THE SENATE |
S.B. NO. |
2388 |
TWENTY-NINTH LEGISLATURE, 2018 |
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STATE OF HAWAII |
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A BILL FOR AN ACT
Relating to Student Health.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. Section 302A-1164, Hawaii Revised Statutes, is amended to read as follows:
"§302A-1164 Self-administration of medication by student
and emergency administration; self-testing and self-management of diabetes by
student; assistance with diabetes testing; blood glucose monitoring by student;
assistance with blood glucose monitoring; permitted. (a)
The department shall permit:
(1) The self-administration of:
(A) Medication by a student for asthma, anaphylaxis, diabetes, or other potentially life‑threatening illnesses; and
(B) Blood glucose
monitoring by a student; [and]
(2) [Department
employees and agents to volunteer] Designated school personnel to
administer:
(A) Insulin or assist a student in administering insulin via the insulin delivery system that the student uses;
(B) Glucagon in an emergency situation to students with diabetes;
(C) Auto-injectable epinephrine, either in accordance with a prescription specific to the person receiving the epinephrine injection or in an emergency situation to students with anaphylaxis; or
(D) Blood glucose
monitoring or assist a student with blood glucose monitoring[.]; and
(3) Designated
school personnel to provide auto-injectable epinephrine to a student for
self-administration in accordance with a prescription specific to the student
on file with the school.
(b) The student's parent or guardian shall provide the department with:
(1) Written authorization for the self-administration of medication or the emergency administration of glucagon or auto-injectable epinephrine;
(2) In the case of self‑administration of medication:
(A) Written certification from the student's physician, advanced practice registered nurse, or physician assistant stating that the student with diabetes may perform the student's own blood glucose checks, administer insulin through the student's insulin delivery system, and otherwise attend to the care and management of the student's diabetes during any school-related activity, and that the student may possess on the student's person all necessary supplies and equipment to perform the diabetes monitoring and treatment activities, if applicable; and
(B) Written certification from the student's physician, advanced practice registered nurse, or physician assistant stating that the student:
(i) Has asthma, anaphylaxis, or another potentially life-threatening illness; and
(ii) Is capable of, and has been instructed in, the proper method of self-administration of medication or blood glucose monitoring; and
(3) In the case of administration of insulin or emergency administration of glucagon to a student with diabetes, blood glucose monitoring of a student, or auto-injectable epinephrine to a student with anaphylaxis, written certification from the student's physician, advanced practice registered nurse, or physician assistant stating that the student has medical orders that insulin, glucagon, blood glucose monitoring, or auto-injectable epinephrine may be administered by a volunteer.
(c) The department shall inform the student's parent or guardian in writing that the department and its employees or agents shall not incur any liability as a result of any injury arising from compliance with this section.
(d) The student's parent or guardian shall sign a statement acknowledging that:
(1) The department and its employees or agents shall not incur any liability as a result of any injury arising from compliance with this section; and
(2) The parent or guardian shall indemnify and hold harmless the department and its employees or agents against any claims arising out of compliance with this section.
(e) The permission shall be effective for the school year for which it is granted and shall be renewed for each subsequent school year upon the fulfillment of the requirements in this section.
(f) Notwithstanding any other law to the contrary, a student who is permitted to self-administer medication under this section shall be permitted to carry an inhaler or auto‑injectable epinephrine, or both, at all times if the student does not endanger the student's person or other persons through the misuse of the inhaler; provided that the department, its employees or agents may confiscate a student's medication, inhaler, or auto-injectable epinephrine if the student's self‑administration of the medication exceeds the student's prescribed dosage, or if the student endangers others with the student's medication, inhaler, or auto-injectable epinephrine.
For the purposes of this section, the term "inhaler" includes:
(1) Metered-dose, breath-actuated, and dry powder inhalers; and
(2) Spacers and holding chambers.
