an allergy.

(4) A school may enter into arrangements with manufacturers of epinephrine auto-injectors or third-party suppliers of epinephrine auto-injectors to obtain epinephrine auto-injectors at fair-market, free, or reduced prices.

(5) Designated school personnel must complete an anaphylaxis training program before providing or administering an epinephrine auto-injector made available by a school. The training must be conducted by a nationally recognized organization experienced in training laypersons in emergency health treatment or other entity or individual approved by the State Department of Health. Training may be conducted online or in person and, at a minimum, shall cover:

(a) Techniques on how to recognize symptoms of severe allergic reactions, including anaphylaxis;

(b) Standards and procedures for the storage and administration of an epinephrine auto-injector; and

The entity that conducts the training shall issue a certificate, on a form developed or approved by the State Department of Health, to each person who successfully completes the anaphylaxis training program.

(6) Not later than October 1, 2014, the State Department of Education, in consultation with the State Department of Health, shall develop and make available to all schools guidelines for the management of students with life-threatening food allergies. The guidelines shall include, but need not be limited to:

(a) Education and training for school personnel on the management of students with life-threatening allergies, including training related to the administration of an epinephrine auto-injector;

(b) Procedures for responding to life-threatening allergic reactions;

(c) A process for the development of individualized health care and allergy action plans for every student with a known life-threatening allergy; and

(d) Protocols to prevent exposure to allergens.

(7) Not later than January 1, 2015, the governing authority of a school shall:

(a) Implement a plan based on the guidelines developed under this subsection for the management of students with life-threatening allergies enrolled in the schools under its jurisdiction; and

(b) Make the plan available on the governing authority's website or the website of each school under the governing authority's jurisdiction, or if those websites do not exist, make the plan publicly available through other practicable means as determined by such governing authority.

(8) A school that possesses and makes available a stock supply of epinephrine auto-injectors under this section shall submit to the State Department of Education, on a form developed by the department, a report of each incident that involves a severe allergic reaction or the administration of an epinephrine auto-injector. The department shall annually publish a report that summarizes and analyzes all reports submitted to it under this section.

(9) A school that possesses and makes available epinephrine auto-injectors and its governing body, school nurses, employees, agents, and volunteers; an authorized health care provider that prescribes epinephrine auto-injectors to a school; and an individual or entity that conducts the training described in this section shall not be liable for damages for any injuries that result from the administration of, self-administration of, or failure to administer an epinephrine auto-injector that may constitute ordinary negligence, regardless of whether authorization was provided by the student's parent or guardian or by the student's health care provider. This immunity does not apply to acts or omissions constituting gross, willful, or wanton negligence. The administration of an epinephrine auto-injector in accordance with this section is not the practice of medicine. The immunity from liability provided under this section is in addition to and not in lieu of that provided under Section 73-25-37 or 73-25-38.

(10) An authorized health care provider may prescribe epinephrine auto-injectors in the name of an authorized entity for use in accordance with this section, and pharmacists and authorized health care providers may dispense epinephrine auto-injectors under a prescription issued in the name of an authorized entity.

(11) An authorized entity may acquire and maintain a stock supply of epinephrine auto-injectors under a prescription issued in accordance with this section. Those epinephrine auto-injectors shall be stored in a location readily accessible in an emergency and in accordance with the epinephrine auto-injector's instructions for use and any additional requirements that may be established by the State Department of Health. An authorized entity shall designate employees or agents who have completed the training required by this section to be responsible for the storage, maintenance, and general oversight of epinephrine auto-injectors acquired by the authorized entity.

(12) An employee or agent of an authorized entity, or other individual, who has completed the training required by this section may, on the premises of or in connection with the authorized entity, use epinephrine auto-injectors prescribed under 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 for immediate self-administration, regardless of whether the individual has a prescription for an epinephrine auto-injector or has previously been diagnosed with an allergy; and

(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.

(13) An employee, agent, or other individual described in subsection (12) of this section must complete an anaphylaxis training program before providing or administering an epinephrine auto-injector made available by an authorized entity. The training shall be conducted by a nationally recognized organization experienced in training laypersons in emergency health treatment or other entity or individual approved by the State Department of Health. Training may be conducted online or in person and, at a minimum, shall cover:

(a) Techniques on how to recognize symptoms of severe allergic reactions, including anaphylaxis;

(b) Standards and procedures for the storage and administration of an epinephrine auto-injector; and

(14) An authorized entity that possesses and makes available epinephrine auto-injectors and its employees, agents, and other trained individuals; an individual who uses an epinephrine auto-injector made available under subsection (16) of this section; an authorized health care provider that prescribes epinephrine auto-injectors to an authorized entity; and an individual or entity that conducts the training described in subsection (13) of this section shall not be liable for any injuries or related damages that result from the administration of, self-administration of, or failure to administer an epinephrine auto-injector in accordance with this section that may constitute ordinary negligence. This immunity does not apply to acts or omissions constituting gross, willful, or wanton negligence. The administration of an epinephrine auto-injector in accordance with this section is not the practice of medicine. The immunity from liability provided under this subsection is in addition to and not in lieu of that provided under Section 73-25-37 or 73-25-38. 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 by its employees or agents outside of this state if the entity or its employee or agent are not liable for those injuries or related damages under the law of the state in which the provision or administration occurred.

(15) An authorized entity that possesses and makes available epinephrine auto-injectors shall submit to the State Department of Health, on a form developed by the department, a report of each incident on the authorized entity's premises that involves the administration of an epinephrine auto-injector. The department shall annually publish a report that summarizes and analyzes all reports submitted to it under this subsection.

(16) An authorized entity that acquires and maintains a stock supply of epinephrine auto-injectors under a prescription issued in accordance with this section may make those epinephrine auto-injectors available to individuals other than those trained individuals described in subsection (12) of this section if the epinephrine auto-injectors are stored in a locked, secure container and are made available only upon remote authorization by an authorized health care provider after consultation with the authorized health care provider by audio, televideo, or other similar means of electronic communication. Consultation with an authorized health care provider for this purpose shall not be considered the practice of telemedicine or otherwise be construed as violating any law or rule regulating the authorized health care provider's professional practice.

SECTION 2. This act shall take effect and be in force from and after July 1, 2014.