Rep. Michelle Mussman

Filed: 3/17/2014

 

 


 

 


 
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1
AMENDMENT TO HOUSE BILL 5892

2    AMENDMENT NO. ______. Amend House Bill 5892 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The School Code is amended by changing Section
522-30 as follows:
 
6    (105 ILCS 5/22-30)
7    Sec. 22-30. Self-administration and self-carry of asthma
8medication and epinephrine auto-injectors; administration of
9undesignated epinephrine auto-injectors school nurse
10administration.
11    (a) For the purpose of this Section only, the following
12terms shall have the meanings set forth below In this Section:
13    "Asthma inhaler" means a quick reliever asthma inhaler.
14    "Epinephrine auto-injector" means a single-use device used
15for the automatic injection of a pre-measured dose of
16epinephrine into the human body medical device for immediate

 

 

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1self-administration by a person at risk of anaphylaxis.
2    "Asthma medication Medication" means a medicine,
3prescribed by (i) a physician licensed to practice medicine in
4all its branches, (ii) a physician assistant who has been
5delegated the authority to prescribe asthma medications by his
6or her supervising physician, or (iii) an advanced practice
7registered nurse who has a written collaborative agreement with
8a collaborating physician that delegates the authority to
9prescribe asthma medications, for a pupil that pertains to the
10pupil's asthma and that has an individual prescription label.
11    "School nurse" means a registered nurse working in a school
12with or without licensure endorsed in school nursing.
13    "Self-administration" means a pupil's discretionary use of
14and ability to carry his or her prescribed asthma medication or
15epinephrine auto-injector.
16    "Self-carry" means a pupil's ability to carry his or her
17prescribed asthma medication or epinephrine auto-injector.
18    "Trained personnel" means any school employee or volunteer
19personnel authorized in Sections 10-22.34, 10-22.34a, and
2010-22.34b of this Code who has completed training under
21subsection (g) of this Section to recognize and respond to
22anaphylaxis.
23    "Undesignated epinephrine auto-injector" means an
24epinephrine auto-injector prescribed in the name of a school
25district, public school, or nonpublic school.
26    (b) A school, whether public or nonpublic, must permit the

 

 

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1self-administration and self-carry of asthma medication by a
2pupil with asthma or the self-administration and self-carry use
3of an epinephrine auto-injector by a pupil, provided that:
4        (1) the parents or guardians of the pupil provide to
5    the school (i) written authorization from the parents or
6    guardians for (A) the self-administration and self-carry
7    of asthma medication or (B) the self-carry of asthma
8    medication or (ii) for (A) the self-administration and
9    self-carry of an epinephrine auto-injector or (B) the
10    self-carry use of an epinephrine auto-injector, written
11    authorization from the pupil's physician, physician
12    assistant, or advanced practice registered nurse; and
13        (2) the parents or guardians of the pupil provide to
14    the school (i) the prescription label, which must contain
15    the name of the asthma medication, the prescribed dosage,
16    and the time at which or circumstances under which the
17    asthma medication is to be administered, or (ii) for the
18    self-administration or self-carry use of an epinephrine
19    auto-injector, a written statement from the pupil's
20    physician, physician assistant, or advanced practice
21    registered nurse containing the following information:
22            (A) the name and purpose of the epinephrine
23        auto-injector;
24            (B) the prescribed dosage; and
25            (C) the time or times at which or the special
26        circumstances under which the epinephrine

 

 

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1        auto-injector is to be administered.
2The information provided shall be kept on file in the office of
3the school nurse or, in the absence of a school nurse, the
4school's administrator.
5    (b-5) A school district, public school, or nonpublic school
6may authorize the provision of an epinephrine auto-injector to
7a student or any personnel authorized under a student's
8Individual Health Care Action Plan, Illinois Food Allergy
9Emergency Action Plan and Treatment Authorization Form, or plan
10pursuant to Section 504 of the federal Rehabilitation Act of
111973 to administer an epinephrine auto-injector to the student,
12that meets the student's prescription on file.
13    (b-10) The school district, public school, or nonpublic
14school may authorize a school nurse or trained personnel to do
15the following: (i) provide an undesignated epinephrine
16auto-injector to a student for self-administration only or any
17personnel authorized under a student's Individual Health Care
18Action Plan, Illinois Food Allergy Emergency Action Plan and
19Treatment Authorization Form, or plan pursuant to Section 504
20of the federal Rehabilitation Act of 1973 to administer an
21epinephrine auto-injector to the student, that meets the
22student's prescription on file; (ii) administer an
23undesignated epinephrine auto-injector that meets the
24prescription on file to any student who has an Individual
25Health Care Action Plan, Illinois Food Allergy Emergency Action
26Plan and Treatment Authorization Form, or plan pursuant to