(g) [Any employee or agent who volunteers to
administer insulin or glucagon in an emergency situation to a student with
diabetes or auto-injectable epinephrine to a student with anaphylaxis or who
volunteers to administer or assist a student with blood glucose monitoring]
Designated school personnel shall [receive instruction in] complete
an emergency health treatment training program prior to the administration of
insulin, glucagon, auto-injectable epinephrine, or blood glucose monitoring. The training shall be conducted by a
nationally recognized organization experienced in training laypersons in
emergency health treatment or an entity or individual approved by the
department of health. Training may be
conducted online or in person and, at a minimum, shall cover:
(1) Techniques on
how to recognize symptoms of diabetic emergencies, including hypoglycemia and
diabetic ketoacidosis, and severe allergic reactions, including anaphylaxis;
(2) Standards and
procedures for the proper administration of insulin, glucagon,
auto-injectable epinephrine, or blood glucose monitoring [by a qualified
health care professional. A
"qualified health care professional" means a licensed physician,
physician assistant, advanced practice registered nurse or registered nurse, or
certified diabetes educator. The
student's parent or guardian shall supply the school with the glucagon kit
required to administer the glucagon, any supplies necessary to administer
insulin, blood glucose monitoring, or with auto-injectable epinephrine supplies
to administer epinephrine. The school
shall store the glucagon kit, insulin supplies, blood glucose monitoring
supplies, or auto-injectable epinephrine supplies in a secure but accessible location.];
and
(3) Emergency follow-up procedures.
The entity that conducts the
training shall issue a certificate, on a form developed or approved by the
department of health, to each person who successfully completes the emergency
health treatment training program.
(h) No later than December 31, 2018, the department, in consultation
with the department of health, shall develop and make available to all schools
guidelines for the management of students with diabetes or life-threatening
allergies. The guidelines shall include:
(1) Education and
training for school personnel on the management of students with diabetes or life-threatening
allergies, including training related to the administration of insulin,
glucagon, and auto-injectable epinephrine;
(2) Procedures for
responding to diabetes and life-threatening allergic reactions;
(3) A process for
the development of individualized health care and emergency action plans for
every student with diabetes or a known life-threatening allergy; and
(4) Protocols to
prevent exposure to allergens.
(i) No later than ,
the board shall:
(1) Implement a
plan based on the guidelines developed pursuant to subsection (h) for the
management of students with diabetes or life-threatening allergies enrolled in department
schools; and
(2) Make the plan
available on the department's web site.
[(h)] (j) Any person[, except for a qualified health
care professional providing the training required in subsection (g),] or
entity who acts in accordance with the requirements of this section shall
be immune from any civil or criminal liability arising from these acts, except
where the [person's] conduct would constitute gross negligence, wilful
and wanton misconduct, or intentional misconduct. This section does not eliminate, limit, or
reduce any other immunity or defense that may be available under state law,
including that provided under section 663-1.5.
(k) The parent or guardian of a student with
diabetes or a life-threatening allergy shall supply the school with the
glucagon kit required to administer the glucagon, any supplies necessary to
administer insulin, blood glucose monitoring, or with auto-injectable
epinephrine supplies to administer epinephrine.
The school shall store the glucagon kit, insulin supplies, blood glucose
monitoring supplies, or auto-injectable epinephrine supplies in a secure but
accessible location.
(l) An authorized health care provider may prescribe auto-injectable
epinephrine in the name of a school for use in accordance with this section. Pharmacists and authorized health care
providers may dispense auto-injectable epinephrine pursuant to a prescription
issued in the name of a school. A school
may:
(1) Maintain a
stock supply of auto-injectable epinephrine for use in accordance with this
section; and
(2) Enter into
arrangements with manufacturers of auto-injectable epinephrine or third-party
suppliers of auto-injectable epinephrine to obtain auto-injectable epinephrine
at fair-market, free, or reduced prices.
(m) A school that possesses and makes available a
stock supply of auto-injectable epinephrine pursuant to this section shall
submit to the department, on a form developed by the department, a report of
each incident that involves a severe allergic reaction or the administration of
auto-injectable epinephrine. The department
shall annually publish a report that summarizes and analyzes all reports
submitted to it pursuant to this subsection.
(n)
As used in this section:
"Authorized health care provider" means an
individual licensed by the State or authorized by the laws of the State to
prescribe prescription drugs within the scope of the person's practice.
"Designated school personnel" means an
employee, agent, or volunteer of a school principal who has completed the training
required under subsection (g) and who has been designated by the school
principal to provide or administer insulin, glucagon, and auto-injectable
epinephrine."
SECTION 2. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 3. This Act shall take effect upon its approval.
INTRODUCED BY: |
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Report Title:
Auto-injectable Epinephrine; DOE; Schools
Description:
Allows schools to stock auto-injectable epinephrine. Authorizes designated school personnel to provide epinephrine to student for self-administration. Requires training to designated school personnel in the administration of insulin, glucagon, and auto-injectable epinephrine.
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.