THE SENATE

S.B. NO.

2388

TWENTY-NINTH LEGISLATURE, 2018

 

STATE OF HAWAII

 

 

 

 

 

 

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.

 

 

 

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