 

 

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1Section 504 of the federal Rehabilitation Act of 1973 that
2authorizes the use of an epinephrine Epinephrine
3auto-injector; and (iii) administer an undesignated
4epinephrine auto-injector to any person student that the school
5nurse or trained personnel in good faith professionally
6believes is having an anaphylactic reaction.
7    (c) The school district, public school, or nonpublic school
8must inform the parents or guardians of the pupil, in writing,
9that the school district, public school, or nonpublic school
10and its employees and agents, including a physician providing
11standing protocol or prescription for school epinephrine
12auto-injectors, are to incur no liability or professional
13discipline, except for willful and wanton conduct, as a result
14of any injury arising from the self-administration of asthma
15medication or the self-administration use of an epinephrine
16auto-injector regardless of whether authorization was given by
17the pupil's parents or guardians or by the pupil's physician,
18physician physician's assistant, or advanced practice
19registered nurse. The parents or guardians of the pupil must
20sign a statement acknowledging that the school district, public
21school, or nonpublic school and its employees and agents are to
22incur no liability, except for willful and wanton conduct, as a
23result of any injury arising from the self-administration of
24asthma medication or the self-administration use of an
25epinephrine auto-injector regardless of whether authorization
26was given by the pupil's parents or guardians or by the pupil's

 

 

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1physician, physician physician's assistant, or advanced
2practice registered nurse and that the parents or guardians
3must indemnify and hold harmless the school district, public
4school, or nonpublic school and its employees and agents
5against any claims, except a claim based on willful and wanton
6conduct, arising out of the self-administration of asthma
7medication or the self-administration use of an epinephrine
8auto-injector regardless of whether authorization was given by
9the pupil's parents or guardians or by the pupil's physician,
10physician physician's assistant, or advanced practice
11registered nurse.
12    (c-5) Upon the effective date of this amendatory Act of the
1398th General Assembly, when When a school nurse or trained
14personnel administers an undesignated epinephrine
15auto-injector to a person student whom the school nurse or
16trained personnel in good faith professionally believes is
17having an anaphylactic reaction, notwithstanding the lack of
18notice to the parents or guardians of the pupil or the absence
19of the parents or guardians signed statement acknowledging no
20liability, except for willful and wanton conduct, the school
21district, public school, or nonpublic school and its employees
22and agents, and including a physician, a physician assistant,
23or an advanced practice nurse providing standing protocol or
24prescription for undesignated school epinephrine
25auto-injectors, are to incur no liability or professional
26discipline, except for willful and wanton conduct, as a result

 

 

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1of any injury arising from the use of an undesignated
2epinephrine auto-injector regardless of whether authorization
3was given by the pupil's parents or guardians or by the pupil's
4physician, physician physician's assistant, or advanced
5practice registered nurse.
6    (d) The permission for self-administration and self-carry
7of asthma medication or the self-administration and self-carry
8use of an epinephrine auto-injector is effective for the school
9year for which it is granted and shall be renewed each
10subsequent school year upon fulfillment of the requirements of
11this Section.
12    (e) Provided that the requirements of this Section are
13fulfilled, a pupil with asthma may self-administer and
14self-carry possess and use his or her asthma medication or a
15pupil may self-administer and self-carry possess and use an
16epinephrine auto-injector (i) while in school, (ii) while at a
17school-sponsored activity, (iii) while under the supervision
18of school personnel, or (iv) before or after normal school
19activities, such as while in before-school or after-school care
20on school-operated property.
21    (e-5) Provided that the requirements of this Section are
22fulfilled, a school nurse or trained personnel may administer
23an undesignated epinephrine auto-injector to any person whom
24the school nurse or trained personnel in good faith believes to
25be having an anaphylactic reaction (i) while in school, (ii)
26while at a school-sponsored activity, (iii) while under the

 

 

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1supervision of school personnel, or (iv) before or after normal
2school activities, such as while in before-school or
3after-school care on school-operated property. A school nurse
4or trained personnel may carry undesignated epinephrine
5auto-injectors on his or her person while in school or at a
6school-sponsored activity.
7    (f) The school district, public school, or nonpublic school
8may maintain at a school in a locked, secure location a supply
9of undesignated epinephrine auto-injectors in any secure
10location where an allergic person is most at risk, including,
11but not limited to, classrooms and lunchrooms. A physician, a
12physician assistant who has been delegated prescriptive
13authority in accordance with Section 7.5 of the Physician
14Assistant Act of 1987, or an advanced practice registered nurse
15who has been delegated prescriptive authority in accordance
16with Section 65-40 of the Nurse Practice Act may prescribe
17undesignated epinephrine auto-injectors in the name of the
18school district, public school, or nonpublic school to be
19maintained for use when necessary. Any supply of epinephrine
20auto-injectors shall be maintained in accordance with the
21manufacturer's instructions. The school district or nonpublic
22school supply of epinephrine auto-injectors may be provided to
23and utilized by any student authorized to self-administer that
24meets the prescription on file or by any personnel authorized
25under a student's Individual Health Care Action Plan, Illinois
26Food Allergy Emergency Action Plan and Treatment Authorization

 

 

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1Form, or plan pursuant to Section 504 of the federal
2Rehabilitation Act of 1973 to administer an epinephrine
3auto-injector to the student, that meets the prescription on
4file. When a student does not have an epinephrine auto-injector
5or a prescription for an epinephrine auto-injector on file, the
6school nurse may utilize the school district or nonpublic
7school supply of epinephrine auto-injectors to respond to
8anaphylactic reaction, under a standing protocol from a
9physician licensed to practice medicine in all its branches and
10the requirements of this Section.
11    (f-5) Upon any administration of an epinephrine
12auto-injector, a school district, public school, or nonpublic
13school must immediately activate the EMS system and notify the
14student's parent, guardian, or emergency contact, if known.
15    (f-10) Within 24 hours of the administration of an
16undesignated epinephrine auto-injector, a school district,
17public school, or nonpublic school must notify the physician,
18physician assistant, or advance practice nurse who provided the
19standing order or prescription for the undesignated
20epinephrine auto-injector of its use.
21    (g) Prior to the administration of an undesignated
22epinephrine auto-injector, trained personnel must submit to
23his or her school's administration proof of completion of a
24training curriculum to recognize and respond to anaphylaxis
25that meets the requirements of subsection (h) of this Section.
26Training must be completed annually. Trained personnel must

 

 

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1also submit to his or her school's administration proof of
2cardiopulmonary resuscitation and automated external
3defibrillator certification.
4    (h) A training curriculum to recognize and respond to
5anaphylaxis, including the administration of an undesignated
6epinephrine auto-injector, may be conducted online or in
7person. It must include, but is not limited to:
8        (1) how to recognize symptoms of an allergic reaction;
9        (2) a review of high-risk areas;
10        (3) steps to take to prevent exposure to allergens;
11        (4) how to respond to an emergency involving an
12    allergic reaction;
13        (5) how to administer an epinephrine auto-injector;
14        (6) how to respond to a student with a known allergy as
15    well as a student with a previously unknown allergy;
16        (7) a test demonstrating competency of the knowledge
17    required to recognize anaphylaxis and administer an
18    epinephrine auto-injector; and
19        (8) other criteria as determined in rules adopted
20    pursuant to this Section.
21    In consultation with statewide professional organizations
22representing physicians licensed to practice medicine in all of
23its branches, registered nurses, and school nurses, the Board
24shall make available resource materials consistent with
25criteria in this subsection (h) for educating trained personnel
26to recognize and respond to anaphylaxis. The Board may take

 

 

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1into consideration the curriculum on this subject developed by
2other states, as well as any other curricular materials
3suggested by medical experts and other groups that work on
4life-threatening allergy issues. The Board is not required to
5create new resource materials. The Board shall make these
6resource materials available on its Internet website.
7    (i) Within 3 days after the administration of an
8undesignated epinephrine auto-injector by a school nurse,
9trained personnel, or a student at a school or school-sponsored
10activity, the school must report to the Board in a form and
11manner prescribed by the Board the following information:
12        (1) age and type of person receiving epinephrine
13    (student, staff, visitor);
14        (2) any previously known diagnosis of a severe allergy;
15        (3) trigger that precipitated allergic episode;
16        (4) location where symptoms developed;
17        (5) number of doses administered;
18        (6) type of person administering epinephrine (school
19    nurse, trained personnel, student); and
20        (7) any other information required by the Board.
21    (j) By October 1, 2015 and every year thereafter, the Board
22shall submit a report to the General Assembly identifying the
23frequency and circumstances of epinephrine administration
24during the preceding academic year. This report shall be
25published on the Board's Internet website on the date the
26report is delivered to the General Assembly.

 

 

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1    (k) The Board may adopt rules necessary to implement this
2Section.
3    (l) A school district, public school, or nonpublic school
4may not use the administration of medications by volunteers to
5reduce the number of school nurses in a school or school
6district.
7(Source: P.A. 96-1460, eff. 8-20-10; 97-361, eff. 8-15-11.)
 
8    Section 99. Effective date. This Act takes effect August 1,
92014.".